After enrollment

After you have enrolled with a health plan, complete the Healthy Michigan Plan Health Risk Assessment form below. The questions in Section 1 may look familiar if you called MI Enrolls to choose your health plan during enrollment. It is okay to complete them again, even if your answers don't match each time you answer. There are no wrong answers.

Your health plan may send you another Healthy Michigan Plan Health Risk Assessment form in the mail that has different questions. It does not matter which Healthy Michigan Plan Health Risk Assessment form you complete, as long as you complete one each year and your doctor signs it and sends it back to your health plan.

Health Risk Assessment form (DCH-1315) PDF   Word   (Spanish)   (Arabic)

Make an Appointment to See Your Doctor

It is important to see your doctor for a check-up as soon as possible after you enroll with a health plan. Before your appointment, complete the Healthy Michigan Plan Health Risk Assessment form. Take this form with you when you go. Your doctor and your health plan will use this information to better meet your health needs.

Your health plan wants to provide you with all the health care you need. If you need assistance with completing this form, call your health plan. You can also call the Beneficiary Help Line at 1-800-642-3195 if you have questions.

Three easy ways to apply