Answers to Frequently Asked Questions about MIChild Converting to Medicaid

On January 1, 2016, MIChild will become a Medicaid expansion program. The MIChild name will still be used in most communications, but you will now be eligible for all Medicaid covered services. This transition will provide increased benefits and improved access for beneficiaries. These changes will also affect how the MIChild program is administered by MDHHS and its partners.

 

Will eligibility for MIChild change?

No.  If you are currently eligible for MIChild you will remain eligible for MIChild.

How will I get care after January 1, 2016?

There will be no gap in coverage, but how you use your coverage will change.  Today, to use your MIChild coverage you show your MIChild ID card and your health plan card to get most services.  Starting on January 1, 2016, you will not use your MIChild ID card anymore.

If you haven’t had health care coverage through the Medicaid program before you will get a new ID card in the mail.  This ID card is called a mihealth card.  Starting on January 1, 2016, be sure to bring this card and any card you may get from your health plan with you when you see the doctor or fill a prescription.

If you had coverage through the Medicaid program before but lost your mihealth card, call MIChild at 1-888-988-6300 (TTY: 1-888-263-5897) to get a replacement.

You will also be assigned a specialist, sometimes known as a caseworker, from the Michigan Department of Health and Human Services (MDHHS).  A specialist is a person who manages your MIChild case.  You will get a letter in late December of 2015 telling you who your specialist is.

What is a mihealth card?

A mihealth card is a plastic card with your name and ID number.  Always keep this card.  You will also need it if you qualify for other health care programs through MDHHS.

Who do I tell about changes that affect my coverage?

Starting on January 1, 2016, you will report changes in your household, income or other information to your MDHHS specialist instead of MIChild.  The next time you renew your coverage, you will do this through MDHHS instead of MIChild.  You will get more information when it is time to renew.

How will my coverage change?

You will still get almost all of the services you have now in MIChild.  There will be no gap in coverage.  You will also have access to more services starting on January 1, 2016.  These new services are:

  • Help with transportation to and from covered services  (if you do not have a ride)
  • Expanded hearing related services
  • Podiatrist (foot doctor) services
  • Expanded nursing facility services
  • Some school-based services (e.g. physical and speech therapy for eligible individuals), unless covered by your health plan
  • Expanded benefits for pregnant women and infants (Maternal Infant Health Program)
  • Home help services
  • Expanded well child benefits (see enclosed brochure for more information)

Acupuncture services will no longer be available starting January 1, 2016.  Dental services will also be changing starting on January 1, 2016.  Under your new dental plan, there is no dollar limit to getting the dental services you need.  Dental services that are not needed to keep your teeth healthy or that are not right for your age will no longer be covered (e.g. onlays, bridges, veneers and periodontal procedures).  Ask your dentist what the right dental treatment is for you.

Vision services are also changing.  Starting on January 1, 2016, vision services will be limited to one routine eye exam every two years.  Visits to your eye doctor for problems in between routine eye exams will be covered.

Can I keep my doctor?

If you stay in the same health plan, you will get to keep your same doctor as long as they continue to participate in your health plan.

If you have to change health plans, you may have to choose a new doctor.  You will get a separate letter in late December of 2015 telling you if you have to change plans.  If you have questions about what health plans your doctor participates with, ask your doctor.

Some people won’t have to choose a health plan as part of this transition.  You will get a letter at a later time telling you if you have the choice or if you will get your medical services through Fee-for-Service MIChild.  Fee-for-Service is the term for services that are not provided through a health plan.  This means that MIChild pays for the service.  You will use your mihealth card to receive these services.  If you will get your services through Fee-for-Service MIChild and your doctor takes Medicaid, you can keep your doctor.

Can I keep my dentist?

The MIChild program will provide dental services only through Healthy Kids Dental (Delta Dental) starting on January 1, 2016.

If you get your dental care through Delta Dental now, you should be able to keep your same dentist.

If you get your dental care through Golden Dental now, you may need to pick a new dentist if your current dentist does not accept Healthy Kids Dental.  You will get a letter about transitioning to Healthy Kids Dental (Delta Dental) in the next few weeks.

Can I keep my behavioral health provider?

Many behavioral health services will be provided through the health plans starting on January 1, 2016.  If you get these services from the Community Mental Health Service Provider or Prepaid Inpatient Health Plan in your area already, they will contact you in the next few weeks about how to work with your provider(s) during this transition.  Substance use disorder services will still be provided by the Prepaid Inpatient Health Plans after January 1, 2016.

Can I keep my health plan?

Many people will stay in the same health plan.  You will be told at a later time if you have to make changes to your health plan or if you will keep your same health plan.

If your current health plan won’t be available after the transition, you may temporarily have “Fee-for- Service” MIChild while you choose a new plan. 

After the transition, some people won’t have to choose a health plan for MIChild medical coverage.  If you do not have to choose a health plan, you will be told at a later time.

Will I be able to continue current treatments or medications that are already approved?

Yes.  If you leave your current health plan and need certain services or medications that require special approval, those approvals should move with you.  Please work with your provider(s) and your new health plan to ensure coordination of services.

How will I get help with a ride to appointments (non-emergency medical transportation)?

If you are in a health plan and you need transportation help to a medical appointment, call your health plan. 

Your health plan does not provide rides for substance use disorder or community mental health services or dental appointments.  If you need help with a ride to these kinds of appointments, who you call depends on where you live. 

  • If you live in Wayne, Oakland or Macomb counties, call Logisticare Solutions at 1-866-569-1902 to schedule your ride.
  • If you live in any other county in Michigan, call your MDHHS specialist for help.

If you are not in a health plan and don’t have a ride to an appointment, where you get help depends on where you live.

  • If you are not in a health plan and you live in Wayne, Oakland, or Macomb County, call Logisticare Solutions at 1-866-569-1902 to schedule your ride.
  • If you are not in a health plan and you do not live in Wayne, Oakland, or Macomb Counties call your MDHHS specialist for help.

Will MIChild still have premiums January 1, 2016?

Yes.  The MIChild program will still have premiums.  

How much will the premium be?

The premium payment will still be $10 per family per month.  You will still get payment information from MIChild, even after January 1, 2016. 

MDHHS cannot process payments, so do not send money to your MDHHS specialist or any MDHHS office.  You will still send your payments to MIChild.

Are there any exceptions to the premium requirement?

Yes, and the rules about who owes a premium are changing for some people.

For example, if someone in your household is on MIChild and is a Native American/Alaska Native you may owe a premium starting on January 1, 2016.  If you or someone in your household has ever received, or is eligible to receive, an item or service from an Indian health care provider or through referral under contract health services, you will not have a MIChild premium.  If you or someone in your household has never received those services and is not eligible to, you may pay a premium.

For Native American/Alaska Native families, MIChild will decide if you have to pay a premium based on information in the Application for Health Care Coverage, Appendix B.  If you need to change your information, go to www.mibridges.michigan.gov.  You can also contact your MDHHS specialist.

If someone on MIChild becomes pregnant or begins receiving hospice care, those families will not have to pay a premium.

MIChild will send you a letter telling you whether or not you will have to pay a premium after January 1, 2016.

How do I pay my premium?

After the transition, if you have a premium due, you will receive a letter and a new coupon with new account information.  You will still send your payments to MIChild.  The payment address has not changed and payments must be mailed.  Premium payments cannot be accepted at your local MDHHS office.  You must use your new coupons starting in 2016. 

What will happen if I don’t pay my premium by the due date?

As part of the transition, no premiums will be due in December of 2015, January of 2016 and February of 2016.  Premiums will start again in March of 2016. 

If premiums are not paid on time, coverage for the child(ren) on MIChild will end.  After coverage ends, if you want MIChild coverage you must submit a new application.

Will there be co-pays?

No.  There will still be no co-pays in MIChild.

Will I need to renew MIChild every year? 

Yes.  Because of the transition, some renewal dates may change.  You will get a letter when it is time to renew.

What if a child with MIChild also has a Medicaid deductible plan?

If someone has both MIChild and a Medicaid deductible plan, the deductible plan will end on December 31, 2015.  This will not impact the child’s MIChild coverage.

Who do I call if I still have questions?

  • If you have questions about the transition, premiums or health plan enrollment, call MIChild at
    1-888-988-6300, TTY: 1-888-263-5897.
  • If you have questions about your eligibility for MIChild after the transition, call your MDHHS specialist.
  • If you have questions about your dental coverage after the transition, call Delta Dental at
    1-800-482-8915.