If you disagree with a decision made concerning state program benefits, the hearing request form you complete and where you must submit it depends on the type of decision you are disputing.
If you are disputing an eligibility decision by the Michigan Department of Health and Human Services (MDHHS) concerning the food assistance program (FAP), the cash assistance program (FIP or SDA), the child development grant program (CDC), the state emergency relief program (SER), direct support services (DSS), State SSI Payment (SSP), or medical insurance under Medicaid, MIChild, and Healthy Michigan Plan:
- You can use this form: Public Benefits Eligibility Hearing Request Form
- Submit the completed form or any other written hearing request to any local MDHHS office.
- A hearing on a FAP decision can also be verbally made to the local MDHHS office.
- Please note: See below for adverse decisions regarding Medicaid-covered services.
If you are currently enrolled in Medicaid or PACE and want to request a hearing about your Medicaid-covered services, a disenrollment request, or a denial of your waiver application:
- by mail at PO Box 30763, Lansing, MI 48909;
- by email at LARA-MOAHR-DCH@michigan.gov; or
- by fax at 517-763-0146.
If you want to appeal an adverse decision made by your managed care health plan, MI Health Link Plan, Community Mental Health Services Program/Prepaid Inpatient Health Plan or MI Choice Waiver Program, and you have completed the agency’s internal appeal process or the agency has failed to properly respond to your internal appeal:
