Do my Medicaid services change if I have Medicare and Medicaid and I do not enroll in MI Health Link?

Answer:  If you opt-out or disenroll from MI Health Link, you will still have Medicaid through regular (also known as fee-for-service) Medicaid. There will no longer be a Medicaid Managed Care health plan for people in a MI Health Link county, except through MI Health Link. Regular or fee-for-service Medicaid means people find a provider or specialist who participates with Medicaid, and makes their own arrangements for services. The providers bill Medicaid directly for services they provide.

Opting out of MI Health Link has no impact on your Medicare plan choices or existing Medicare plan as long as you opt-out before the start date of enrollment in MI Health Link.

If you are currently in a Medicaid Health Plan and choose to not enroll in MI Heath Link, you will have regular or fee-for-service Medicaid which means:

  • Transportation services for medical appointments will no longer be coordinated through a health plan. The Michigan Department of Health and Human Services will schedule the transportation, except in select counties.
  • Care coordination will not be provided. Regular or fee-for-service Medicaid does not have care coordination.

Here are a few examples of how MI Health Link health plans coordinate services:

Dental – Adult dental services are covered through the MI Health Link health plan. Each MI Health Link health plan has a network of dental providers. If you need assistance, the care coordinator will help schedule appointments with a dentist in the plan’s network.

Long Term Supports and Services –MI Health Link enrollees receive the supports and services necessary for them to live independently in the community. Medicare Advantage and Medicaid health plans do not provide Long Term Supports and Services.

Transportation – The MI Health Link health plan must arrange for transportation to covered medical services when no other transportation is available. This service coverage is unlimited as long as transportation is for a medical need.

Behavioral Health – People with behavioral health, substance use disorder or intellectual/developmental disability needs will have access to the services they need. People who currently receive services through Community Mental Health or a Pre-paid Inpatient Health Plan (PIHP) will not have any change to existing service plans.

Nursing Facility Care – The MI Health Link care coordinator will continue to work with the enrollee during a long term nursing facility stay to ensure all of the enrollee’s needs are met. The care coordinator will also help with transitions between the nursing facility and a person’s home.