If you have BOTH Medicare and full Medicaid with no spend down, you are considered a “dual eligible” beneficiary.
Dual Eligible beneficiaries in several Michigan counties have the option to receive coverage from a MiHealth Link health insurance program. These programs are similar to Medicare Advantage plans. They include hospital, medical, and prescription benefits, plus some extra benefits. Users also have no prescription copay costs for covered meds.
MiHealth Link plans also have restricted networks of providers and specialists, set formularies of covered medications, and they require prior authorizations for medical appointments. Clients might need to change to in-network doctors, or to different medications.
MDHHS is launching quarterly “passive enrollments” into MiHealth Link plans in 2022. Dual beneficiaries may receive letters telling them that they WILL BE ENROLLED into a MiHealth Link insurance plan. If you don’t wish your health and prescription Part D insurance to be changed, you must respond to the letter and call Michigan Enrolls to disenroll, PRIOR TO the effective date of the new coverage.
If you opted out of passive enrollments more than 12 months ago, you can again be passively enrolled unless you respond to the letters. DPOA caregivers will need to have documents on file with MDHHS in order to speak on behalf of cognitively impaired or nonverbal duals during a call to Michigan Enrolls.
MMAP counselors can coach you through your MiHealth Link options. Call MMAP at 1-800-803-7174.