I need health care coverage.  What should I do?

Step 1. Determine the size of your tax household and your income. 

Your household size depends on many factors. If mom and dad are married and live together with their two children, the household size is 4.  If everyone in your household is not on the same tax return, or people on your tax return are not living in your house, your household size may not be the same as your tax household size.  How many people are in your family?  Who is on your tax return?  How are the people in your household related?

To determine your income, you need pay stubs for everyone who works, income information for all members of the household and a copy of your most recent taxes. The Marketplace will look at your Modified Adjusted Gross Income (MAGI) and Medicaid will look at the last 30 days of household income. Income includes Social Security (not SSI), alimony, self-employment income, pensions, investments and job income. 

Check to see what programs you and your family are eligible for. Here are the income limits for 2019: Medicaid, MIChild and Marketplace

Do you have an offer of employer insurance? If you do, you can still apply for Medicaid but subsidized plans on the Marketplace may not be available--you may need to take the employer-offered insurance. If you need help figuring this out, do it before or during your employer's open enrollment period.

If anyone is over 65 or getting RSDI (social security disability), take a look at our Medicare page. Medicare sometimes works together with Medicaid, or with employer insurance.

Step 2. Sign Up online or make an appointment.  

You can apply online.  You make an appointment with an advocate to help you and answer your questions.  Click here to find an agency.  Bring social security numbers (if you have them, if not that's okay), current income information (30 days) and names of all members of your household with you to your appointment. Also, please bring information about any insurance your employer offers, even if you think it is expensive.

For Medicaid programs (Healthy Michigan Plan, Healthy Kids, MIChild and MOMS), apply using MiBridges at michigan.gov/mibridges or make an appointment

For the Marketplace, sign up at healthcare.gov or make an appointment.

Step 3. Choose your health plan. 

Once you have Medicaid or MIChild is active, you need to choose a health care plan.  These plans will be listed in a letter announcing your coverage. You should call MIEnrolls (888-367-6557 or 800-975-7630) and indicate your choice as soon as possible. 

Find details about health plans in this blog post.

Contact your doctor or specialist to find out which health plans they accept.  If you do not have a doctor, you can call the health plan to find a doctor who is accepting new patients. Michigan Enrolls can also help you choose a doctor. 

On the Marketplace, your eligibility letter will indicate your tax credit.  Choose how much of your tax credit to use and select your health plan.  Once you enroll in your health plan, you will need to wait a week for your information to be sent to the health plan.  You will then need to call the health plan to pay your first premium before your health coverage begins.  It may also be possible to pay your first premium online if you are using healthcare.gov.

Step 4. Report any changes.  

For Medicaid and MIChild, report any changes to your household or income through the Report Changes button in your MiBridges account at michigan.gov/mibridges or contact your caseworker. You can also fax information about changes to Medicaid at (517) 346-9888. (Make sure to put your name and case number on every page!)

For the Marketplace, report any changes by logging into your account at healthcare.gov or calling the Marketplace at 800-318-2596.

Which program do you think you are eligible for?

Medicaid          MIChild          Marketplace          Employer Insurance