Healthy Michigan

Healthy Michigan is a health care program through the Michigan Department of Community Health (MDCH).  The Healthy Michigan Plan provides health care coverage for individuals who:  

  • Are age 19-64 years
  • Have income at or below 133% of the federal poverty level under the Modified Adjusted Gross Income methodology
  • Do not qualify for or are not enrolled in Medicare
  • Do not qualify for or are not enrolled in other Medicaid programs
  • Are not pregnant at the time of application
  • Are residents of the State of Michigan 
  • Eligibility for the Healthy Michigan Plan is determined through the Modified Adjusted Gross Income methodology, coordinated through the Department of Human Services. All criteria for the Modified Adjusted Gross Income eligibility must be met to be eligible for the Healthy Michigan Plan.

Per federal requirement, individuals eligible for services under the Healthy Michigan Plan must have access to the following 10 Essential Health Benefits:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder treatment services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care.         

 

Healthy Michigan Plan participants may be subject to copay or cost-sharing obligations.  Aetna Better Health Healthy MI members should schedule their Health Risk Assessment within 60 days after they are enrolled in our health plan.

Copay

Covered Services

Income less than or equal to 100% FPL

Income more than 100% FPL

Physician Office Visits (including Freestanding Urgent Care Centers)

$2

$4

Outpatient Hospital Clinic Visit

$2

$4

Emergency Room Visit for Non-Emergency Services

• Copayment ONLY applies to non-emergency services

• There is no Copayment for true emergency services

$3

$8

Inpatient Hospital Stay (with the exception of emergent admissions)

$50

$100

Pharmacy

$1 preferred $3 non-preferred

$4 preferred $8 non-preferred

Chiropractic Visits

$1

$3

Dental Visits

$3

$4

Hearing Aids

$3 per aid

$3 per aid

Podiatric Visits

$2

$4

Vision Visits

$2

$2

 

Michigan residents can enroll at any time online, by phone, or in person.