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  • Mi Dch-1074 2015

Get Mi Dch-1074 2015-2025

ENROLLMENT APPLICATION HOSPICE MEMBERSHIP NOTICE Fax to: (517) 3731437 1. Effective Date / / ENROLLMENT UPDATE Michigan Department of Health and Human Services 2. Effective Date / / DISENROLLMENT.

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Is Your Address Up-to-Date with MDHHS? Please report any change in phone number, email or address to the Michigan Department of Health and Human Services (MDHHS) if you are a Medicaid beneficiary. You can do this by going to the MIBridges website at .michigan.gov/mibridges.

How long does it take to process an application? ProgramStandard of PromptnessNon-expedited Food Assistance (FAP)30 DaysMedicaid (MA)45 DaysMedicaid for pregnant women15 DaysMedicaid with required disability determination90 Days6 more rows

Claims Submission Address Michigan Complete Health Attn: Claims P.O. Box 3060 Farmington, MO 63640 Michigan Complete Health Customer Service: 1-844-239-7387 (TTY users should call 711).

The most efficient and reliable change reporting is online at MI Bridges, .michigan.gov/MI Bridges, or by calling MI Bridges at 888-642-7434. Constituents who use either of these options will receive a confirmation number to track their changes.

Legal Resources Birth certificate, marriage license and citizenship/naturalization papers. Social Security Card. Medicare Card. Health insurance card (example, Blue Cross) Life insurance policy(ies) Burial plot information.

Who is eligible Are age 19-64 years. Have income at or below 133% of the federal poverty level* (about $18,000 for a single person or $37,000 for a family of four) Do not qualify for or are not enrolled in Medicare. Do not qualify for or are not enrolled in other Medicaid programs.

You can do this by going to the MIBridges website at .michigan.gov/mibridges. You will need to create an account by choosing Register if you don't have one. Please report changes in both the Profile section and the Report Changes area.

The medically needy pathway also has an asset limit of $2,000 for an individual and $3,000 for a couple. 2) Asset Spend Down – Persons who have countable assets over Medicaid's limit can still become asset-eligible by spending down extra assets on non-countable ones.

Information about these programs can be found on the Michigan Medicaid Program Page. Medicaid provides free or low-cost health coverage to eligible needy persons....Michigan Medicaid Health Care Program? Household Size*Maximum Income Level (Per Year)1$19,3922$26,2283$33,0644$39,9004 more rows

You may use the DHS-2240, Change Report Form, to report changes to your specialist. If you choose this method you must answer all questions on the form for everyone in your household.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232