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  • Application For A 1915(c) - State Of Michigan - Michigan

Get Application For A 1915(c) - State Of Michigan - Michigan

Administration Michigan Department of Community Health 400 South Pine Street Lansing, MI 48933 Dear Mr. Fitton: I am pleased to inform you that your request to amend Michigan s home and community-based services Waiver for Children with Serious Emotional Disturbances (SEDW) is approved. This waiver is authorized under 1915(c) of the Social Security Act. The amended waiver will continue to serve children with serious emotional disturbances who would otherwise require the level of care provide.

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How to fill out the Application For A 1915(c) - State Of Michigan - Michigan online

This guide will provide you with clear instructions on how to complete the Application For A 1915(c) online for the State of Michigan. The process is designed to be user-friendly, catering to various levels of familiarity with legal documents.

Follow the steps to successfully complete your application.

  1. Click the ‘Get Form’ button to access the online application form.
  2. Begin by filling out the 'Request Information' section. This includes providing the program title as 'Waiver for Children with Serious Emotional Disturbance' and the waiver number 'MI.0438'. Make sure to check any relevant boxes regarding the types of services requested.
  3. In the 'Purpose(s) of Amendment' section, clearly describe the reasons for any changes you are requesting in the waiver application. This may involve expanding services or updating eligibility criteria.
  4. Proceed to the 'Nature of the Amendment' section where you will specify the components affected by the amendment. Mark all applicable subsections that are being revised.
  5. Next, enter information regarding service utilization. Provide details such as the number of individuals expected to receive services and how costs will be covered.
  6. Review the 'Participant Access and Eligibility' section. Here, you will confirm any eligibility criteria and the necessary documentation of services.
  7. Once all sections are completed, review your application for accuracy. Ensure that all required information is included.
  8. After finalizing your application, save changes, and submit the form. You may also have the options to download, print, or share your application.

Get started by filling out your application online today!

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In most cases, MDHHS has 45 days to make a decision after you apply. If MDHHS needs to make a disability determination as part of your application, it has 90 days to make a decision. If you are pregnant when you apply, MDHHS has 15 days to make a decision.

The Healthy Michigan Plan is a Medicaid health care program through the Michigan Department of Health and Human Services (MDHHS). Eligibility for this program will be determined using the Modified Adjusted Gross Income methodology.

In most cases, MDHHS has 45 days to make a decision after you apply. If MDHHS needs to make a disability determination as part of your application, it has 90 days to make a decision. If you are pregnant when you apply, MDHHS has 15 days to make a decision.

For 2023 that means income at or below $2,742 a month and no more than $2,000 of countable assets.

Income & Asset Limits for Eligibility 2024 Michigan Medicaid Long-Term Care Eligibility for SeniorsType of MedicaidSingleIncome LimitAsset LimitInstitutional / Nursing Home Medicaid$2,829 / month*$2,000Medicaid Waivers / Home and Community Based Services$2,829 / month†$2,0001 more row • Jan 16, 2024

To qualify, you must: Meet the medical requirements of Social Security's definition of disability. Be working and earning income (this can be part-time work). Have countable income less than 250% of the federal poverty level (in 2024, this equates to $3,157.50/mo.

See if you qualify for the Healthy Michigan Plan. 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.

What to bring to your DHS appointment Proof of Income. Pay Stub(s) from the last 30 days. Bank Statement from the last 30 days. Social Security awards letter. Tax Return. Unemployment letter. Social Security Number. Identification. Driver's License. State ID. Proof of Address. ID with current address. Utility Bill.

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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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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