Michigan Medicaid Health Link Program: Helping the Elderly Remain at Home

Program Description

While Michigan Health Link is not strictly intended for the elderly, it is relevant to many aging Michiganders, since many services and supports are intended to help delay / prevent nursing home placement. This is a managed care program for persons who are eligible for both Medicaid and Medicare. In addition to the medical care benefits provided by Medicare, Health Link offers supports that help beneficiaries remain living at home rather than move to an institutional setting. For example, personal care, adult day care, home modifications and meal delivery are all supports that are non-medical, help persons remain living independently and are included benefits of this program.

Unfortunately, Health Link is not currently available statewide. However, it is available in 25 counties within the state, which includes Wayne County, Macomb County, all of the counties in the Upper Peninsula, and some of the Southwest counties.

Health Link is a relatively new program as of March 2015, and it coordinates benefits of both Medicaid and Medicare to cover physical and behavioral health care, acute care, prescription drugs, dental, vision, long-term home and community based care assistance and supports, and nursing home care. The Health Link Program includes a Home and Community Based Services (HCBS) Waiver referred to as the Expanded Community Living Supports (ECLS) Waiver.

This program is a partnership between three entities: The Michigan Department of Health and Human Services (MDHHS), the Centers for Medicare & Medicaid Services (CMS), and Integrated Care Organizations (ICOs). As of 2017, there are seven ICOs, which are also known as Michigan Health Link Plans. These include Aetna, AmeriHealth, Michigan Complete Health, HAP Midwest, Meridian, Molina, and the Upper Peninsula Health Plan.

Michigan residents who are currently receive personal care assistance via the state plan, Medicaid Home Help Services Program, will continue to have these same services provided via the Health Link Program. As with the Home Help Services Program, individuals enrolled in the Health Link Program are able to choose their own caregivers. This includes family members, given they are able to enroll in the ICO’s provider network. 

 

Eligibility Guidelines

In order to be eligible for the MI Health Link, one must be a Michigan resident, a minimum of 21 years old, and enrolled in both Medicaid and Medicare.

Medicaid Eligibility
As of 2017, in order to be eligible for Medicaid in Michigan, an elderly individual must not have monthly income in excess of $1,005, which is 100% of the Federal Poverty Level. In addition, one must not have assets over $2,000. Some assets, such as an individual’s primary home is considered exempt, given the individual lives in the home and the home is not valued over $560,000. Being over the income or asset limit does not automatically disqualify one from Medicaid. However, in instances such as these, consulting a professional Medicaid planner is highly advised. Learn more here.

Medicare Eligibility
In simplified terms, in order to be eligible for Medicare, one must be 65 years of age or under the age of 65 and be blind or disabled.

Geographic Requirements
One must live in one of the following MI counties.

Alger
Baraga
Barry
Berrien
Branch
Calhoun

Cass
Chippewa
Delta
Dickinson
Gogebic
Houghton

Iron
Kalamazoo
Keweenaw
Luce
Mackinac
Macomb

Marquette
Menominee
Ontonagon
Schoolcraft
St. Joseph
Van Buren
Wayne

Care need assessments are completed in order to determine if one requires state plan personal care assistance via Health Link or more extensive services via the Expanded Community Living Supports (ECLS) Waiver. Make note, for one to be eligible for services under ECLS, one must require a nursing home level of care.

Note one cannot be enrolled in both MI Health Link and the MI Choice Waiver or PACE.  

Benefits and Services

All benefits that are covered by Medicaid and Medicare are covered by MI Health Links, and include the following supports and services. Make note, benefits may vary slightly based on one’s health care plan through their ICO.

  • Adult Day Program
  • Care Coordination
  • Chore Services
  • Community Transition Services
  • Dental and Vision Services
  • Diagnostic Testing
  • Durable Medical Equipment
  • Emergency / Acute Care
  • Home Health Services
  • Home modifications
  • Hospitalization / Surgeries 
  • Lab Services
  • Meal Delivery
  • Medical / Nonmedical Transportation 
  • Medical Supplies
  • Nurse Advice Line
  • Nursing Home Services
  • Personal Care Assistance
  • Prescription Drugs
  • Respite Care

 

How to Apply / Learn More

One must be enrolled in both Medicaid and Medicare to be eligible for MI Health Link. If one is not enrolled in Medicaid, they should contact the local MDHHS County office. One can click here for a list of offices. For information about enrolling in Medicare, click here.

To learn more about the MI Health Link program, click here. In most cases, eligible applicants will receive a letter from Michigan ENROLLS instructing them how to enroll in this program. Often times, individuals are passively enrolled, as they don’t contact Michigan ENROLLS to opt out of the program within 60 days of receipt of the letter. However, individuals may also choose to actively enroll in the program and choose their health plan, or they can opt out of the program completely. One can also call MI ENROLLS at 800-975-7630 to enroll in this program.