State Medical Program Is Re-Opening for Enrollment (Issue Alert)

Issue Alert - 10-09-01

Date:

09/13/2010

Program Area:

Adult Medical Program (AMP) -- also known as Adult Benefits Waiver (ABW) or County Health Plan A

Issue Summary:

Enrollment in the AMP/ABW/Plan A will be open October 1, 2010 through November 30, 2010

Persons Affected:

Uninsured individuals (or those with County Plan B coverage) with income below 35% of the federal poverty level and cash assets of less than $3,000.

For More Information:

Center for Civil Justice 320 S. Washington, 2nd Floor Saginaw, MI 48607 (989) 755-3120, (800)724-7441             (800)724-7441   Fax: (989) 755-3558 E-mail: info@ccj-mi.org


Background

The Adult Medical Program (AMP) provides health coverage to uninsured individuals who are unable to qualify for Medicaid and who have monthly income below 35% of the federal poverty level ($316 a month  for an individual, $425 a month for a couple) and cash assets (bank or retirement accounts, securities, cash) totaling less than $3,000.  When evaluating income eligibility for AMP, the Department of Human Services (DHS) considers gross income, but excludes the first $200 plus 20% of the remainder of an applicant’s earned income.

AMP is also known as the Adult Benefits Waiver (ABW) program, because it is partially funded with federal Medicaid funds under a waiver granted by the federal government.

Although DHS determines eligibility for AMP/ABW, the health coverage for eligible recipients is provided either by the Department of Community Health (DCH) or, in most counties, by the County Health Plan. When the AMP/ABW coverage is provided by the county, it usually is known as County Health Plan A. 

Beginning July 1, 2004, enrollment in the AMP/ABW program was frozen, except for brief periods.  During the freeze, no new applications are approved (including applications by AMP/ABW recipients who fail to complete their yearly redeterminations on time). 
 

What's Happening?

Individuals who submit applications to DHS on or after October 1, 2010 and on or before November 30, 2010 may be approved for AMP/ABW, if they qualify.  

IMPORTANT NOTE: During past open enrollment periods, DHS refused to approve AMP/ABW for individuals whose applications for medical coverage were PENDING in the open enrollment period if their applications were SUBMITTED prior to the start date of enrollment. Therefore, individuals who have an application for medical coverage pending at DHS should submit a new application -- or meet with their DHS caseworker to update and re-sign their pending application during the enrollment period between October 1 and on or before November 30, 2010.   

DHS must RECEIVE the application on or after October 1  AND on or before November 30, 2010 in order for the individual to be considered for AMP eligibility. Applications received prior to October 1 or after the enrollment period closes will be denied AMP based on the freeze.

What Should Advocates Do?

Get the word out about the open enrollment period. 

Share this information with other agencies or organizations that work with very low income, uninsured, childless adults including persons with disabilities who may not meet the stringent standard for disability-based Medicaid, persons who are homeless, domestic violence survivors, etc. 

Get the word out to local medical providers, including free clinics and federally qualified health centers. 

Share this information with attorneys who represent Social Security and SSI disability applicants, to assist those who need medical coverage but may be unable to establish Medicaid eligibility while their RSDI/SSI case is pending.

Make sure clients with [pending Medicaid applications re-apply during the AMP open enrollment period if their eligibility for Medicaid is uncertain.

What Should Clients Do?

If you are uninsured or have County Plan B coverage you should submit an application to DHS during this open enrollment period.   Check the box for "medical assistance." 

If you already have applied for medical assistance or Medicaid, you must RE-APPLY to be considered for AMP if your application was submitted before October 1, 2010.    You can re-apply by meeting with your caseworker to update and re-sign you pending application if it has not been approved or denied yet. It must be re-signed after September 30 and before December 1, 2010.   If it is difficult for you to meet with your caseworker or to get to the DHS office, you can file a new application.

If you cannot complete the full application form, you can 
(1) submit an 1171F "Filing Document" to protect your application date, or 
(2) submit the application with just your name, address, birth date and signature. 

DHS must help you fill out the application if you ask them for help. The Filing Document is available at DHS or online at http://michigan.gov/fia (click on "Doing Business with FIA" and "Forms & Applications").

Upcoming Community Events

Family to Family Class
Thu, 10/30/2014 - 6:30pm
Family to Family Education Program
Thu, 10/30/2014 - 6:30pm - 9:00pm
Family to Family Class
Thu, 11/06/2014 - 6:30pm