MICHIGAN HEALTH CARE MATRIX (January 2007)

Michigan State Planning Project for the Uninsured
Executive Highlights and Advisory Council Recommendations (October 2006)

Michigan Contact Directory

Blue Cross Blue Shield of Michigan

600 East Lafayette Blvd.
Detroit, MI 48226

Phone: 1-800-848-5101

Web Site: http://www.bcbsm.org

Individuals who qualify for the federal Health Care Tax Credit (HCTC) can use their tax credit dollars to purchase either the Health Coverage Community Blue Option with RX Plan 1 or the Blue Value Option 9 with RX Plan 2 health insurance products from this state-qualified health plan.

Michigan Adult Medical Program (AMP)

Phone: 1-800-642-3195

Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2943_4860-35199--,00.html

Adult Medical Program (AMP) provides basic medical care to low income adults who do not qualify for Medicaid. There are asset and income limits. Some counties have a county health plan that the person must be enrolled in to receive AMP benefits. Additional services may be available through the county health plan.

If an eligible person has access to employer sponsored health insurance the Department of Community Health (DCH) may provide the person with a voucher (equal in value to the cost of AMP) that can be used to join the employer sponsored plan. Enrollment in the employer-sponsored plan would be granted/authorized instead of receiving AMP.

Michigan Association of Health Underwriters

Marcy Lay
Executive Director
124 Weset Allegan
Suite 1700
Lansing, MI 48933

E-mail: laym@ckronline.com
Web Site: http://www.mahu.org

Michigan Breast and Cervical Cancer Control Program

Phone: 800-922-MAMM

Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2940_2955-13487--,00.html

Since 1991, the Michigan Department of Community Health (MDCH) has implemented a comprehensive Breast and Cervical Cancer Control Program (BCCCP) through a multi-year grant from the U.S. Centers for Disease Control and Prevention. With these funds, low-income women now have access to life-saving cancer screening services and follow-up care, including cancer treatment if that should be needed.

Through this program, women who have breast and cervical cancer will be identified at earlier stages of these diseases, when treatment is less expensive and the survival rate is more favorable. Working together, participating medical providers and local health agencies can ensure that the highest quality breast and cervical cancer control services are available to all women in their communities.

Women throughout Michigan may seek these services from local health departments and over 700 contracted BCCCP providers across the state. Services are also available through tribal health clinics of federally recognized Indian tribes.

To be eligible for BCCCP services, women must meet the following criteria:

Have an income < 250% of federal poverty level (see chart below);

Be uninsured or underinsured for these tests; and

Be age 40 - 64 for breast/cervical cancer screening and for diagnostic follow-up of breast/cervical abnormalities or

Be age 18 - 39 and have been identified with a cervical abnormality through the Family Planning program (Title X).

Note: Women who are enrolled in a managed care program, a health maintenance organization, or Medicare Part B are not eligible for the BCCCP.

Michigan Children's Special Health Care Services

Sixth Floor, Lewis Cass Building
320 South Walnut Street
Lansing, MI 48913

Phone: 1-800-359-3722

Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2942_4911_35698-15087--,00.html

Children's Special Health Care Services (CSHCS) is a program within the Department of Community Health. It is for children and some adults with special health care needs and their families.

It helps persons with chronic health problems by providing:

Coverage and referral for specialty services, based on the child's health problems. 
Family centered services to support you in your primary role as caretaker of your child. 
Community-based services to help you care for your child at home and maintain normal routines. 
Culturally competent services which demonstrate awareness of cultural differences. 
Coordinated services to pull together the services of many different providers who work within different agencies. 

Children must have a qualifying medical condition and be 20 years old or under. Persons 21 and older with cystic fibrosis or certain blood coagulation disorders may also qualify for services.

CSHCS covers more than 2,700 diagnoses. Some common medical conditions that may qualify for CSHCS are:

cancer 
cerebral palsy 
cleft palate/cleft lip 
liver disease 
club foot 
hypospadius 
deformed limbs/amputations 
myelodysplasia/spina bifida 
certain vision disorders 
paralysis/spinal injuries 
hemophilia/blood clotting disorders 
cystic fibrosis/other chronic lung conditions 
hearing loss 
insulin-dependent diabetes 
muscular dystrophy 
certain heart conditions 
epilepsy/hydrocephalus 
neurological disorders 
kidney disease 
sickle cell anemia

Michigan Dental Program

Merry Gastambide
Coordinator
MDCH, DHWDC, HAPIS 
2479 Woodlake Circle, Suite 300 
Okemos, MI 48864

Phone: 1-888-826-6565

Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2940_2955_2982-45691--,00.html

The Michigan Dental Program (MDP) covers dental care for Persons Living with HIV/AIDS who qualify for the program. The program is currently closed to new applicants.


The following criteria must be met before an applicant can be placed on the Michigan Dental Program:

Applicant must have documentation of HIV disease. 
Applicant must be a resident of the State of Michigan. 
Applicant income level cannot exceed 450% of the federal poverty level (as of 11/01/02) per month. 
Applicant cannot have any other type of dental insurance available to him/her, including veterans' dental benefits through the Veterans Administration. 
Applicant may utilize the service of a case manager or client advocate to ensure continuity of care, to assist applicant with the Medicaid application process, to assist applicant in demonstrating inability to utilize Medicaid providers in their area and/or demonstrate financial need. 

Covered services include both preventive and restorative care including, but not limited to, cleanings, x-rays, fillings, crowns, bridges, root canals, dentures, extractions, bite splints and periodontal work. The program covers any medically necessary service including those traditionally not covered by insurance such as quarterly cleanings, sealants, and fluoride treatments.

Michigan Department of Community Health

Sixth Floor, Lewis Cass Building
320 South Walnut Street
Lansing, MI 48913

Phone: 517-373-3740
TTD: 517-373-3573

Web Site: http://www.michigan.gov/mdch

Michigan Early On Program

Michigan Department of Community Health
Sixth Floor, Lewis Cass Building
320 South Walnut Street
Lansing, MI 48913

Phone: 517-373-3740
TTD: 517-373-3573

E-mail: scoblicm@michigan.gov
Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2942_4911_4912-12605--,00.html

Early On is a statewide, comprehensive, coordinated interagency system of early intervention services for infants and toddlers birth to age three years with disabilities and their families. In Michigan, Early On is coordinated by the Michigan Department of Education and provides services under Part-C of the Individuals with Disabilities Education Act (IDEA).

An outreach system which includes the components of public awareness, inquiry, screening and referral was established. Every local health department has at least one professional in place who is designated as its liaison to help families access Early On services. Any family concerned about the development or health of their child can access the system by contacting a local agency or by calling 1-800-EARLY ON.



Local communities receive funding through their local Intermediate School District (ISD) to implement Early On. Each local ISD jurisdiction has an interagency coordinating council (comprised of individuals from human service agencies, parents, educators, and other agency personnel who serve families) that guides implementation locally. Implementation is also guided through local memoranda of understanding between education, mental health, public health, and social services.

Infants and toddlers from birth through age two who need early intervention services because they are experiencing developmental delays and/or have a diagnosed physical or mental condition that has a high probability of resulting in developmental delay are eligible. 
At a state's discretion, children age birth through two who are at risk of developmental delay may also be eligible. 
Available services include assistive technology device; audiology; family training, counseling, and home visits; health services; medical services; nursing services; nutrition services; occupational therapy; physical therapy; psychological services; service coordination services; social work services; special instruction; speech-language pathology; transportation and related costs; and vision services. 
To the maximum extent appropriate to the needs of the child, Early On services will be provided in natural environments including the home and community settings. 
Monies are allocated based on the number of infants and toddlers eligible for Early On services within each ISD and a base grant (based on size and numbers) for administration and coordination functions. 
Early On is a family-focused process, with emphasis on family strengths and abilities, which requires the development of an individualized family service plan specific to each enrolled family, based on the findings of a multidisciplinary evaluation of the child and family.

Michigan Elder Prescription Insurance Coverage

Michigan Department of Community Health

Phone: (517) 241-3424

Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2940_3183_4892---,00.html

Michigan's Elder Prescription Insurance Coverage (EPIC) program was implemented in October of 2001 to assist the state's low-income seniors with the cost of their prescription drugs. 

Routine enrollment in EPIC is currently closed. However, EPIC has an emergency enrollment component that is available for individuals who meet the qualifying criteria. Emergency enrollment requires that individuals have household income at 150 percent or less of the FPL and a true medical emergency must exist. The emergency enrollment period is 45 days and the emergency benefit is available up to two times a year.

Michigan Family Planning Program

Michigan Department of Community Health
Sixth Floor, Lewis Cass Building
320 South Walnut Street
Lansing, MI 48913

Phone: 517-373-3740
TTD: 517-373-3573

E-mail: owense@michigan.gov
Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2942_4911_4912-12562--,00.html

The Michigan Family Planning Program makes available general reproductive health assessment, comprehensive contraceptive services, related health education and counseling, and referrals as needed to every citizen of the state. The program's strong educational and counseling component helps to reduce health risks and promote healthy behaviors. While services are available to anyone, the primary target population is low-income women and men. Individuals with income levels at or below poverty can receive the full array of program services at no cost. No one is denied services because of inability to pay.

Michigan Healthy Kids

Phone: 1-888-988-6300
Phone: 1-800-642-3195

Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2943_4672-17752--,00.html

Healthy Kids is a program that provides a wide range of health care coverage and support services for qualifying pregnant women, babies and children under age 19.

Michigan HIV/AIDS Drug Assistance Program

Merry Gastambide
Coordinator
MDCH, DHWDC, HAPIS 
2479 Woodlake Circle, Suite 300 
Okemos, MI 48864

Phone: 1-888-826-6565

Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2940_2955_2982-44913--,00.html

The Michigan DAP program helps cover prescription costs for certain FDA-approved drugs for HIV/AIDS patients who qualify for the program.

The Michigan DAP program currently covers 173 HIV-specific and related medicines, as well as four vaccines. It includes all FDA-approved antiretrovirals. 

To be eligible for the Michigan DAP program:

You must have HIV disease. 
You must be a state of Michigan resident. 
Your income level should be no more than 450% of poverty level. 
You must have applied for public assistance (Medicaid and/or State Medical Program), and have a denied, pending or spend down status within 90 days of application to the DAP. 
Once each year all currently enrolled clients go through a redetermination process to insure their continuing eligibility.

Michigan Maternal and Child HIV/AIDS Program

Michigan Department of Community Health

Phone: 313-456-4365
TTD: 517-373-3573

E-mail: MalamudH@michigan.gov
Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2942_4911_4912-12591--,00.html

Maternal and Child HIV/AIDS Program services are aimed at achieving the best possible comprehensive care for women and children infected or affected by HIV/AIDS disease. This model program serves to assure that coordination of existing medical care and social support services exists for families living with HIV/AIDS, including coordination with Title V of the Social Security Act (Children's Special Health Care Services) Program and related programs. The program is based on a family-centered care approach of service delivery that recognizes the ever-present influence of family in the care and management of HIV disease. 
The Maternal and Child HIV/AIDS Program administers the Ryan White Title IV funds. The Title IV Program supports services for children, youth, women, and families living with HIV. Title IV services are designed to be comprehensive, community based, culturally competent, and family centered. Currently, Title IV funds are allocated to medical and case management agencies in Detroit. These agencies provide primary and specialty medical care, psychological services, logistical support and coordination, and outreach and case management, Title IV employs family case managers and family advocates who serve to link families with needed care across service systems. Title IV works to assure HIV positive women have access to medical therapies that reduce transmission of HIV to their newborn(s), as well as access to clinical trials that provide them state-of-the-art treatment. Title IV further assures HIV exposed and HIV positive children have access to available clinical trials. HIV positive women are also offered opportunities to develop and use advocacy and leadership skills in the area of policy and program development for the HIV service system.

Agencies involved in delivering family-centered, coordinated, comprehensive care services include:

AIDS Consortium of Southeast Michigan, 
AIDS Partnership Michigan, 
City of Detroit Health Department, 
Detroit Community Health Connection, 
Wayne State University/Detroit Medical Center-Children's Hospital of Michigan, 
Wayne State University/Detroit Medical Center-University Health Center, 
Wayne State University/Detroit Medical Center-Hutzel Hospital. 
These agencies serve clients from southeast Michigan, including Detroit, Wayne, Oakland, Macomb, St. Clair, and Monroe counties. The Title II family advocacy services are available statewide.

The target populations are: women, adolescents, children and families with HIV; and sexually-active women and youth. Women, children and adolescents receiving services from Title IV contracted agencies have access to primary and tertiary care for HIV disease. They can also receive the following services:

Comprehensive, coordinated family centered care and case management services; 
Access to an emergency fund, for eligible expenses; 
Gynecological services; 
Psychological services; 
Information and access to available clinical trial participation; 
Opportunities to participate in a community advisory board; 
Transportation for Title IV related meetings and/or activities; 
Resources to enhance development of leadership skills in women and/or adolescents affected by HIV; and 
Health education materials, information and referrals for other health and psychosocial services.

Michigan Maternity Outpatient Medical Services (MOMS)

Phone: 1-800-642-3195

Web Site: http://www.michigan.gov/dhs/0,1607,7-124-5453_5530-105987--,00.html

The goal of the MOMS program is to provide immediate health coverage for pregnant women. It provides outpatient prenatal coverage only. The MOMS program is available to provide immediate prenatal care while a Medicaid application is pending. Other women who may be eligible for MOMS include:

Teens who, because of confidentiality concerns, choose not to apply for Medicaid, and

Non-citizens who are only eligible for emergency services only

The woman must use Medicaid benefits if and when they become available. Prenatal health care services will be covered by MOMS and/or Medicaid for the entire pregnancy and for two months after the pregnancy ends. There is an income test for all persons except teens. The local health department can help women apply for the MOMS program.

Michigan Medicaid

Michigan Department Community Health
Sixth Floor, Lewis Cass Building
320 South Walnut Street
Lansing, MI 48913

Phone: 1-517-373-3500
Phone: 1-800-642-3195 
TTD: 1-517-373-3573

E-mail: geigerter@michigan.gov
Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2943_4860---,00.html

Michigan Medicare/Medicaid Assistance Program

Phone: 1-800-803-7174
Phone: 1-517-886-1029

E-mail: info@mymmap.org
Web Site: http://www.mymmap.org/index.php

This program provides free health benefit counseling services to those aged 65 and older, those who are Medicare beneficiaries due to disability, and their families. MMAP's provides timely, objective and accurate information and support to Michigan beneficiaries so that they can make informed decisions about their health care. Information and assistance is provided in the areas of: Medicare, Medicare + Choice (managed care options), Medigap insurance, Medicaid, long term care insurance. 

Counselors at local agencies provide information about benefits, comparative information about insurance products and managed care plans and assistance with claims, denials of service and other insurance related problems.

Michigan MIChild

Michigan Department of Community Health
P. O. Box 30195
3423 N. Martin Luther King Jr. Blvd.
Lansing, MI 48909

Phone: 1-888-988-6300
Phone: 517-373-3740 
TTD: 517-373-3573

Web Site: http://www.michigan.gov/mdch/1,1607,7-132-2943_4845_4931---,00.html

Michigan Office of Financial and Insurance Services

611 West Ottawa Street, 3rd Floor
PO Box 30220
Lansing, MI 48933-1070

Phone: (517) 373-0220 
Phone: (877) 999-6442 
Fax: (517) 335-4978

E-mail: ofis-info@michigan.gov
Web Site: http://www.michigan.gov/cis/0,1607,7-154-10555-40268--,00.html

Michigan Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Program

Phone: 800-922-MAMM

Web Site: http://www.michigan.gov/mdch/0,1607,7-132-2940_2955-13487--,00.html

The WISEWOMAN Program is an extension of the Breast and Cervical Cancer Control Program (BCCCP) and focuses on Cardiovascular Disease (CVD) risk factor reduction. CVD risk factors are assessed via blood pressure and cholesterol screening and evaluation of health history and current behaviors related to nutrition, physical activity, and smoking. Based on their CVD risk factors, clients work with lifestyle counselors to determine their lifestyle behavior change goals. These goals focus on changes to nutrition, physical activity, and smoking behaviors.

To help clients achieve their lifestyle behavior change goals, lifestyle counselors provide follow-up contacts with the clients. Support, encouragement, reinforcement, and education are offered during these lifestyle counseling sessions.

The WISEWOMAN Program is currently offered by the following 9 health departments:

District Health Department #2 - Alcona, Iosco, Ogemaw, and Oscoda Counties 
District Health Department #4 - Alpena, Cheboygan, Montmorency, and Presque Isle Counties 
District Health Department #10 - Crawford, Kalkaska, Lake, Mason, Mecosta, Missaukee, Newaygo, Oceana, and Wexford Counties 
Genesee County Health Department 
Huron County Health Department - Huron, Sanilac, and Tuscola Counties 
Ingham County Health Department - Ingham and Washtenaw Counties 
Kalamazoo County Health Department - Berrien County 
Lenewee County Health Department 
Public Health Delta & Menominee Counties

MiRx Card

MiRx Enrollment 
P.O. Box 30412
Lansing, MI 48909

Phone: 1-800-259-8016.

The MiRx Card is a new Michigan prescription drug discount card program that is designed to lower prescription drug costs for Michigan residents who do not have prescription drug coverage. There is no cost for the card and there is no cost to enroll in the program.

The MiRx Card represents a major step in the way that Michigan delivers prescription drug coverage to residents who may not otherwise be able to afford their prescription drugs. There is no age limit to participate in the program. The MiRx Card provides discounts at the more than 2500 participating pharmacies around the State. 

Michigan residents may qualify for the MiRx Card if they have an income levels at or below the State’s median income level. The median income level for a single individual is $27,930 and for a family of four the income level is $56,550. 

MiRx Card enrollees will present their cards at participating pharmacies and can expect savings of up to 20% off the retail price of common prescription drugs. Savings will depend on the kind of drugs used and if they are generic or brand.

MI CHILD
MIChild is a health insurance program.  It is for uninsured children of Michigan’s working families. MIChild services are provided by many HMOs and other health care plans throughout Michigan.  Call 1-888-988-6300 for more information. Click here for brochure.

Special Preventive Services to Keep Infants Healthy

Maternal and Infant Health Program services are specialized preventive services provided to pregnant women, mothers, and their infants to help reduce infant deaths and illnesses.   Qualified health plans (QHPs) are required to provide Maternal and Infant Health Program services to their members when they are determined to be medically necessary. Maternal and Infant Health Program services may require prior authorization from a QHP or its providers.

The following list provides the name of a person at each QHP who can be contacted regarding MSS/ISS services. This list is updated as QHPs notify MDCH of changes. Therefore, you should check this list periodically for the most current information.