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Dhs 1004 Form
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People also ask
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What documents are needed for Medicaid in Michigan?
You can find your caseworker's specialist ID on the top right corner of a notice you received from the Michigan Department of Health and Human Services (MDHHS). The specialist ID is usually a combination of the specialist's name. -
What is the primary eligibility requirement for Medicaid?
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. -
How long does it take to get approved for Michigan Medicaid?
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. -
How do I report changes to DHS Michigan?
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. -
What is the Public Health Emergency (PHE) and how does it affect me?
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. -
What qualifies a person for Medicaid in Michigan?
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. -
Is Healthy Michigan Plan the same as Medicaid?
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. -
Is there a blank printable version of the MDHHS-1010 (Redetermination) and DHS-1004 (Health Care Coverage Supplemental Questionnaire) available online?
Reporting Changes The easiest and most reliable way to report changes is online using MI Bridges. You can also call MI Bridges at 888-642-7434 or use DHS Form-2240 to report changes. It is best to report changes in writing and keep copies of the e-mail, fax, or letter as proof you reported the changes on time.
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