MHA Monday Report April 10, 2017

Posted on April 10, 2017

Healthy Michigan Plan Co-payments Increase for Some Beneficiaries

The Medical Services Administration recently released a final policy to comply with a state legislative requirement. The final policy outlines increases to Healthy Michigan Plan co-payments for individuals with income greater than 100 percent of the federal poverty level. Effective for dates of services on and after April 1, 2017, co-payment amounts will increase for these individuals as follows:

  • Physician office, outpatient hospital clinic, dental, and podiatric visits will increase to $4.
  • Emergency department visits for nonemergency services will increase to $8.
  • Inpatient hospital visits will increase to $100.
  • Chiropractic visits will increase to $3.
  • Pharmacy will increase to $4 and $8 for preferred and nonpreferred, respectively.

The co-payment amounts will not change from current levels for individuals with income equal to or less than 100 percent of the federal poverty level. In addition, services and populations currently exempt from co-payments will remain exempt.

Consistent with current policy, co-payments for Healthy Michigan Plan individuals enrolled in a Medicaid Health Pan will not be collected at point of service; they will be collected through their MI Health Account. Healthy Michigan Plan individuals covered by fee-for-service will be subject to co-payments at point of service.

According to a recent Healthy Michigan Plan Progress Report issued by the Michigan Department of Health & Human Services, approximately one in six Healthy Michigan Plan enrollees will be affected by this policy. Members with questions should contact Jason Jorkasky at the MHA.


  • MHA Monday Report April 10, 2017

Tags: Pyxis, Medicare, MAPS, Medicaid, pharmacy, Healthy Michigan Plan, Health PAC, Healthcare Leadership Award, Appriss, goal, Human Resources Conferance, WPS local coverage determination, sleep labs, Joint Commission, laboratory fee schedule, RCA2, MBI, HICN, Board meeting

Posted in: Monday Report

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