Michigan Medicaid Eligibility 2026: Who Qualifies and What’s Covered

Last Updated: February 2026

Michigan Medicaid gives free or low-cost health coverage to people with low income.

In 2026, over 2.6 million Michigan residents get Medicaid benefits. This guide covers every eligibility rule, income limit, and new law change you need to know.

Quick Answer Summary:

• Healthy Michigan Plan adults (19–64): Income limit is 138% FPL — about $1,835/month for one person or $3,795/month for a family of four
• Children under 19: Qualify up to 217% FPL — about $4,940/month for a family of three
• Pregnant women: Qualify up to 200% FPL — about $3,607/month for a household of two
• Aged, Blind & Disabled: Income limit is about 100% FPL ($1,330/month) with a $2,000 asset limit
• Nursing Home & HCBS Waivers: Income limit is $2,982/month with a $9,950 asset limit
• New in 2026: The OBBBA law cuts federal funding, restricts non-citizen eligibility starting October 2026, and requires 6-month renewals for expansion adults starting December 2026

What Is Michigan Medicaid?

Michigan Medicaid is a government health insurance program for low-income residents. It is also called Medical Assistance (MA). Here is what you should know about the program basics.

Who Runs Michigan Medicaid?

The Michigan Department of Health and Human Services (MDHHS) runs this program. It follows federal guidelines. The federal and state governments share the cost.

What Is the Healthy Michigan Plan?

In 2014, Michigan expanded Medicaid under the Affordable Care Act. This created the Healthy Michigan Plan (HMP). HMP covers about 750,000 adults. It is the largest Medicaid program in the state.

You can learn more about Medicaid eligibility requirements for 2026 across all states to compare how Michigan stacks up.

Who Qualifies for Michigan Medicaid in 2026?

Michigan Medicaid covers several groups of people. You must meet basic rules before the state checks your income. Below are the core requirements every applicant must meet.

Basic Eligibility Rules

• Residency: You must live in Michigan.
• Citizenship: You must be a U.S. citizen or have qualified immigration status.
• Category: You must fit a qualifying group (children, pregnant women, parents, adults 19–64, seniors 65+, or people who are blind or disabled).
• Income: Your income must fall below program limits.
• Assets: Most programs have no asset test. Long-term care programs do.
• Medical need: Required only for long-term care programs.

2026 Federal Poverty Level (FPL) Chart for Michigan

Income limits for Michigan Medicaid are based on the Federal Poverty Level. The 2026 FPL numbers were published on January 15, 2026. These numbers set the bar for every Medicaid program.

2026 FPL Income Table

Each additional person adds about $5,680 per year ($473 per month) at 100% FPL.

You can also check the full Medicaid income limits by state in 2026 for a side-by-side comparison.

Source: HHS ASPE 2026 Poverty Guidelines (Federal Register, January 15, 2026)

Michigan Medicaid Income Limits by Program in 2026

Each Medicaid program has its own income limit. Some also have asset limits. Below is a breakdown for every major program in Michigan.

Healthy Michigan Plan (HMP) — Adults 19–64

This is for adults aged 19 to 64 who do not have Medicare.

• Income limit: 138% FPL
• Single person: About $1,835 per month ($22,025 per year)
• Family of four: About $3,795 per month ($45,540 per year)
• Asset test: None
• Premiums: About 2% of income for people above 100% FPL. These go into a MI Health Account.

Children’s Medicaid & MIChild (CHIP)

These programs cover children under age 19.

• Income limit: 217% FPL
• Family of three: About $4,940 per month
• Infants under 1: Income limit is 195% FPL
• Children ages 1–18: Regular Medicaid up to 160% FPL. MIChild covers up to 212–217% FPL.
• MIChild premium: About $10 per family per month
• Asset test: None

Pregnant Women

Pregnant women get expanded coverage in Michigan.

• Income limit: 200% FPL
• Household of two: About $3,607 per month
• Coverage lasts through: Prenatal care, delivery, and 12 months of postpartum care
• Asset test: None
• Note: The unborn child counts as a household member. This raises your income threshold.

Aged, Blind & Disabled (ABD) — Regular Medicaid

This program serves seniors 65 and older, plus people who are blind or disabled.

• Income limit: About 100% FPL ($1,304–$1,330 per month for one person)
• Asset limit: $2,000 (single) / $3,000 (couple)
• Note: People who receive SSI may get automatic Medicaid eligibility.

Nursing Home Medicaid (Long-Term Care)

This covers nursing facility care for people who need it.

• Income limit: 300% of the Federal Benefit Rate (FBR) = $2,982 per month
• Asset limit: $9,950 (individual)
• Must need: Nursing Facility Level of Care (NFLOC)
• Spend-down: If your income is too high but doesn’t cover nursing home costs, you may still qualify.

Home & Community Based Services (HCBS) Waivers

HCBS waivers let people get care at home instead of a nursing home.

• Income limit: $2,982 per month (same as Nursing Home Medicaid)
• Asset limit: $9,950 (individual)
• Programs include: MI Choice Waiver and other home-based care options
• Must show: Medical need for nursing-facility level of care

For details on provider payment rates, see the Medicaid Fee Schedule 2026 guide.

Spousal Protections for Married Couples in 2026

When one spouse needs nursing home or HCBS waiver Medicaid, the other spouse gets financial protections.

These are called Spousal Impoverishment Rules. They prevent the at-home spouse from losing everything.

Key 2026 Spousal Allowances

The at-home spouse can keep enough assets and income to live on. Income can transfer from the applicant spouse to meet the MMNA.

Asset Rules, Look-Back Period & Penalties

Asset rules apply mainly to long-term care Medicaid. Most other programs do not count assets. Understanding these rules can protect your eligibility.

Countable vs. Exempt Assets

Countable assets include:

• Cash and bank accounts
• Stocks, bonds, and investments
• Cryptocurrency
• Real estate (other than your primary home)
• IRAs (Michigan counts these)

Exempt assets include:

• Personal belongings and household items
• One automobile
• Primary home (with conditions — see below)

Home Equity Rules

Your home is usually exempt if you, your spouse, or a dependent child lives there. If no one lives there, you must state your intent to return.

• Home equity limit (long-term care): $752,000 in 2026
• Regular Medicaid: No home equity limit

The 5-Year Look-Back Rule

Michigan checks 60 months of financial records for nursing home and HCBS waiver applicants. Gifts or transfers below fair market value may trigger a penalty period.

• 2026 penalty divisor: $12,216.30 per month
• Does NOT apply to: Regular Medicaid, children’s Medicaid, or pregnant women’s programs

Estate Recovery

After a long-term care Medicaid recipient passes away, MDHHS may seek repayment from the person’s estate. This often includes the home.

Major Federal Law Changes Affecting Michigan Medicaid (OBBBA)

The One Big Beautiful Bill Act of 2025 (OBBBA) became law on July 4, 2025. It makes big changes to Medicaid across the country. Michigan residents will feel these changes starting in 2026 and 2027.

Medicaid Expansion Funding Cuts (2026)

OBBBA removes the enhanced federal funding rate for Medicaid expansion states. Michigan could lose about $900 million per year in federal support for the Healthy Michigan Plan.

Non-Citizen Eligibility Changes (October 1, 2026)

Starting October 1, 2026, some groups lose full Medicaid coverage.

Still eligible:

• Lawful permanent residents (after 5-year wait)
• Cuban/Haitian entrants
• Compact of Free Association (COFA) migrants
• Lawfully residing children and pregnant immigrants (in states that cover them)

Moved to Emergency Services Only:

• Refugees
• Humanitarian parolees
• Asylum grantees
• Certain abused spouses and children
• Victims of human trafficking

About 66,400 non-citizens in Michigan may be affected.

Medicaid Work Requirements (January 1, 2027)

Starting January 2027, some Healthy Michigan Plan enrollees must complete 80 hours per month of approved activities. These include work, school, job training, or community service.

Exempt groups:

• Pregnant individuals
• Disability benefit recipients
• Full-time students
• Caregivers of children under 13
• People with documented disabilities

Key 2026 preparation dates:

• June 1, 2026: Federal guidance must be released
• September 30, 2026: MDHHS begins outreach to affected enrollees

More Frequent Eligibility Checks (December 2026)

Expansion adults must now renew eligibility every 6 months instead of once a year. This starts around December 2026. Children and pregnant women stay on annual renewals.

Retroactive Coverage Reduction

For non-expansion enrollees, retroactive coverage drops from 3 months to 2 months before your application date.

Nursing Home & HCBS Outlook

Nursing home funding is protected under OBBBA. However, Home and Community Based Services may face budget cuts. The law includes $1 trillion in Medicaid cuts over 10 years and faces ongoing legal challenges.

Sources: michigan.gov/mdhhs; mplp.org; ama-assn.org

2026 Michigan Medicaid Program Updates

Several Michigan-specific program changes take effect in 2026. These updates affect managed care plans, home help services, and the CHAMPS system.

Mi Coordinated Health (MICH) — Dual Eligible Plan Changes

MICH combines Medicare and Medicaid into one managed care plan. In 2026:

• Upper Peninsula Health Plan is no longer in Chippewa, Gogebic, or Menominee counties
• Aetna and Molina are unavailable in St. Joseph County (southwest Michigan)
• Wayne County has many plan choices including Aetna, AmeriHealth, HAP CareSource, Priority, Humana, Molina, UnitedHealthcare, and Wellcare-Meridian

Home Help Program Updates

• New form MDHHS-6200 replaces the old DHS-54A form for certifying medical need
• Caregiver pay rates adjusted for Michigan’s January 2026 minimum wage increase
• Core eligibility rules for Home Help remain the same

CHAMPS Prior Authorization Redesign

MDHHS is updating the CHAMPS system screens on March 21, 2026. The system looks different, but the submission process stays the same.

What Does Michigan Medicaid Cover?

Michigan Medicaid covers a wide range of health services. Most people are enrolled in a managed care plan. Here are the main covered services.

Covered Benefits Include

• Doctor and specialist visits
• Hospital care (inpatient and outpatient)
• Prescription drugs
• Mental health and substance use treatment
• Preventive and wellness care
• Maternity and newborn care
• Lab tests and X-rays
• Home and community-based services (if eligible)
• EPSDT services for people under 21
• Dental, vision, and hearing (varies by program)

Some services need prior authorization. You may need to pick a primary care provider.

How to Apply for Michigan Medicaid in 2026

Applying for Michigan Medicaid is free. You can apply in several ways. Start as soon as you think you qualify.

Application Methods

Processing Times

• Standard: About 45 days
• Disability-related: Up to 90 days
• Pregnant women and children under 21: Priority processing in about 10 days
• Emergencies: Fast-tracked in about 5 days

Documents You Need

• Government-issued ID (driver’s license, state ID, or birth certificate)
• Social Security card or number
• Proof of income (pay stubs, W-2s, tax returns, SSI or unemployment letters)
• Proof of Michigan residency
• Medical records (for long-term care applications)

Retroactive Coverage

You may get up to 3 months of retroactive coverage. Under OBBBA, this drops to 2 months for certain non-expansion groups.

Source: MI Bridges — mibridges.michigan.gov

Michigan Medicaid Renewal & Ongoing Requirements

Keeping your Medicaid active requires regular renewals and reporting. Missing a renewal can cause you to lose coverage.

What You Need to Do

• Renew on time: Most programs require annual renewal. Expansion adults shift to every 6 months starting late 2026.
• Report changes: Tell MDHHS right away if your income, address, or household size changes.
• Get prior approval: Some treatments need approval before your visit.
• Stay eligible: Coverage continues only as long as you meet the rules.

Key Contacts & Official Resources

Frequently Asked Questions

Disclaimer: This article is for informational purposes only. It is not legal or financial advice. Eligibility rules change as federal and state policies evolve. Always verify current requirements with MDHHS or an authorized enrollment counselor.