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BAM 115 10 of 36 APPLICATION PROCESSING BPB 2026-003 2-1-2026

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

form(s), DCH-1426 or MDHHS-1010 and program specific supplement form(s) on file may be updated and re-signed if both of the following apply: • The application/redetermination was initially certified within the last 12 months. • The client is interviewed (if required) and provides any needed verification before redetermination. MAGI Medicaid MDHHS must use information currently available in the State of Michigan systems to renew eligibility. Do not request information from the beneficiary if the information is already available to MDHHS. This includes completing a renewal form. See BAM 210, Redetermination/Ex parte review/Renewal. FIP At redetermination, if an adult mandatory group member is added to the group, send the individual the DHS-1173 and DHS-1538. Do not approve the redetermination until the DHS-1173 and DHS- 1538 are signed and returned. See additional requirements in BAM 210, Member Add at Redetermination. WHEN A DCH-1426 IS NOT REQUIREDMA Only No DCH-1426 is required to apply for or renew Medicaid or in the following instances: • Transfers to: Transitional MA; see BEM 111. Special N Support; see BEM 113. Refugee Medical Aid; see BEM 630, Refugee Assistance Program. • Transfers between Medicaid categories; see At Program Transfer, in this item. • Supplemental Security Income (SSI) recipients. • Automatically eligible newborns; see BEM 145, Newborns. Authorize the newborn's MA as soon as the child's birth is reported. Contact the newborn's mother if there is not enough information to obtain a beneficiary ID for the child in Bridges.

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Page 10

Official source

BAM 115 10 of 36 APPLICATION PROCESSING BPB 2026-003 2-1-2026

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

form(s), DCH-1426 or MDHHS-1010 and program specific supplement form(s) on file may be updated and re-signed if both of the following apply: • The application/redetermination was initially certified within the last 12 months. • The client is interviewed (if required) and provides any needed verification before redetermination. MAGI Medicaid MDHHS must use information currently available in the State of Michigan systems to renew eligibility. Do not request information from the beneficiary if the information is already available to MDHHS. This includes completing a renewal form. See BAM 210, Redetermination/Ex parte review/Renewal. FIP At redetermination, if an adult mandatory group member is added to the group, send the individual the DHS-1173 and DHS-1538. Do not approve the redetermination until the DHS-1173 and DHS- 1538 are signed and returned. See additional requirements in BAM 210, Member Add at Redetermination. WHEN A DCH-1426 IS NOT REQUIREDMA Only No DCH-1426 is required to apply for or renew Medicaid or in the following instances: • Transfers to: Transitional MA; see BEM 111. Special N Support; see BEM 113. Refugee Medical Aid; see BEM 630, Refugee Assistance Program. • Transfers between Medicaid categories; see At Program Transfer, in this item. • Supplemental Security Income (SSI) recipients. • Automatically eligible newborns; see BEM 145, Newborns. Authorize the newborn's MA as soon as the child's birth is reported. Contact the newborn's mother if there is not enough information to obtain a beneficiary ID for the child in Bridges.