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BAM 115 12 of 36 APPLICATION PROCESSING BPB 2026-003 2-1-2026
BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES
Exception: A person might be eligible for one, two or all three retro months, even if not currently eligible. The DHS-3243, Retroactive Medicaid Application, is used to apply for retro MA. Only one DHS-3243 is needed to apply for one, two or all three retro MA months; see Retro Ma Applications in BAM 110. Do not request a DHS-3243 if the individual is eligible under Children under 19 (U19), Pregnant Women (PW), or MIChild (MCD) Retro MA Eligibility Requirements. Eligibility must be made for each of the three retro months; see Standard retro MA eligibility requirements in this item. When the need for retroactive coverage, including specific months, is indicated on the DCH-1426, DHHS 1171, Healthcare coverage supplement, or MI Bridges, a separate DHS-3243 is not required. Children Under 19 (U19), Pregnant Women (PW), MIChild (MCD) Determine eligibility for the application month first. An individual who is eligible for Children under 19 (U19), Pregnant Women (PW), or MIChild (MCD) for the application month is eligible for retro MA when all of the following conditions are met. This applies even if the retro MA question on the application is not answered or is answered no. 1. The client is eligible for Children under 19 (U19), Pregnant Women (PW), or MIChild (MCD) for the application month. 2. For a pregnant woman, the woman was pregnant or under age 19 for the retro MA month. 3. The person was a Michigan resident. Retro MA cannot be approved for a month if you know the person was not a Michigan resident for the retro MA month. However, assume a person was a Michigan resident unless you have information to the contrary, such as information on the application indicating the person lived in another state. 4. The person is not ineligible because of BEM 265, Institutional Status. Retro MA cannot be approved for a retro MA month if you know the person would be ineligible because of institutional status. However, assume a person was not institutionalized unless you have information to the contrary.