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BAM 115 13 of 36 APPLICATION PROCESSING BPB 2026-003 2-1-2026

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

5. Any applicable post-eligibility patient-pay amount has been computed. An application month may be a long-term care and/or hospital (L/H) month or you may have information suggesting that a retro MA month is an L/H month. In such situations, decide whether a retro MA month is an L/H month and compute the post-eligibility patient-pay amount. Do not approve retro MA coverage for a month until that decision and/or computation is completed. 6. Use the Standard Retro MA Eligibility Requirements below to determine retro MA eligibility if the client is not eligible for Children under 19 (U19), Pregnant Women (PW), or MIChild (MCD) for the application month. Parent/Caretaker (PCR), Healthy Michigan Plan (HMP), Former Foster Care (FFC) MAGI groups which were automatically approved and certified using federal trusted data sources meet the requirements for retroactive Medicaid with no additional verification. • Individuals must request and be approved for only the specific months they need coverage for, not automatic coverage as is true for U19, PW, and MIChild. • Must meet programmatic requirements for requested months. PCR-must have a dependent child during the requested month(s). HMP- retro month must be April 2014 or later. Not a Medicare recipient, at least age 19 and under 65. FFC- not in foster care during retro months. Standard Retro MA Eligibility Requirements MA Only Determine eligibility for each retro MA month separately. To be eligible for a retro MA month, the person must: • Meet all financial and nonfinancial eligibility factors in that month, and