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BAM 115 8 of 36 APPLICATION PROCESSING BPB 2026-003 2-1-2026

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

At Initial Application All Programs A separate application is required for each group. Exception: Only one application form is required when MA groups, even with separate case numbers, live together such as spouses applying for different MA categories. An application may be photocopied or cross referenced for multiple case files. An application form is generally valid for 12 months from the date eligibility is initially certified in Bridges. Exception: For FAP, the period might be fewer or more than 12 months; see Benefit Periods under eligibility decisions in this item. MA Only A separate application is required for anyone not in the home, such as one spouse at home and the other in long term care (LTC). FAP Only A FAP group might be ineligible in the month of application but eligible for a future month due to changes in circumstance: • Use the same MDHHS-1171 and MDHHS-1171-FAP, to deny eligibility for the application month and to determine eligibility for later months. • It is not necessary to interview the FAP group again, but Bridges will request any additional needed verification. • Do not deny and re-register the application in Bridges. Certifying approval for the next month disposes of the registration. At Program Transfer All Programs When recipients request benefits, they are not currently receiving, use the MDHHS-1171 or DCH-1426 on file if it was approved within the last 12 months.

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Page 8

Official source

BAM 115 8 of 36 APPLICATION PROCESSING BPB 2026-003 2-1-2026

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

At Initial Application All Programs A separate application is required for each group. Exception: Only one application form is required when MA groups, even with separate case numbers, live together such as spouses applying for different MA categories. An application may be photocopied or cross referenced for multiple case files. An application form is generally valid for 12 months from the date eligibility is initially certified in Bridges. Exception: For FAP, the period might be fewer or more than 12 months; see Benefit Periods under eligibility decisions in this item. MA Only A separate application is required for anyone not in the home, such as one spouse at home and the other in long term care (LTC). FAP Only A FAP group might be ineligible in the month of application but eligible for a future month due to changes in circumstance: • Use the same MDHHS-1171 and MDHHS-1171-FAP, to deny eligibility for the application month and to determine eligibility for later months. • It is not necessary to interview the FAP group again, but Bridges will request any additional needed verification. • Do not deny and re-register the application in Bridges. Certifying approval for the next month disposes of the registration. At Program Transfer All Programs When recipients request benefits, they are not currently receiving, use the MDHHS-1171 or DCH-1426 on file if it was approved within the last 12 months.