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BAM 210 8 of 25 REDETERMINATION/EX PARTE REVIEW BPB 2026-016 7-1-2026

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

at the client’s home or another agreed upon location. Hardship conditions include but are not limited to illness, transportation difficulties, work hours, etc. SCHEDULING All Programs Bridges generates a redetermination packet to the client on the fourth day of the month before the redetermination is due. The packet is sent to the mailing address in Bridges. The packet is sent to the physical address when there is no mailing address. The packet is also sent to the MA authorized representative on file. Redetermination/renewal forms may include: • MDHHS-1010, Redetermination (all programs) and program specific supplement form(s): • MDHHS-1010-CASH- Cash Assistance. • MDHHS-1010-CDC- Child Development and Care. • MDHHS-1010-FAP-Food Assistance. • MDHHS-1010-HC- Health Care Coverage. • MDHHS-1046, Semi-Annual Contact Report (FAP). • MDHHS-1171, Assistance Application and program specific supplement form(s). • MDHHS-1171-Cash, Supplement- Cash Assistance. • MDHHS-1171-CDC, Supplement- Child Development and Care. • MDHHS-1171-HCC, Supplement- Health Care Coverage. • MDHHS-1171-FAP, Supplement- Food Assistance Program. • MDHHS-2240-A, Mid-Certification Contact Notice (MA and FAP). • DCH-1426, Application for Health Coverage and Help Paying Costs. • OMB 0938-1213, A federal application for Health Coverage and Help Paying Costs.

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Official source

BAM 210 8 of 25 REDETERMINATION/EX PARTE REVIEW BPB 2026-016 7-1-2026

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

at the client’s home or another agreed upon location. Hardship conditions include but are not limited to illness, transportation difficulties, work hours, etc. SCHEDULING All Programs Bridges generates a redetermination packet to the client on the fourth day of the month before the redetermination is due. The packet is sent to the mailing address in Bridges. The packet is sent to the physical address when there is no mailing address. The packet is also sent to the MA authorized representative on file. Redetermination/renewal forms may include: • MDHHS-1010, Redetermination (all programs) and program specific supplement form(s): • MDHHS-1010-CASH- Cash Assistance. • MDHHS-1010-CDC- Child Development and Care. • MDHHS-1010-FAP-Food Assistance. • MDHHS-1010-HC- Health Care Coverage. • MDHHS-1046, Semi-Annual Contact Report (FAP). • MDHHS-1171, Assistance Application and program specific supplement form(s). • MDHHS-1171-Cash, Supplement- Cash Assistance. • MDHHS-1171-CDC, Supplement- Child Development and Care. • MDHHS-1171-HCC, Supplement- Health Care Coverage. • MDHHS-1171-FAP, Supplement- Food Assistance Program. • MDHHS-2240-A, Mid-Certification Contact Notice (MA and FAP). • DCH-1426, Application for Health Coverage and Help Paying Costs. • OMB 0938-1213, A federal application for Health Coverage and Help Paying Costs.