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BEM 131 1 of 3 HEALTHY KIDS BPB 2022-001 1-1-2022

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

DEPARTMENT POLICY Medicaid (MA) Only Other Healthy Kids (OHK) and the Healthy Kids Expansion (HKE) are two programs in the MAGI U-19 Medicaid category. OHK and HKE are available to children under the age of 19 whose household income does not exceed 160 percent of the Federal Poverty Level (FPL). Both programs are defined by age, household income, and whether the child has other comprehensive insurance. The MAGI U-19 income limits for Other Healthy Kids and the Healthy Kids Expansion are: Program Age Income (% of FPL) Has other comprehensive insurance? MAGI U-19 OHK >=1 and <=5 >54% and <144% N/A

>=1 and <=5 >=144% and <=160% Yes

>=6 and <=18 >54% and <110% N/A

>=6 and <=18 >=110% and <=160% Yes MAGI U-19 HKE >=1 and <=5 >=144% and <=160% No

>=6 and <=18 >=110% and <=160% No

All eligibility factors must be met in the calendar month being tested. However, only certain eligibility factors apply before annual renewal. If the month being tested is a Long-Term Care or Hospital (L/H) month and eligibility exists, go to BEM 546 to determine the post- eligibility patient-pay amount.

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Official source

BEM 131 1 of 3 HEALTHY KIDS BPB 2022-001 1-1-2022

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

DEPARTMENT POLICY Medicaid (MA) Only Other Healthy Kids (OHK) and the Healthy Kids Expansion (HKE) are two programs in the MAGI U-19 Medicaid category. OHK and HKE are available to children under the age of 19 whose household income does not exceed 160 percent of the Federal Poverty Level (FPL). Both programs are defined by age, household income, and whether the child has other comprehensive insurance. The MAGI U-19 income limits for Other Healthy Kids and the Healthy Kids Expansion are: Program Age Income (% of FPL) Has other comprehensive insurance? MAGI U-19 OHK >=1 and <=5 >54% and <144% N/A

>=1 and <=5 >=144% and <=160% Yes

>=6 and <=18 >54% and <110% N/A

>=6 and <=18 >=110% and <=160% Yes MAGI U-19 HKE >=1 and <=5 >=144% and <=160% No

>=6 and <=18 >=110% and <=160% No

All eligibility factors must be met in the calendar month being tested. However, only certain eligibility factors apply before annual renewal. If the month being tested is a Long-Term Care or Hospital (L/H) month and eligibility exists, go to BEM 546 to determine the post- eligibility patient-pay amount.