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BEM 137 2 of 3 HEALTHY MICHIGAN PLAN BPB 2024- wrk001BPB 2024-001 1-1-2024

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

visits, and non-emergency visits to the emergency department for beneficiaries age 21 years and older. Health Risk Assessment The Michigan Department of Health and Human Services (MDHHS) has developed a Healthy Michigan Plan Health Risk Assessment that encompasses a broad range of health issues and behaviors including, but not limited to: • Physical activity. • Nutrition. • Alcohol, tobacco, and substance use. • Mental health. • Influenza vaccination. • Chronic conditions. • Recommended cancer or other preventative screenings. The DCH-1315, Health Risk Assessment form, is available through the health plans or at www.michigan.gov/Assistance Programs/Health Care Coverage/ Healthy Michigan Plan. NONFINANCIAL ELIGIBILITY FACTORS The Medicaid eligibility factors in the following items must be met. • BEM 220, Residence. • BEM 221, Identity. • BEM 223, Social Security Numbers. • BEM 225, Citizenship/Alien Status. • BEM 255, Child Support. • BEM 256, Spousal/Parental Support. • BEM 257, Third Party Resource Liability. • BEM 265, Institutional Status. • BEM 270, Pursuit of Benefits. Credible Coverage Parents requesting health care coverage for themselves must provide proof that their children have credible coverage, even if not applying for the children.

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Official source

BEM 137 2 of 3 HEALTHY MICHIGAN PLAN BPB 2024- wrk001BPB 2024-001 1-1-2024

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

visits, and non-emergency visits to the emergency department for beneficiaries age 21 years and older. Health Risk Assessment The Michigan Department of Health and Human Services (MDHHS) has developed a Healthy Michigan Plan Health Risk Assessment that encompasses a broad range of health issues and behaviors including, but not limited to: • Physical activity. • Nutrition. • Alcohol, tobacco, and substance use. • Mental health. • Influenza vaccination. • Chronic conditions. • Recommended cancer or other preventative screenings. The DCH-1315, Health Risk Assessment form, is available through the health plans or at www.michigan.gov/Assistance Programs/Health Care Coverage/ Healthy Michigan Plan. NONFINANCIAL ELIGIBILITY FACTORS The Medicaid eligibility factors in the following items must be met. • BEM 220, Residence. • BEM 221, Identity. • BEM 223, Social Security Numbers. • BEM 225, Citizenship/Alien Status. • BEM 255, Child Support. • BEM 256, Spousal/Parental Support. • BEM 257, Third Party Resource Liability. • BEM 265, Institutional Status. • BEM 270, Pursuit of Benefits. Credible Coverage Parents requesting health care coverage for themselves must provide proof that their children have credible coverage, even if not applying for the children.