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BEM 168 10 of 17 MI COORDINATED HEALTH (MICH) BPB 2026-005 2-1-2026

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

FINANCIAL ELIGIBILITY FACTORS Use special MA policies in the MA eligibility determination: • A waiver participant is a group of one even when he/she lives with a spouse; see BEM 211. • The Special MA Asset Rules in BEM 402 apply when completing the Initial Asset Assessment; see special initial asset assessment rules for waiver applicants in this item for rules on determining the first period of continuous care. • The extended-care category is available to waiver participants; see BEM 164. • Gross income must be at or below 300 percent of the SSI Federal Benefit Rate. An individual cannot spenddown income to waiver eligibility; see BEM 500. A waiver participant may no longer qualify for waiver services; however, they may still qualify for MA. Note: An ex parte review (see glossary) is required before Medicaid closures when there is an actual or anticipated change unless the change would result in closure due to ineligibility for all Medicaid. When possible, an ex parte review should begin at least 90 days before the anticipated change is expected to result in case closure. The review includes consideration of all MA categories; see BAM 115 and 220. Initial Asset Assessment for 1915 (C) Waiver Applicants An Initial Asset Assessment (IAA) may be needed for potential Waiver participants with a spouse. The IAA is used to protect a certain amount of the couple’s combined resources for the community spouse. It does not determine the start of Medicaid eligibility. Use policy in BEM 402 to determine if an IAA is appropriate. An IAA uses a first day of continuous care; see BEM 402 for definition. The first period of continuous care is a period of at least