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

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

The PIHPs are responsible for managing Medicaid Specialty Services and Supports in specified geographic regions, under contract with the Michigan Department of Health and Human Services (MDHHS) consistent with the Michigan Mental Health Code (MMHC). The MICH and PIHPs coordinate and manage care for jointly served enrollees. ELIGIBILITY MI Coordinated Health (MICH) is a Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP) for Michigan residents that: • Age 21 or older at the time of enrollment including individuals age 21 and older served by the Children’s Specialized Health Care Services (CSHCS) program. • Are enrolled in both Medicare and Medicaid. Entitled to Medicare Part A, Medicare Part B, and Medicare Part D. • Receiving full Medicaid benefits (this includes individuals who are eligible for Medicaid through expanded financial eligibility limits under a 1915(c) waiver or who reside in a Nursing Facility, including those who have a monthly Patient Pay Amount). • Do not live in a state-operated veteran’s home. • Are not currently enrolled in hospice care. • Live in Michigan in the following regions/counties: Region 1: Upper Peninsula (except Chippewa, Gogebic, and Menominee). Region 8: Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, St. Joseph, Van Buren. Region 10: Macomb. Region 12: Wayne. • It is allowable for an Enrollee residing in a MI Coordinated Health region to be admitted to a Nursing Facility outside the HIDE-SNP region for a service that cannot be obtained in the HIDE-SNP region (and replacement is not based on the family