Page 6

BEM 168 6 of 17 MI COORDINATED HEALTH (MICH) BPB 2026-005 2-1-2026

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

Note: The MI Coordinated Health Waiver is not an MA category, but there are special eligibility rules for people approved for the waiver; see Financial Eligibility Factors in this item. 1915 (C) WAIVER ADMINISTRATION MI Coordinated Health administers the HCBS Waiver through contracts with Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP). 1915 (C) Waiver Eligibility To be eligible for the MI Coordinated Health HCBS waiver, an individual must do all of the following: • Be enrolled in the MI Coordinated Health program. • Meet nursing facility level of care as determined by Michigan's Medicaid Nursing Facility Level of Care Determination tool. • Have a need for one or more of the Waiver services listed in the MI Coordinated Health waiver application. Enrollees must receive at least one waiver service each month to remain enrolled in the MI Health Link HCBS Waiver. 1915(C) Waiver Enrollment Process The HCBS waiver enrollment process includes: Assessment HDE and/or the HDE’s contracted vendor are responsible for completing an assessment to verify a member’s medical and functional eligibility for the Waiver. Once all Waiver enrollment materials are complete, the HDE must enter the HCBS Waiver enrollment in CHAMPS and upload an enrollment packet for MDHHS to review. Additionally, HDEs must complete new Waiver assessments and submit to MDHHS at least annually. The MDHHS local office is still responsible for financial eligibility determination.

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Page 6

Official source

BEM 168 6 of 17 MI COORDINATED HEALTH (MICH) BPB 2026-005 2-1-2026

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

Note: The MI Coordinated Health Waiver is not an MA category, but there are special eligibility rules for people approved for the waiver; see Financial Eligibility Factors in this item. 1915 (C) WAIVER ADMINISTRATION MI Coordinated Health administers the HCBS Waiver through contracts with Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP). 1915 (C) Waiver Eligibility To be eligible for the MI Coordinated Health HCBS waiver, an individual must do all of the following: • Be enrolled in the MI Coordinated Health program. • Meet nursing facility level of care as determined by Michigan's Medicaid Nursing Facility Level of Care Determination tool. • Have a need for one or more of the Waiver services listed in the MI Coordinated Health waiver application. Enrollees must receive at least one waiver service each month to remain enrolled in the MI Health Link HCBS Waiver. 1915(C) Waiver Enrollment Process The HCBS waiver enrollment process includes: Assessment HDE and/or the HDE’s contracted vendor are responsible for completing an assessment to verify a member’s medical and functional eligibility for the Waiver. Once all Waiver enrollment materials are complete, the HDE must enter the HCBS Waiver enrollment in CHAMPS and upload an enrollment packet for MDHHS to review. Additionally, HDEs must complete new Waiver assessments and submit to MDHHS at least annually. The MDHHS local office is still responsible for financial eligibility determination.