Michigan Medicaid Income Guidelines

[Candela, Kathryn]

Hello everyone,

 

I am reaching out to the group with a question related to Medicaid eligibility. I have a patient here at the cancer center who apparently had qualified for Medicaid but recently has lost that benefit. This patient is a single mom who has two of her three children living with her: a 19 y/o and an 11 y/o.  She completely supports both of them, as her 19 y/o is still in high school. The mom collects Social Security survivor benefits for herself and the youngest child, receiving $3,027/month. When she completed the application for Medicaid, she reported a household size of 3; she does still claim her 19 y/o on her taxes. Recently, when she lost her Medicaid, she was told that her household size is not a family of 3, that she cannot include her 19 y/o as part of her household.

 

I would appreciate any insight this group might be able to provide. I am routinely helping our patients apply for Medicaid and thought I understood how to determine the family/household size, but there must be something I am not understanding. Also, if anyone has a copy of the Michigan Medicaid Income Guidelines for 2026, I would appreciate having a copy of that.

 

Thank you all, in advance, for any feedback you may have.

 

Kathryn

 

Kathryn Candela, LMSW

Clinical Oncology Social Worker

Karmanos Cancer Institute at McLaren Macomb

1080 Harrington St.

Mt. Clemens, MI 48043

 

Office: 586.493.7506

  Cell:  586.610.7433

Email:  Kathryn...@mclaren.org

 

McLaren confidentiality statement: "The information contained in this communication, including attachments, is confidential, may be privileged, and is intended only for the use of the named recipient(s). Unauthorized use, disclosure, forwarding or copying is strictly prohibited and may be unlawful. If you have received this communication in error, please notify me IMMEDIATELY at the phone number or pager listed above."

[Karen Kierpaul]

Kathryn - 

Michigan Medicaid guidelines only allow for children to age 18 - that is what lowered the family size of 3 down to 2 people.

Good luck - lots of good reading resources below.

SEE info below:

For 2026, Michigan Medicaid eligibility generally requires a household income at or below 138% of the Federal Poverty Level (FPL) for adults (approx. $21,597/year for an individual), or up to 217% FPL for children. Long-term care applicants (nursing home/waiver) must meet a 2026 income limit of $2,982/month. 

Key 2026 Michigan Medicaid Income Guidelines

• Healthy Michigan Plan (Adults 19-64): Income at or below 133%-138% of FPL.
• Children (18 or younger): Income at or below 217% of FPL.
• Pregnant Women: Income at or below 200% of FPL.
• Long-Term Care/HCBS Waivers: The 2026 income limit is $2,982 per month for the applicant.
• Asset Limit (Long-Term Care): A 60-month "look-back" period is enforced for asset transfers.
• Medicaid Work/Community Rules: Changes may require verifying income and working, volunteering, or caregiving, though specific implementation dates for 2026 are subject to, or pending, federal guidance. 

For the most accurate eligibility determination, visit the Michigan Department of Health and Human Services (MDHHS) website or use the MI Bridges portal. 

https://www.healthinsurance.org/medicaid/michigan/#:~:text=Call%20the%20application%20help%20line,of%20FPL.%20Children%20ages%201%2D18

https://www.davidwaterstradt.com/understanding-medicaid-planning-in-michigan-for-2026#:~:text=To%20qualify%20for%20Medicaid%20in,vary%20and%20change%20over%20time.

Medicaid - Health Care Programs Eligibility

State of Michigan (.gov)

https://www.michigan.gov › mdhhs › assistance-programs

Click here to learn more about the Health Care programs available in Michigan.

Michigan Medicaid Eligibility: 2026 Income & Asset Limits

Medicaid Planning Assistance

https://www.medicaidplanningassistance.org › medicaid...

Dec 19, 2025 — In 2026, a single Nursing Home Medicaid applicant in Michigan is eligible if they meet the following criteria: 1) Income under $2,982 / month 2) ...Read more

2026 Medicaid Income Limits by State: Eligibility Chart & ...

Jarvis Law Office

https://jarvisfirm.com › Blogs

Medicaid Eligibility Chart 2026 ; Michigan, Medicaid Waivers / HCBS, $2,982 / month ; Michigan, Regular Medicaid / Aged, Blind & Disabled, $1,305 / month (eff. 4/ ...Read more

Federal Poverty Levels

Washtenaw Health Project

https://washtenawhealthproject.org › federal-poverty-le...

2025 Federal Poverty Levels for most programs are effective April 1, 2025–March 31, 2026. Download PDF here. Qualifying Income Levels for Healthy Michigan Plan ...Read more

Federal Poverty Guidelines

State of Michigan (.gov)

https://www.michigan.gov › CancerDocuments

PDF

The 2026 poverty guidelines and calculation of. 250% of poverty levels used ... Medicaid Eligible. 1. $15,960.00. $39,900.00. $22,025.00. 2. $21,640.00. 

https://mi.db101.org/mi/programs/health_coverage/how_health/program2.htm#:~:text=Is%20Your%20Income%20Low%20Enough,counted%20as%20a%20family%20member.

https://www.healthinsurance.org/medicaid/michigan/#:~:text=217%25%20of%20the%20federal%20poverty,for%20adults%20under%20age%2065

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