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CLAIMS FOR WAIVER SERVICES AND SUPPORTIVE LIVING FACILITIES Atypical providers, excluding Home Health, and supportive living facilities will be required to submit claims to Michigan Complete Health on a CMS 1500 form. This can be done through our secure provider portal or via submission of paper claims.
FAX REQUEST FOR HARD COPIES TO: 517-241-1164 or mail: MDHHS Forms Request 320 S.
A Michigan Medicaid prior authorization form requests Medicaid coverage for a non-preferred drug prescription in the state of Michigan. In this form, the physician provides their clinical reasoning for making this request instead of prescribing a drug from the Preferred Drug List (PDL).
Income Asset Limits for Eligibility 2023 Michigan Medicaid Long-Term Care Eligibility for SeniorsType of MedicaidSingleInstitutional / Nursing Home Medicaid$2,742 / month*$2,000Medicaid Waivers / Home and Community Based Services$2,742 / month$2,000Regular Medicaid / Aged Blind and Disabled$1,215 / month$2,0001 more row 25-Jan-2023
 Medicaid covers medically necessary durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) for beneficiaries of all ages.
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Beneficiaries need to call the Beneficiary Help Line at 1-800-642-3195 to request a card replacement. Or they can request a replacement card using the myHealthButton and the myHealthPortal . Go to the following website at .michigan.gov/myHealthPortal for more information.
How do I cancel my Medicaid in Michigan? You can call Michigan ENROLLS at 888.367. 6557 (TTY 771) to cancel your Michigan Medicaid.
Phone: beneficiaries can complete a renewal by phone through the Phone Renewal Help Line at 833-599-6444, TTY 866-501-5656.

msa homehelpproviders michigan gov