Michigan medicaid 2026

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  1. Click ‘Get Form’ to open the Michigan Medicaid Request for Hearing form in the editor.
  2. In Section 1, enter your full name, telephone number, Social Security number, and address. Ensure all details are accurate as they will be used for identification.
  3. Provide your Medicaid ID number and sign the form. If you have a legal guardian, they should also sign on your behalf.
  4. In Section 2, indicate if you have chosen someone to represent you at the hearing. If yes, ensure they complete Section 3 with their information.
  5. Complete Section 4 by providing details about the agency involved in the action being disputed. This includes the agency's name and contact information.
  6. Attach any necessary documents, such as a copy of the notice from the agency regarding their decision. Review all sections for completeness before submission.

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Your states Medicaid contact information: Michigan.gov/MIBridges. Your states Medicaid phone number: 888-367-6557.
For most states, the Medicaid income limit is $2,901 per month for a single applicant and $5,802 per month for married applicants, typically set at 300% of the Federal Benefit Rate (FBR).
In Michigan, these programs pay for Medicare Part B premiums, Medicare Part A and B cost-sharing, and in some cases Part A premiums. Qualified Medicare Beneficiary (QMB): The income limit is $1,235 a month if single and $1,663 a month if married.

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