New Program: Creating MIChild, to provide coverage for children under age 19 living in families at or below 200% of the fpl.

NOTE: After approval of plan by HCFA, the Michigan legislature and governor approved an amendment in their SCHIP program that will:


• expand Medicaid eligibility for children up to 150% fpl
  
• provide MIChild coverage for children 150-200% fpl.

This amendment will need to be approved by HCFA

Mental Health Benefits

All services must be determined to be medically necessary and provided through a managed care environment. Mental health services are covered when arranged through a community mental health service program (CMHSP).

Inpatient: up to 365 days per benefit year
Outpatient: covered for physician diagnosis, evaluation, or treatment when arranged through a CMHSP.
Inpatient Substance Abuse: covered when medically necessary as determined by a Substance Abuse Coordinating Agency as appropriate for the diagnosis.
Outpatient Substance Abuse: covered for physician diagnosis, evaluation, or treatment when arranged through a CMHSP or Substance Abuse Coordinating Agency as appropriate for the diagnosis.
Wrap-around Services: Alternative treatment as deemed medically appropriate by the community mental health service program. Case management and coordination services through the community mental health services program.
Prescription Drugs: $1 copay; also covers laboratory/diagnostic tests related to mental health
Children with Special Health Care Needs (CSHCN)Children’s Special Health Care Services (Title V) Coordination- CSHCN without other insurance will have a choice of enrolling in MIChild, CSHCN managed care program with optional supplemental primary coverage, or the fee for service CSHCN program for specialty care only.