Changes in Healthcare Coverage for people who have both Medicaid and Medicare – “Dual Eligibles”
The Michigan Department of Community Health (MDCH) is developing a demonstration to strengthen services and supports for individuals who are dually eligible for Medicare and Medicaid. In the demonstration, services and supports for persons who are dually eligible will be delivered by newly created Integrated Care Organizations (ICOs) and currently existing Prepaid Inpatient Health Plans (PIHPs). ICOs will be responsible for the provision of all physical health, long term care, and pharmacy services, while PIHPs will be expected to cover behavioral health and habilitative services for people with developmental disabilities, mental illness, or substance use issues. The ICOs and PIHPs will be connected through the Care Bridge, a care model that requires the coordination of services and supports between the two entities and involved providers.
MDCH is hosting a series of public forums to share information about the status of the project, as well as receive feedback on the implementation process from dually eligible individuals, their families, providers, and other interested organizations. These forums will be organized on a quarterly basis and will be rotated amongst the four regions throughout the demonstration period. Information on the forums and other updates may be found at: http://www.michigan.gov/mihealthlink.
- MDCH Webpage for updated information on Integrated Care for People Eligible for Medicare and Medicaid – http://www.michigan.gov/mihealthlink
- Letter to Consumers, Family Members, Guardians and other Stakeholders – February 13, 2012
- Dual Eligibility Flowchart to help you determine if this information applies to you
- For more details and information on the state planning see: Michigan Association of CMH Boards’ Changes in Healthcare Coverage for people who have both Medicaid and Medicare.