Michigan Health Insurance for a Grandchild in Kinship Care

Two Programs, One Application

Michigan has two main health coverage programs for children under 19: Healthy Kids (Medicaid) and MIChild (the state's CHIP program). Both are applied for through MI Bridges, and MDHHS determines which program the child qualifies for based on household income.

Under federal MAGI household rules, if the child's biological parents don't live in your home, their income is excluded from the calculation. MDHHS evaluates eligibility using the child's MAGI household under the applicable tax and caretaker rules.

Income Thresholds

Healthy Kids (Medicaid): Children from birth through age 18 in households at or below 195% of the federal poverty level. A 5% FPL disregard pushes the effective limit to about 200% FPL. Zero premiums, zero co-pays, full medical, dental, and vision coverage.

MIChild: Children under 19 in households between 195% and 212% FPL (effectively up to ~217% FPL with the disregard). The family pays a flat $10 per month premium total, regardless of how many children are covered. No co-pays for covered services.

For a household of two (grandparent and one grandchild), 200% FPL is roughly $3,606 per month. A household of three pushes that to about $4,554. Many grandparents on Social Security fall comfortably within these thresholds.

Automatic Enrollment Through FIP

If you've applied for the child-only FIP cash grant and been approved, the child is automatically enrolled in Medicaid. No separate health coverage application is needed. This is one of the strongest reasons to apply for FIP first — even if the monthly cash amount is modest, it triggers comprehensive health coverage with no additional paperwork.

Children receiving Title IV-E Guardianship Assistance (GAP) payments are also categorically eligible for Medicaid through the end of the assistance period.

What's Covered

Healthy Kids Medicaid provides:

• Primary care through a Managed Care Organization (MCO) — you'll choose or be assigned an MCO and a primary care provider
• Mental health services through Community Mental Health (CMH) agencies
• Dental care through Healthy Kids Dental
• Vision exams and glasses
• Prescriptions
• Hospital and emergency care
• Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) for children, which requires the state to cover any medically necessary service even if it isn't on the standard adult Medicaid list

For children in kinship care who have experienced trauma — and many have, given the circumstances that lead to relative placements — the mental health coverage through CMH is particularly important. It covers counseling, behavioral health services, and psychiatric evaluation without a separate application or additional cost.

Medical Consent Without Custody

Having Medicaid coverage doesn't automatically mean a doctor will treat the child at your request. Providers need proof that you have authority to consent to medical care. A court guardianship order (under MCL 700.5215) or an executed power of attorney (under MCL 700.5103) gives you that authority.

For routine care, some providers will accept a PA 113 Temporary Authorization for Kinship Care form, which doesn't require court involvement. For more complex situations — surgery, psychiatric medication, or hospitalization — most facilities want a guardianship order or power of attorney.

If you're in an emergency situation, Michigan law allows providers to treat a child without consent when delay would endanger the child's life or health.

12-Month Continuous Eligibility

Once a child is approved for Healthy Kids Medicaid, coverage runs for 12 continuous months. Minor changes in household income during that year don't trigger a mid-year cancellation. The child stays covered until the annual redetermination date, unless they move out of state or turn 19.

At redetermination, MDHHS first tries to verify eligibility automatically using state databases — wage records from the Unemployment Insurance Agency, Social Security Administration data. If the electronic check confirms eligibility, coverage renews without you doing anything. You'll receive a notice confirming the renewal.

If automated verification fails, MDHHS sends a renewal form with a 30-day response window. Missing this deadline can result in coverage ending — but there's a 90-day reconsideration window where you can submit the missing documents and have coverage reinstated retroactively without filing a brand new application.

Retroactive Coverage

Medicaid in Michigan can be applied retroactively for up to 3 calendar months before the application month. If a grandchild arrived in your care in July and you didn't apply until October, MDHHS can cover medical bills incurred in July, August, and September if the child was eligible during those months.

This is worth knowing if you delayed applying because you didn't realize the child was eligible. Save any medical bills from before the application date and ask the caseworker about retroactive coverage when the application is processed.

Coverage for the Caregiver

The Healthy Michigan Plan covers low-income adults aged 19-64 at incomes up to 133% FPL (effectively 138% with the federal disregard). If you're a grandparent under 65 without other health insurance, you may qualify alongside the child's coverage. Adults over 65 are covered through Medicare, and adding a grandchild to your household doesn't affect your Medicare enrollment.

The Financial Help for Grandparents and Relatives Raising a Child in Michigan guide walks through health coverage alongside every other Michigan benefit — with a document tracker to keep redetermination deadlines and renewal dates in one place.

See more Michigan guides →