How to Change Your Michigan Medicaid Plan: Timing and Steps

To change your Michigan Medicaid health plan, call Michigan ENROLLS at 1-888-367-6557 or log in at healthcare4mi.com. You can switch for any reason within your first 90 days on a plan, again during your annual open enrollment month, or at any time if you have a qualifying life event. Outside those windows, you’re locked in.1Michigan ENROLLS. Frequently Asked Questions

When You’re Allowed to Switch

Your First 90 Days

When you first enroll in a Medicaid health plan, you have 90 days to change to a different plan for any reason. This applies whether you picked the plan yourself or the state auto-assigned you one because you didn’t choose within about 22 to 28 days of becoming eligible. Being auto-assigned doesn’t shorten your window. You still get the full 90 days from your effective date.1Michigan ENROLLS. Frequently Asked Questions2State of Michigan. FOM 805 – Glossary of Terms

Your Annual Open Enrollment Month

Once the 90 days close, your next opportunity is your annual open enrollment month. Your month is set by the last digit of your case number. Case number ending in 9? Your open enrollment is September. A reminder letter arrives the month before.1Michigan ENROLLS. Frequently Asked Questions

Qualifying Life Events

Certain changes open a special window outside the regular periods. Common ones include getting married or divorced, having or adopting a child, moving to a new county or service area, and losing other health coverage. Have documentation ready when you call, such as proof of a new address or a birth certificate.3HealthCare.gov. Qualifying Life Event (QLE)

How to Request the Change

By Phone

Call Michigan ENROLLS at 1-888-367-6557. TTY users can call 1-888-263-5897. Have your Medicaid ID number, date of birth, and the name of the plan you want ready. If you haven’t decided, the representative can walk you through what’s available in your county.4State of Michigan. Hotlines

Online

Log in at healthcare4mi.com and use the Michigan ENROLLS portal to change plans.5Michigan ENROLLS. Michigan ENROLLS Note that MI Bridges is a different system: it handles applications and case updates like a new address or income change, not health plan switches.

In Person

Your local MDHHS county office can help face-to-face. Find yours through the MDHHS County Offices page at michigan.gov. Community navigators and enrollment assistors also offer free help with plan changes.6State of Michigan. County Offices

Check the New Plan Before You Call

The most common mistake is switching without checking whether the new plan actually covers your doctor and your prescriptions. Spend a few minutes on this. It’s easier than reversing course later.

Provider Networks

The biggest practical difference between plans is which doctors, specialists, and hospitals are in-network. Michigan ENROLLS can confirm whether a specific provider or facility participates in a given plan. Ask before you commit.7Department of Health and Human Services. Beneficiary Support – Section: Important Phone Numbers

Prescription Coverage

All Michigan Medicaid health plans share a common formulary maintained by MDHHS, most recently updated for dates of service on or after February 1, 2026. If your drug is on the common formulary, every plan covers it. For drugs not on the common formulary but on the Michigan Pharmaceutical Product List, your provider can request prior authorization. You can search the Michigan Preferred Drug List at mi.primetherapeutics.com to check specific medications.8State of Michigan: MDHHS. State of Michigan Medicaid Health Plan Common Formulary

Plan Ratings

MDHHS publishes a guide to Michigan Medicaid health plans with ratings across five performance categories, HEDIS results, and the Michigan Consumer Assessment of Health Plans Survey, which reflects how members rate their plan. All are on the MDHHS Medicaid Health Plans page.9State of Michigan: MDHHS. Medicaid Health Plans

What Happens After You Switch

You’ll get a confirmation letter by mail with your new plan’s effective date. Your new plan will send new ID cards. Keep your old cards until the new ones arrive and coverage is active.

If You’re in the Middle of Treatment

Michigan has continuity-of-care protections so a plan change doesn’t cut off ongoing care. Under MI Health Link guidance, your new plan must generally let you keep seeing your current providers for at least 90 days after enrollment, even if they’re out-of-network for the new plan. For members receiving specialty behavioral health services or habilitation supports, the minimum is 180 days.10State of Michigan: MDHHS. MI Health Link Continuity of Care Guidance

Specific treatments get more protection. Scheduled surgeries authorized within 180 days before enrollment must be honored. Chemotherapy and radiation already underway must be covered through the full course with the same provider. Dialysis patients keep their provider and service level for at least 180 days. Organ and bone marrow transplant plans of care carry over entirely.10State of Michigan: MDHHS. MI Health Link Continuity of Care Guidance

One catch: for these protections to apply to a specialist, you need to have seen that specialist at least once in the 12 months before your enrollment date. If it’s been longer, the new plan isn’t required to treat them as an existing provider. Worth keeping in mind if you’re timing a switch around upcoming care.

Getting Records Moved

Your new plan won’t automatically have your medical history. Contact your current providers and ask them to send records to your new primary care doctor and any specialists. Doing this before the new coverage kicks in avoids scrambling over prescription refills or referrals later.

If Your Request Is Denied

If your plan change is denied, or your new plan denies a service you expected to be covered, you can appeal. You have 60 calendar days from the denial notice to file an internal appeal with the health plan, orally or in writing. Standard appeals must be resolved within 30 calendar days; expedited appeals, for situations where your health is at risk from waiting, within 72 hours.11State of Michigan. Appeals and Grievances Technical Requirements P-6-3-1-1

If the denial reduces or stops services you were already receiving, you can ask for benefits to continue during the appeal. Request continuation within 10 calendar days of the denial notice or before the reduction was set to take effect, whichever is later.11State of Michigan. Appeals and Grievances Technical Requirements P-6-3-1-1

If the internal appeal doesn’t go your way, you can request a State Fair Hearing through the Michigan Administrative Hearing System using form MDHHS-5617-MAHS. You have to finish the internal appeal first, unless the plan missed its decision deadline. To keep benefits running through the hearing, MAHS must receive your request within 10 calendar days of the appeal decision.12State of Michigan. Request for Hearing for Medicaid Enrollees or Waiver Applicants

Quick Contacts