To apply for the Healthy Michigan Plan, you fill out the MDHHS-1171 Assistance Application: complete the general household section first, then work through the Healthcare Coverage program details that start around page 13, attach proof of identity, residency, citizenship, and income, and submit the packet online through MI Bridges, by mail, by fax, or in person at a local Michigan Department of Health and Human Services office. The state then has up to 45 days to decide.1eCFR. 42 CFR 435.912 – Timely Determination and Redetermination of Eligibility Below is a walk-through of what each part of the form asks for, what to have on hand before you start, and what happens once you send it in.
Before You Open the Form
The MDHHS-1171 is the single application Michigan uses for several benefit programs, including healthcare, food assistance, cash assistance, child care, and emergency relief. You do not fill out every page. The form routes you through a general household section first, then sends you to “Program Details” for the specific benefits you want. For the Healthy Michigan Plan, that means the main application plus the Healthcare Coverage program details.2Michigan Department of Health and Human Services. MDHHS-1171 Assistance Application and Program Supplements
One scheduling note worth knowing up front: if you are applying only for healthcare coverage, you do not need to schedule an interview with an MDHHS specialist. That requirement applies to other benefit programs.2Michigan Department of Health and Human Services. MDHHS-1171 Assistance Application and Program Supplements
Documents to Gather First
Pull these together before you start writing. A missing document is the most common reason a case stalls during the review period.
- Social Security numbers for every household member listed on the application.
- Proof of Michigan residency, such as a state ID, driver’s license, or utility bill showing your current address.
- Proof of citizenship or immigration status: a U.S. passport, birth certificate, or immigration documents such as a Permanent Resident Card.
- Income records: recent pay stubs, W-2 forms, or your most recent federal tax return. If your income varies from month to month, you’ll be asked for an estimate for this year and next year.
- Employer information: names and addresses for any current employers. The state uses this to check whether you have access to job-based insurance.
- Existing insurance details: policy numbers and coverage type for any health insurance you currently carry. Medicaid is the payer of last resort, so other coverage has to be disclosed.3Michigan Department of Health and Human Services. Other Insurance
- Unpaid medical bills from the past three months, if any. These support a request for retroactive coverage.
Filling Out the Household Section
The first several pages of the MDHHS-1171 are about who lives with you and how you’re related. At the top, mark your language preference. Then work through each person in the household one at a time: legal name, date of birth, Social Security number, and relationship to you.
Accuracy here matters more than speed. The household you describe on this page is the household the state uses to count income later, so put down the people you actually live with and claim on your taxes the way you really file. If someone in the home is not applying for benefits themselves, they still get listed; the form will later ask whether their income counts.
Filling Out the Healthcare Coverage Program Details
This section, starting around page 13, is where eligibility is actually decided. Work through it in order and answer every prompt, even the ones that seem not to apply.
Group Details
You’ll be asked whether anyone in the household is American Indian or Alaska Native, which affects cost-sharing exemptions; whether anyone has a health condition that limits daily activities; whether anyone was in foster care in Michigan when they turned 18; and whether anyone applying is currently incarcerated. Each of these questions opens or closes a different eligibility pathway, so answer them honestly rather than skipping.
Tax Filing Information
Report whether you plan to file a federal tax return next year, whether you’re filing jointly, and whether anyone will be claimed as a dependent. The state uses your answers to construct your “tax household,” which is how it counts income for Modified Adjusted Gross Income (MAGI) purposes. MAGI starts from the adjusted gross income on line 11 of your federal Form 1040 and adds back untaxed foreign income, non-taxable Social Security benefits, and tax-exempt interest.4HealthCare.gov. Modified Adjusted Gross Income (MAGI)
Income Estimates
Enter your income figures and tie each one to a document you can produce if asked. If your hours or pay change month to month, check the box that indicates variable income and provide your best estimate of total income for this year and next year. A mismatch between what you write here and what shows up in government databases is the fastest way to trigger a verification request and slow your application down.
Past Medical Bills
If you have unpaid bills from the past three months, say so in this part of the form. That answer is what prompts the state to consider retroactive coverage back to the date the care was received, provided you would have qualified during those months.
Other Insurance
Disclose any current coverage. The form asks specifically whether you lost job-based insurance in the past three months, whether anyone has Medicare, and whether an employer currently offers coverage. There are follow-up questions about COBRA, retiree plans, and whether an employer plan meets minimum value standards. Answer each one; a blank here reads as missing information rather than “no.”
Automatic Renewals
Near the end of the healthcare section you’re asked whether you agree to let the state use IRS data to check your eligibility in future years. Saying yes is worth it. At your annual renewal, the state can often confirm your income from federal records without sending you a packet, so coverage can continue without any paperwork on your end.
Sign and Date
The application is not valid without a signature. If you’re submitting online through MI Bridges, you sign electronically; on paper, sign and date the signature page in ink. An unsigned form is treated as not received.
Submitting the Application
You have four ways to get the completed form and your documents to MDHHS.
- Online through MI Bridges at michigan.gov/mibridges. Create an account, complete the application digitally, and upload scanned copies of your supporting documents. Your dashboard then shows the application status, lets you report changes later, and stores correspondence from the department. Trained community partners called MI Bridges Navigators are available if you want help with the online process.5MI Bridges. Apply For Benefits
- By mail. Print the MDHHS-1171 from the MDHHS website, fill it out, and mail it with copies of your supporting documents to your local office.
- By fax. Fax the completed form and documents to your local MDHHS office.
- In person. Bring everything to your nearest county MDHHS office. The directory is at michigan.gov/ContactMDHHS or on the MDHHS county offices page.6Michigan Department of Health and Human Services. County Offices
The online route gives you a timestamped record of what you sent and when, which is useful if a question comes up later about whether the state received your documents.
What Happens After You Submit
Federal regulations give the state up to 45 days to decide a MAGI-based Medicaid application like the Healthy Michigan Plan.1eCFR. 42 CFR 435.912 – Timely Determination and Redetermination of Eligibility During that window the department checks your income, citizenship, and residency against federal and state databases.
You’ll get a written notice of case action, either by mail or in your MI Bridges inbox if you opted into paperless communication. The notice tells you whether you’ve been approved or denied and explains the reason. If the state needs more documentation before it can decide, it sends a verification request listing exactly what’s missing and a deadline to respond. Do not ignore that notice. Missing the response deadline results in a denial, and you’d have to start the application over.
If you asked for retroactive coverage because of unpaid bills from the three months before you applied, that question is reviewed as part of the same determination. Note that federal legislation passed in 2025 reduces retroactive coverage for expansion-population adults to one month beginning in January 2027.
Quick Eligibility Check Before You Start
The Healthy Michigan Plan is for Michigan residents ages 19 through 64 with household Modified Adjusted Gross Income at or below 133 percent of the federal poverty level, who are U.S. citizens or qualified immigrants, who are not enrolled in Medicare, who don’t qualify under another Medicaid category, and who are not pregnant at the time of application. Pregnant applicants are routed to a different Medicaid category with broader benefits.7Michigan Department of Health & Human Services. BEM 137 – Healthy Michigan Plan
Using the 2026 federal poverty guidelines, 133 percent works out to roughly $21,227 a year for one person, $28,781 for two, $36,336 for three, and $43,890 for four.8HHS ASPE. 2026 Poverty Guidelines – 48 Contiguous States A built-in 5 percent income disregard effectively raises the threshold slightly, so if you’re close to the line, apply and let the state do the math.
If You’re Denied
A denial notice has to explain the decision, the reason behind it, the law or policy supporting it, and your appeal rights. If you disagree, you can request a fair hearing by completing form DCH-0018, Request for Hearing, and sending it to:9Michigan Department of Health and Human Services. Medicaid Fair Hearings
Michigan Office of Administrative Hearings and Rules
Michigan Department of Health and Human Services
P.O. Box 30763
Lansing, MI 48909
You can also fax the request to 517-763-0146 or call 517-335-7519 for general inquiries. Medicaid beneficiaries can use the toll-free line at 1-800-648-3397. The hearings page does not state an exact deadline, but federal Medicaid rules generally give applicants 90 days from the date of the notice to request a hearing, so file as soon as you can after receiving an adverse decision.