Michigan: URGENT Retraction of 12/3/2021 Confirming Eligibility for Molina Plans

URGENT: Retraction of 12/3/2021 Confirming Eligibility for Molina Plans

Please note, Molina is providing additional clarification on the 12/3/2021 notice of updated eligibility criteria for their Michigan Medicare Plans. They apologize for any confusion and appreciate your continued support and partnership.

As you know, effective 1/1/22 Molina will have two DSNP's and one non-DSNP plan:

H5926-001 Complete Care (Full DSNP)

• To be eligible for this plan you must live in the plan service area, be eligible for Medicare and further determined to be in one of the following Medicare Savings Program (MSP) to be eligible: QMB, QMB+, SLMB+ or FBDE. 
• QMB – these Dual Eligibles have coverage of their Medicare Premiums and protection from Medicare cost-sharing however do not have Full Medicaid benefits. 
• QMB+, SLMB+ or FBDE - these Dual Eligibles have full Medicaid benefits.

H5926-005 Complete Care Select (Partial DSNP)

• To be eligible for this plan you must live in the plan service area, be eligible for Medicare and further determined to be one of the following Medicare Savings Program (MSP) to be eligible: SLMB, QI or QDWI.
• These Dual Eligibles have some level of assistance but DO NOT have Full Medicaid benefits. The MI State system may show Benefit Plan IDs such as: ALMB, QDWI or SLMB.  

If the MI State Benefit Plan ID is:

• MA-HMP, this means they are enrolled in Medicaid Expansion and should not be enrolled/eligible for Medicare. If the beneficiary is entitled to Medicare, you must determine the MSP Level before proceeding. Molina can help you do this by checking the Medicare systems. Medicare Eligibles with a MI State Benefit Plan ID of MA-HMP should contact the state with their Medicare information immediately. 
• SPENDDOWN – You can enroll this member based on best available evidence that the member has some level of MSP, however Molina must determine the MSP Level before spenddown is reached with their processing of the application. 

H5926-006 Molina Medicare Choice Care (Non-DSNP)

To be eligible for this plan you must have Medicare Parts A & B and live in the plan service area.