Why should health plans determine initial eligibility? Why not send applications directly to MIChild?
The child may begin to receive services quicker when eligibility is determined by the health plan. For initial eligibility, the begin date of coverage is the date the health plan receives the application and necessary verifications and makes the actual eligibility determination. If MIChild makes the determination, the begin date of service is usually the first of the month following the month of approval. In addition, initial determinations may be a marketing benefit to give a health plan a competitive advantage over other plans. There are no health plans currently determining initial eligibility.
