LANSING, MI — Michigan Medicaid members are beginning to see a set of changes that will affect coverage, renewals and eligibility over the next several months. Some updates began taking effect Oct. 1, while a second round is scheduled to start Jan. 1, 2027.
The Michigan Department of Health and Human Services says the changes will not apply the same way to every enrollee. Some people will keep full coverage, while others will see benefits narrowed or will have to meet new requirements to stay enrolled. The state says notices will be sent by mail when coverage is changing.
Immigration-related coverage changes began Oct. 1
The first set of changes affects some non-citizens who are legally living in Michigan. Under the new rules, people whose immigration status is not included in the state’s protected categories will move to emergency services only coverage.
That emergency-only coverage pays for treatment of emergency medical conditions, but it does not cover routine or preventive care. The state says affected members will get written notice by mail. Michigan also says lawful permanent residents who have met or are exempt from the five-year bar, Cuban/Haitian entrants and Compacts of Free Association migrants will continue to receive full coverage.
Pregnant people and children under 21 keep full benefits
Michigan officials say most pregnant individuals and children under age 21 who lawfully reside in the state will also continue to receive full Medicaid coverage. That means they will not be shifted into the emergency-only category under the Oct. 1 change.
The state’s update separates these groups from other Medicaid members with immigration statuses that are not listed in the protected categories. For those members, the change is more limited: they can still receive care for emergency medical conditions, but not the broader set of services that comes with full coverage.
Work rules will begin for some Healthy Michigan Plan members
A second major change starts Jan. 1, 2027, when some Medicaid enrollees will have to show proof of work or other approved activities. The requirement mainly affects Healthy Michigan Plan members ages 16 through 64, according to the state.
To satisfy the rule, enrollees would need to earn at least $580 in one month during the review period or complete at least 80 hours of approved activities in a month. Michigan says failing to meet the requirement could lead to loss of coverage, even if the person otherwise qualifies for Medicaid.
Several groups are exempt from the work requirement
Not everyone in the Healthy Michigan Plan will have to meet the new work rules. Michigan says people under 19 or over 64 are exempt, along with those who have a disability or serious health condition.
Pregnant people are also exempt, as are members who are caring for a child or a family member. The state says people will learn whether the requirement applies to them through mailed information and messages in the MI Bridges portal.
Retroactive coverage and renewals will be tighter
The Jan. 1 changes also shorten how far back Medicaid can reach to cover care. Healthy Michigan Plan members may receive retroactive coverage for only one month before applying, while other Medicaid groups may receive coverage for up to two months before applying.
That is a change from the previous rule, which could cover services going back three months before the application date. The state is also moving Healthy Michigan Plan eligibility checks to every six months instead of once a year, and it will ask more often for updated income and household-size information.
More than 2.6 million Michiganders rely on Medicaid
Michigan says the changes affect a large share of the state’s population because Medicaid covers about one in four residents. As of August 2025, the state reported more than 2.6 million people in Michigan were enrolled in Medicaid programs.
State figures also show about 750,000 adults were enrolled in the Healthy Michigan Plan. That makes the new work and renewal rules especially significant for one of the state’s largest coverage groups, even as the Oct. 1 immigration-related changes apply to a narrower set of members.
