Get Dch 0078 Form 2022-2024

Please contact your MDHHS caseworker if your name and/or address have changed. Report NAME CHANGES and ADDRESS CHANGES to your MDHHS caseworker. A mihealth card can not be issued until these changes are reported to your MDHHS worker.

Medicaid requires prior authorization (PA) to cover certain services before those services are rendered to the beneficiary. The purpose of PA is to review the medical need for certain services. It does not serve as an authorization of fees or beneficiary eligibility.

Then, select the Prior Authorization and Notification tool on your Link dashboard. Or, call 888-397-8129.

To add, terminate or change other insurance on-line, visit https://.Michigan.gov/ReportTPL to access the form and instructions. Allow 7-10 business days for the request to be completed.

If you think your drug may require a prior authorization, call your insurer directly to confirm.

A Michigan Medicaid prior authorization form requests Medicaid coverage for a non-preferred drug prescription in the state of Michigan. In this form, the physician provides their clinical reasoning for making this request instead of prescribing a drug from the Preferred Drug List (PDL).

Tell you which doctors, pharmacies and hospitals are part of each Medicaid health plan. Answer general questions you may have about Medicaid benefits. Enroll you in the Medicaid Health Plan you choose. For more information, call Michigan ENROLLS at 1-888-367-6557.