Michigan MDHHS Notice Decoder: Understanding Medicare Savings Program Letters

A letter from MDHHS arrives, and it might as well be written in a different language. The notice uses abbreviations your parent has never seen, references policy manual sections by number, lists dollar amounts without explaining how they were calculated, and buries the actual decision in the middle of a page of boilerplate. Your parent calls you in a panic, and neither of you can tell whether they've been approved, denied, or something in between.

Here's how to decode the most common MDHHS notices related to Michigan's Medicare Savings Programs.

The DHS-1605: Notice of Case Action

The DHS-1605 is the main notice MDHHS sends when they've made a determination about your parent's benefits. Every approval, denial, change, and termination comes through this form. The key information is in the body of the letter, not the header — scan past the date and case number to find the action line.

Approval notice. The letter will state which program category your parent was approved for: QMB, SLMB, or ALMB. It lists the effective date of coverage and may show the countable income and asset amounts the caseworker calculated. If the category says "QMB," your parent gets Medicare premiums plus all cost-sharing paid. If it says "SLMB" or "ALMB," it's the Part B premium only.

ALMB vs. QI confusion. Michigan's notices use "ALMB" (Additional Low-Income Medicare Beneficiary), which is the state's name for the federal QI (Qualified Individual) program. If your parent's notice says ALMB, they have the same benefit that federal resources call QI — Part B premium payment from a capped federal block grant. The different names cause enormous confusion, but the benefit is identical.

Denial notice. The DHS-1605 will state the reason for denial — usually over-income, over-assets, or failure to provide requested verification. It also lists the appeal deadline, 90 calendar days from the notice date. Read the denial reason carefully: a denial for "failure to provide verification" (a procedural issue) is very different from a denial for "income exceeds program limits" (a substantive finding).

The DHS-3503: Verification Checklist

This isn't a decision — it's a request for information. When the caseworker needs additional documentation to complete the evaluation, they send the DHS-3503, which lists exactly what's missing: bank statements, income proof, Medicare card copy, identity verification, or other items.

The critical detail is the deadline. The DHS-3503 gives a minimum of 10 calendar days to respond. If you don't respond by that date, MDHHS can deny the application or close the case for failure to verify eligibility — a procedural action, not a finding that your parent doesn't qualify.

When you receive a DHS-3503, treat it as urgent. Upload the requested documents through MI Bridges and fax them as backup. Don't wait until day 9.

Redetermination Notices

MDHHS periodically reviews active MSP cases to verify continued eligibility — this is the redetermination process. The redetermination notice asks your parent to confirm or update their income, assets, and household information.

The response deadline for a DHS-1010 redetermination form or DHS-3503 verification checklist is 30 calendar days from issuance. If MDHHS closes an MSP case for a missing redetermination packet, policy permits reinstatement without a new application when the completed packet and missing verifications are received within 90 days after the effective closure date. Respond by the deadline in the notice.

If the redetermination results in a category change (for example, moving from QMB to SLMB because income increased), MDHHS sends a new DHS-1605 explaining the change. Your parent has the right to appeal that change within 90 calendar days.

The Income Calculation Section

The most confusing part of many notices is the income breakdown. MDHHS lists gross income sources, applied disregards, and the resulting countable income. Here's how to check the math:

1. Find the gross Social Security amount listed. Compare it to your parent's current SSA Benefit Verification Letter. If they don't match, the caseworker may be using outdated information.
2. Look for the $20 standard unearned income disregard. It should appear as a deduction.
3. If your parent has earned income, verify the $65 exclusion plus 50% disregard was applied.
4. Compare the resulting countable income to the 2026 limits for each MSP tier.

If the calculated income on the notice doesn't match your own math — especially if the disregards appear to be missing — that's a concrete reason to request a fair hearing.

What the Notice Doesn't Tell You

MDHHS notices don't explain the BENDEX delay. An approval notice for QMB or SLMB means the state will pay your parent's Part B premium, but it doesn't tell you that Social Security may continue deducting the premium for 60–90 days while the data exchange processes between MDHHS and SSA.

The notice also doesn't explain that MSP approval automatically qualifies your parent for Extra Help (Part D Low-Income Subsidy). That's a separate federal benefit that eliminates or reduces prescription drug costs — and your parent gets it without filing another application.

Our Michigan Medicare Savings Programs & Extra Help Guide includes a complete notice decoder that maps every standard MDHHS notice type to plain-language explanations, required follow-up actions, and the specific deadlines you need to track.

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