How to Appeal a Michigan Medicare Savings Program Denial
When MDHHS denies a Medicare Savings Program application or terminates existing coverage, the DHS-1605 notice arrives in the mail with dense language about income calculations, asset determinations, and appeal rights. The notice gives you a deadline. Missing it means starting the entire application over.
Two Deadlines That Matter
90 calendar days from the DHS-1605 notice date: the absolute deadline to request an administrative hearing through the Michigan Office of Administrative Hearings and Rules (MOAHR). After this, your only option is a brand-new application.
12 calendar days from the notice date: the deadline to preserve continued benefits while the appeal is pending. If MDHHS is terminating existing coverage, filing within this window keeps MSP benefits active until the administrative law judge issues a decision. Miss this window and coverage stops during the appeal — you'd only get it reinstated if the ALJ rules in your favor.
The 12-day window is the one families don't see until it's too late. A DHS-1605 that arrives on a Tuesday gives you less than two weeks to file, and mail delivery eats several of those days.
How to File the Hearing Request
Submit Form DCH-0092 (Request for Administrative Hearing) or a signed written statement explaining what you're appealing and why. You can deliver it by mail, fax, or in person to either MDHHS or directly to MOAHR.
Faxing is the fastest confirmation method — keep the transmission receipt as proof of filing date. MOAHR's hearing fax line is 517-763-0146. You can also call MOAHR at 1-800-648-3397 to confirm receipt.
The Informal Conference Trap
After filing, the MDHHS caseworker may offer an informal conference to review the calculations. These conferences sometimes resolve the issue — a caseworker who miscounted income or missed an asset exclusion can correct the determination without a formal hearing.
But attending the informal conference does not pause or extend the 90-day hearing deadline. If the conference doesn't resolve the problem, you still need the formal hearing request filed within the original 90-day window. Don't let an ongoing conference lull you into missing the deadline.
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What Happens at the MOAHR Hearing
Hearings are conducted by a MOAHR Administrative Law Judge via telephone or video conference. Both sides exchange evidence beforehand — your documentation of income, assets, Medicare enrollment, and the DHS-1605 notice on one side, and the caseworker's case file and eligibility calculations on the other.
The ALJ issues a binding written Decision and Order. If the decision goes against you, you have 30 days to request reconsideration or appeal to Circuit Court.
Common Denial Reasons Worth Appealing
Income miscalculation. The caseworker used the wrong gross income figure, failed to apply the $20 unearned income disregard, or counted an adult child's income against the parent. These are straightforward errors that the hearing process corrects.
Asset overcount. An excluded asset (home, vehicle, burial fund) was counted, or the caseworker included assets belonging to a non-spouse household member.
Missing verification treated as failure. Documents were submitted but not attached to the case file — common when multiple documents are faxed or uploaded to MI Bridges in a batch.
Free legal help with appeals is available through Michigan Legal Help, Legal Aid and Defender Association, Elder Law of Michigan, and the Center for Civil Justice.
The Michigan Medicare Savings Programs & Extra Help Guide covers each denial reason in detail and includes a hearing preparation checklist.
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