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PLAN FIRST! Family Planning Services
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On March 1, 2006, the Centers for Medicare and Medicaid Services (CMS) approved Michigan's submission of a Section 1115 demonstration waiver to provide family planning services to Michigan citizens meeting certain eligibility requirements.
The demonstration waiver is approved for five (5) years with an implementation date of July 1, 2006. This program will enable the Michigan Department of Community Health (MDCH) to provide family planning services to women who otherwise would not have medical coverage for these services.
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| Eligibility |
Through this waiver, MDCH will offer eligibility for family planning services to women of childbearing age, 19 through 44 years of age, who are not currently Medicaid eligible, do not have private insurance, including Medicare, and who have family income at or below 185% of the federal poverty level (FPL) (See chart below.)
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Federal Poverty Level (2007)* |
Size of Family Unit |
185% of Poverty Level |
1 |
$18,889 |
2 |
$25,327 |
3 |
$31,765 |
4 |
$38,203 |
5 |
$44,641 |
6 |
$51,079 |
7 |
$57,517 |
8 |
$63,955 |
Each additional member (beyond 8) |
add $6,438 |
| *The federal poverty level figures are updated annually. |
Coverage will be limited to women who reside in Michigan. Applications are available at local health departments, local Department of Human Services (DHS) offices, and Title X clinics.
Family planning staff can help you complete and submit your application. You must include a copy of your official birth certificate and your drivers license or other State ID with your application. |
| Covered Services |
A woman's coverage will continue for the duration of the waiver as long as the eligibility criteria are met. Program determinations will be completed annually. Family planning services are defined as any medically approved means, including diagnostic evaluation, pharmaceuticals, and supplies, for voluntarily preventing or delaying pregnancy. |
There will be no patient co-pays for family planning services, supplies or pharmaceuticals. Services covered under this waiver include: |
- Initial physical exam and health history, including patient education and counseling relating to reproductive health and family planning options;
- Annual physical examination for reproductive health/family planning purposes, including a pap smear and testing for sexually transmitted infections when indicated;
- Brief and intermediate follow up office visit related to family planning;
- Necessary family planning/reproductive health-related laboratory procedures and diagnostic tests;
- Contraceptive management including drubs and supplies;
- Insertion, implant or injection of contraceptive drugs or devices;
- Removal of contraceptive devices;
- Sterilization services and related laboratory services (as long as a properly completed sterilization consent form has been submitted); and
- Medications required incidental to or as part of a procedure done for family planning purposes.
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| The Family Planning service benefit will not include coverage of abortions or treatment for infertility. |
| Brochure and Application |
Please print the application and bring it along with your ID and birth certificate to your next visit at the Family Planning Clinic. Clinic staff will help you submit your application. |
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