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October 2015 Update CSP Edit Set A new edit set for electronic submission of data to the CSP is now available. The edit set is available on the MUCH File Transfer (FTP) site at https://sso.mdch.state.mi.us/.

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How to fill out mdhhs premium assistance application

01

Begin by downloading the MDHHS Premium Assistance Application form from the official MDHHS website.

02

Fill in your personal information, such as your name, address, and contact details, in the designated sections of the form.

03

Provide accurate details about your household size and income. Include information about all individuals living in your household, including their names, dates of birth, and relationship to you.

04

Indicate whether you or anyone in your household is pregnant, disabled, blind, or aged 60 or older.

05

If applicable, provide information about your current health coverage, including any insurance plans you have or are eligible for.

06

Sign and date the application form to certify that the information provided is accurate to the best of your knowledge.

07

Submit the completed application form along with any required supporting documents to the MDHHS office in your county.

08

Wait for a response from MDHHS regarding your eligibility for premium assistance. You may be contacted for additional information or required to attend an interview.

Who needs mdhhs premium assistance application?

01

Individuals and families in the state of Michigan who require financial assistance to pay for health insurance premiums can benefit from the MDHHS Premium Assistance Application. This application is designed for individuals with low income who are not eligible for Medicaid or other public health coverage programs but still need help affording health insurance premiums. It is particularly relevant for those who do not have access to employer-sponsored health insurance or cannot afford private health insurance plans on their own. Eligibility criteria apply, and the application process helps determine whether an individual or family qualifies for premium assistance.

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