Written by a parent, not a doctor. Nothing here is medical advice.

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Michigan program

Help paying an insurance premium (CSHCS)

CSHCS can pay an insurance premium when keeping that coverage costs less than the specialist care.

What it is

CSHCS can pay an insurance premium when keeping that coverage costs less than the specialist care.

Keeping insurance can be difficult when pay drops. CSHCS has a specific premium benefit for enrolled families. It compares the premium with the specialist-care costs it expects to pay.

Eligibility rules
  • CSHCS enrollment, financial need and a cost comparison are required. The two lowest fee classes meet the financial-need test. Higher fee classes can receive a separate review of medical or dependent-care expenses and changed circumstances.
  • The premium is compared with projected CSHCS costs for the approved condition. Above the two lowest fee classes, qualifying out-of-pocket medical or dependent-care costs generally need to reach 10% of annual gross income, with changed-circumstance review available.
What you get
  • Payment of a qualifying insurance premium after CSHCS review.
What the help covers
  • This helps keep qualifying insurance active rather than replacing it with a new plan.
  • CSHCS may help pay an employer, COBRA, Marketplace or Medicare premium when its separate financial-need and cost-effectiveness tests are met. The approval letter states what it will pay and from when; a pending request does not change an insurer’s premium deadline. Your coordinator can help check the timing and any amount the family must still pay.
If you decide to apply
  1. Ask the local CSHCS coordinator about the Insurance Premium Payment Benefit and form MSA-0725.
  2. Bring proof of the premium and the insurance details for review.

MDHHS CSHCS: 1-800-359-3722 · Official page ↗

If you decide to apply
  • If you choose to request help, the coordinator can review MSA-0725 and premium records. Approved regular help can start on the first day of the receipt month, with annual renewal. The letter identifies payment timing and any remaining family amount; a pending request does not change the insurer’s due date.
  • Earlier-premium help has narrower conditions, including the guidance’s 30-day termination circumstance. Your coordinator confirms whether that exception applies before you rely on reimbursement.
Good to know

Enrollment in CSHCS alone does not promise premium payment. Financial need and the cost comparison both matter.

Other details
  • MSA-0725 belongs to the CSHCS premium benefit. MDHHS can identify any separate general Medicaid premium-assistance route and its written rules; the two programs should not be treated as interchangeable.
Official sources
Ask your social worker

“Could CSHCS help pay our insurance premium? What are the benefits and conditions, and would you help us request a review if it fits?”

Why I’m asking: I want to understand whether keeping our insurance could cost less through this benefit.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Send MSA-0725 with proof of the premium.

Your social worker

The local CSHCS office handles the form.

The care team

Nothing.

Who decides
MDHHS CSHCS.
Ask your social worker
“We have a work plan with a premium and my child is in CSHCS. Can we ask about the Insurance Premium Payment Benefit?”

How to apply

First step: Ask the local CSHCS office for form MSA-0725.

  1. Ask the CSHCS office for form MSA-0725.
  2. Take the premium amount from a recent pay slip or the insurer’s bill.

Official application / program page ↗

Where it starts: Ask the local CSHCS office for form MSA-0725.

What to gather

  • The premium amount from a pay slip or insurer bill
  • CSHCS enrolment details

How long: No decision time was published. Cover normally starts the first day of the month the form arrives.

What a yes looks like

A written CSHCS approval identifies the premium, effective month, payment arrangement and any remaining family responsibility.

What a no looks like, and the next move

Usually a cost-effectiveness answer: the premium is higher than the care the state expects to pay for.

Watch out

  • This is not Michigan’s general Medicaid premium help. That programme could not be confirmed either way.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

CSHCS can pay a family’s insurance premium when that costs less than paying for the specialist care.

Covers: Payment of a qualifying health-insurance premium

Legal protection: Approved regular help can begin with the first day of the receipt month; payment timing, narrower earlier-premium exceptions and annual renewal require the program’s written decision.

What it costs the family: The written approval states covered premiums and any remaining family amount. A pending request does not alter the insurer’s payment deadline.

The eligibility facts, as published

Requirement
CSHCS enrollment plus financial need and cost effectiveness. The lowest two fee classes meet the need test; higher classes have qualifying medical/dependent-care expense and changed-circumstance review. Eligible premium types include employer, COBRA, Marketplace and Medicare.
Form
MSA-0725

The trap: This is not a general Medicaid premium-payment programme. Michigan’s ordinary Medicaid premium-help rules could not be verified at all, so nothing about them is claimed here either way.

Where I read this

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