Please complete this brief screening to determine if you may be eligible for Ingham Health Plan (IHP).
A separate IHP application is required for each household member seeking coverage.
1. Verify your home address is Ingham County. Complete a zip-code-lookup
(Click on the drop down arrow to view County information.)
2. Verify your HOUSEHOLD GROSS INCOME falls within income eligibility guidelines for IHP (See Chart Below). This is income before taxes and deductions. If income is at or below Medicaid eligibility, please apply for Medicaid health coverage first. IHP is for people who don't have or qualify for other health coverage such as Medicaid, Medicare or commerical.
Sorry, it appears you are not eligible for Ingham Health Plan. You may be eligible for Medicaid or health insurance on the Federal Marketplace.
Based on your screening, it appears you MAY be eligible to apply for IHP.
Completing the application does not guarantee enrollment in IHP.
IHP is not insurance and has limited coverage benefits.
Application and ALL required documents must be submitted for application to be considered complete. Once application and supporting documents are reviewed by an Enrollment Specialist, enrollment status will be determined.
You will be notified of your enrollment status within 3 business days by email.
Before proceeding gather the following information to assist with the application process:
Supporting documents will need to be uploaded to the application before submitting.
You are able to 'Save' your application and 'Continue Later' if needed. Due to HIPAA, you will be required to create a JotForm account. The link to complete your application will be sent to the email provided on the application. You must complete your application within 2 weeks. After that, any incomplete applications will be deleted and you'll need to start from the beginning.
Choose your Doctor's Office: If IHP application is approved, Applicant will be "assigned" a primary care Office. Please review the list of IHP participating provider offices. Please select an office of your choice.
You are being asked to complete this form because you indicated one of the following:
1) You have not filed a Schedule C tax document, or
2) The Schedule C you filed is not an accurate representation of your current year's income.
To complete the application you will need to upload, in PDF or JPEG format, copies of the required supporting documents.
You can scan documents using an app or take a picture with a cell phone.
All documentation MUST be legible.
1. Picture Identification
2. Proof of you live in Ingham County (at least one of following)
3. Proof of income must be recent (within the past 30 days) for ALL wage earners in household (at least one of following for ALL wage earners)
4. Immigration Documents, if applicable (visa, green card, permanent residency card)
5. Medicaid status documents, if applicable