Michigan: Support timely care for HIDE-SNP members

As of Jan. 1, 2026, Michigan replaced MI Health Link with MI Coordinated Health, a Highly Integrated Dual Eligible Special Needs Plan (HIDE-SNP) program for eligible adults enrolled in Medicare and full Medicaid in participating regions.

The program coordinates Medicare and most Medicaid-covered services, including physical health care, pharmacy benefits and long-term services. To support timely access and consistent care delivery, use the following primary care appointment availability standards.

Primary care appointment availability standards

Appointment type	Maximum wait time	Authority
Routine primary care, adult and pediatric	15 business days	42 CFR §438.68(e)(1)(ii)
Nonemergency, nonurgent care requiring medical attention	7 business days	42 CFR §422.112(a)(6)(i)(B); HIDE-SNP Contract §9.1(B)(a)
Urgently needed services or emergency	Immediately	42 CFR §422.112(a)(6)(i)(A)

Access and availability guidelines

Schedule routine primary care physician (PCP) care within 15 business days and nonurgent symptomatic care within 7 business days
Provide 24/7 practice coverage. During non-office hours, access by telephone to a live voice (that is, an answering service, care provider on-call, hospital switchboard or PCP’s nurse triage) will immediately page an on-call medical professional so referrals can be made for nonemergency services. Avoid recorded messages.
Offer office hours that are no less available than those offered to other patients
Provide needed scheduling accommodation, accessible communication and language assistance