Medicaid Food Benefits · Michigan

Food as Medicine benefits through Medicaid

Michigan Medicaid plans are expanding access to “food as medicine” benefits and offering new ways for patients to get nutritious food as part of their care.

Depending on plan, region, and patient eligibility, benefits may include medically tailored meals, home-delivered meals, healthy food packs, or produce prescriptions. These benefits are designed for patients with certain health conditions, recovery needs, or challenges accessing food. We believe these benefits are a critical step towards making healthy eating easier, improving outcomes, and supporting whole-person care.

Medicaid Food as Medicine benefit types:
In Lieu of Services (ILOS)Medicaid MI Choice Waiver
What is ILOS

In Lieu of Services (ILOS)

ILOS are medically-appropriate, cost-effective alternatives to traditional Medicaid services that address health-related social needs. Michigan’s Medicaid Health Plans are authorized to provide nutrition-based ILOS when they are clinically justified and cost-effective. These benefits are funded by the health plans themselves as lower-cost alternatives to more expensive medical care.

2

Access to food and nutrition is a critical unmet need that disproportionately affects Michigan’s most vulnerable populations.

3

ILOS provides a pathway to integrate existing community-based nutrition services directly into clinical care delivery.

3

Investing in food and nutrition significantly improves health outcomes and reduces healthcare costs

Although new to Michigan, ILOS has already shown strong results in other states.
In California, FAM benefits were associated with an 18.7% reduction in inpatient service costs, 6.0% reduction in outpatient service costs, and 20.0% reduction in emergency room costs after just six months.
Read the COMMMUNITY SUPPORTS, OR IN LIEU OF SERVICES (ILOS), ANNUAL REPORT
Check ILOS Coverage

ILOS Coverage Checker for Michigan

ILOS benefits are dependent on Medicaid Health Plan and Michigan prosperity region. This can make it challenging to determine if a patient has coverage for an ILOS nutrition benefit though their plan.

There are two quick ways to check coverage:
1) Check the map created by MDHHS displaying coverage across the state

MDHHS ILOS Map

2) Use the digital coverage checker below by entering the patient’s ZIP code and selecting their Medicaid plan from the dropdown. The tool will show which of the four ILOS nutrition services (see next section) are covered in the patient’s prosperity region. It also includes available eligibility criteria and referral information.

Please note that this information is based on publicly available data from state agencies and Medicaid Health Plans. Coverage and availability may change and are determined at the discretion of each plan. Always confirm current coverage, eligibility requirements, and referral processes directly with the plan.

Check plan and region coverage

Enter the patient ZIP code and Medicaid plan. The tool will use spreadsheet data to estimate county and Michigan prosperity region, then show which food benefit types are offered for that plan in that region.

Use this if the ZIP could not be matched or maps to more than one county/region.

Loading data.

Coverage results

Coverage is based on the selected plan and resolved Michigan prosperity region.

Patient Eligibility Requirements

The patient must have at least one item from each list below for referral consideration.

Clinical factors

At least one of the following should be documented:

Documented food or nutrition need

At least one of the following should be documented:

Referring the Patient

  1. Gather the needed information.
    • Complete the plan referral or prior authorization form.
    • Send the form to the plan contact or reach out with questions.

    If the patient is eligible, next steps will be for the plan or its food service partner to contact the patient to enroll them.
    ILOS Service types

    ILOS nutrition benefit options for eligible members

    Michigan Medicaid Health Plans offer four distinct In Lieu of Services benefit types designed to address nutritional needs and food insecurity for eligible members.

    Service Type 1 of 4

    Medically Tailored Home-Delivered Meals

    A fresh or frozen home delivered meal that is ready to eat and medically tailored for aspecific disease or condition. This service includes an initial evaluation with a certified nutrition professional to assess and develop a medically appropriate nutrition care plan, the preparation and delivery of the prescribed nutrition care regimen and regular reassessment.

    Frequency

    Up to 2 meals/day (14/week) for up to 6 months, or longer if medically necessary.

    Setting

    Nutrition assessment often completed over the phone by the meal provider but can be done in clinic, during a home visit, or as part of a telehealth appointment. Meals delivered directly to a patients home.

    Eligibility (at least one)
    Nutrition-sensitive condition: diabetes, CHF, COPD, hypertension, HIV, cancer, sickle cell, renal disease, gestational diabetes
    Discharged from hospital or skilled nursing facility within last 60 days
    At risk for nutritional deficiency due to food insecurity
    Service Type 2 of 4

    Healthy Home-Delivered Meals

    Nutritionally-balanced home-delivered meals (hot, cold, frozen, or shelf-stable) promoting improved nutrition. Each meal must provide at least one-third of recommended Dietary Reference Intakes. Must align with Dietary Guidelines for Americans and evidence-based guidelines for specific conditions.

    Frequency

    Up to 2 meals/day (14/week) for up to 6 months, or longer if medically necessary

    Setting

    Delivered directly to the enrollee’s home

    Eligibility (at least one)
    Nutrition-sensitive condition: diabetes, CHF, COPD, hypertension, HIV, cancer, sickle cell, renal disease
    Pregnant with high-risk conditions (gestational diabetes, preeclampsia, low birth weight)
    Child with elevated blood lead levels or childhood obesity; eligible for CSHCS
    Service Type 3 of 4

    Healthy Food Packs

    An assortment of medically-tailored or nutritionally-appropriate foods. Must not contain ultra-processed foods or foods with excessive sugar or salt. May include nutrition education materials. Must meet enrollees’ cultural, dietary, or religious preferences.

    Frequency

    Typically weekly for up to 6 months, or longer if medically necessary

    Setting

    Pick-up at community setting (food pantry, clinic) OR delivered to enrollee’s home

    Eligibility (at least one)
    Nutrition-sensitive condition: diabetes, CHF, COPD, hypertension, HIV, cancer, sickle cell, renal disease
    Pregnant with high-risk conditions; former foster care youth; child with elevated blood lead
    At risk for nutritional deficiency due to food insecurity
    Service Type4 of 4

    Produce Prescriptions

    Vouchers to purchase any variety of fruits, vegetables, or plants/seeds that produce fruits and vegetables — redeemable at partnering grocery stores or farmers markets. Items must align with WIC-eligible, GusNIP-eligible, or Double Up Food Bucks Michigan-eligible foods.

    Frequency

    Up to 6 months, or longer if medically necessary. Duration and cadence set by voucher provider.

    Setting

    Enrollees redeem vouchers at participating food retailers, grocery stores, or farmers markets

    Eligibility (at least one)
    Nutrition-sensitive condition: diabetes, CHF, COPD, hypertension, HIV, cancer, sickle cell, renal disease
    Pregnant with high-risk conditions; former foster care youth; child with elevated blood lead
    At risk for nutritional deficiency due to food insecurity

    Questions about ILOS food benefits?

    NVP is building tools and resources to make ILOS easier to navigate for everyone — patients, clinicians, and health plans. Reach out to connect with our team.

    Contact the NVP TeamBack to Home