Compare Affordable Michigan individual and family Marketplace health insurance online. Quickly view multiple plans from the top-rated companies at the lowest available rates and enroll in less than 25 minutes. We review numerous flexible options with the help of the federal subsidy that can save you thousands of dollars. We help you shop and find the plans that cost you the least, and still provide quality benefits. You can also choose non-Obamacare options and Senior coverage if you have reached age 65.
By providing your zip code at the top of the page, within minutes, you can view top-rated Michigan medical insurance plans at the lowest prices provided by large and small carriers. Small business options (SHOP Exchange) can also be viewed along with short-term, student, high-deductible, catastrophic, and HSA plans. Student, child-only, no-deductible, vision, and dental options are also offered. 2022 rates have slightly increased (average of Marketplace carriers).
We realize it isn’t easy researching and comparing hundreds of options. Our job is to find the policies that best provide the coverage you need, at the rate that fits into your budget. No two plans are the same, so it’s important to understand the differences in each policy, whether they are classified as Platinum, Gold, Silver, Bronze or Catastrophic. And sometimes, keeping an existing plan may be a more cost-effective option, rather than changing to a different plan.
Michigan Senior Medigap Coverage Also Offered
2024 Senior Medicare Supplement and Advantage contracts can help reduce out-of-pocket expenses for persons that have reached age 65. Medigap coverage has a separate Open Enrollment period, and although many policies are standardized, rates and network provider availability will vary. The Michigan Department of Health and Human Services provides many programs for Seniors, both Medicare and Medicaid-eligible.
Consumers that have reached age 65 do not utilize the Marketplace for their benefits. Original Medicare is provided by the federal government, and any additional plans are available from private insurers. The Open Enrollment period (Fall) is also different, and begins on October 15th, and ends on December 7th. To offer Medigap coverage in Michigan, companies must be authorized and approved by the MI. Department of Insurance and Financial Services.
The following insurers are licensed to offer Medicare Supplement products in the state of Michigan:
Alliance, Americo, Assured Life, Bankers Fidelity, BCBS, Capitol Life, Central States, Cigna, Colonial Penn, Continental Life, Coventry, Everest, Everence, Equitable, Globe Life, GPM Health, Guarantee Trust Life, Humana, KSJK Life, Loyal American, Lumico Life, McLaren Health, Medico, National Health, Pan-American Life, Philadelphia American Life, Oxford Life, Pekin Life, Priority Health, Shenandoah Life, State Farm, Sterling National Life, S, USA Life, Thrivent, Transamerica, Unified Life, Union Security, United American, UnitedHealthcare-AARP, United World Life, and USAA.
MI Medicare Advantage contracts are issued by private companies that are contracted and approved by Medicare to provide Parts A and B benefits. Prominent plans issued by major carriers include Erickson Advantage Freedom, Erickson Advantage Guardian, BCN Advantage HMO ConnectedCare, BCN Advantage HMO MyChoice Wellness, HealthPlus MedicarePlus Options 0 and 1, HumanaChoice, PriorityMedicare, HAP Senior Plus, BCBS Medicare Plus Blue PPO Assure, Paramount Elite, Alliance Medicare PPO, Molina Medicare Options Plus, Meridian Advantage Plan Of Michigan, Harbor Medicare, Upper Peninsula Health Plan, and McLaren Advantage.
What Is The Michigan Health Insurance Marketplace?
When the Affordable Care Act (ACA) legislation was passed, state residents began to enroll/ purchase their healthcare coverage through websites like ours, and the federally-operated Marketplace. Most residents are immediately eligible, unless you are an undocumented immigrant, in the country illegally, or incarcerated. Also, Medicaid and Medicare-eligible applicants (as previously mentioned) may also not be eligible.
A federal subsidy can pay up to 100% of the premium, depending on household earnings as defined by the Federal Poverty Level. For 2020 effective dates, the new enrollment period began in November, although “Special Enrollment Periods” allow you to apply for a plan if you qualify for one of several available exemptions. Divorce, adopting a child, moving to a different service area, or losing employer-provided benefits are common exceptions.
Nobody is declined for medical reasons and there is no tax penalty charged if “qualified” coverage is not purchased. This penalty (actually a tax) was $695 per adult and $347.50 per child, or 2.5% of your household income, whichever was the largest. However, it was pro-rated, if you met ACA (Affordable Care Act) requirements for a portion of the calendar year. This penalty was eliminated last year.
Although a “partnership” between the federal and state governments to jointly run the Exchange was originally discussed, it was determined that it would be best for citizens to allow the federal government to handle the Marketplace enrollment, as they do in most other states (State-Federal Partnership Exchange). Senate Majority Leader Randy Richardville indicated that most Senators felt there were too many uncertainties in the original legislation to warrant a state-run program. More details are provided near the bottom of this page.
Who Are The Participating Companies
The carriers that offer (On-Exchange) coverage are Blue Cross Blue Shield of Michigan, Blue Care Network, McLaren Health Plan, Meridian, Molina, Oscar, Physicians Health Plan, Priority Health, UnitedHealthcare, and US Health And Life (Ascension) Each of the carriers offers a large variety of individual and family healthcare options consisting of comprehensive, major medical and qualified high deductible contracts. “Off-Exchange” options are also available. Previously, Meridian merged with Ambetter, and Priority Health merged with Total Health Care. Health Alliance Plan is available as an off-Marketplace option.
Several of these carriers also offer short-term options that allow for temporary coverage. Policies that are designed for only a few months are indeed cheap, but will have some limitations. You can read more about them near the bottom of this article. We also discuss them in detail throughout this website. Although temporary options are quickly approved and feature extremely low premiums, pre-existing conditions are not covered and you are still “non-compliant” regarding the purchase of a qualified plan. Thus, the previously-mentioned tax penalty would apply.
We do not recommend the purchase of limited benefit or medical discount policies. Often advertised as genuine health care, in actuality…they are not. Exclusions are plentiful and customer satisfaction is usually low. Most major companies do NOT offer this type of policy. In many instances, it is lesser-known carriers that offer these options. Buyer beware!
NOTE: Aetna, and Priority Health, no longer offer Exchange plans. Also, any company that intends to raise its rates at least 10%, must publish (in writing) the proposed increases. The DIFS will review the proposed increases and has a total of 60 days to determine if the new prices are justifiable.
Proposed 2024 Average Rate Changes
Alliance – 14.80% increase. Personal Alliance plan.
Blue Care Network Of Michigan – 5.36% increase. Blue Cross, Blue Cross Extra, Blue Cross Virtual Primary Care, and Blue Cross Bronze.
BCBS Of Michigan – 4.01% decrease. Blue Cross, Blue Cross Premier Silver Standard, and Blue Cross Premier Bronze Extra.
Health Alliance – 12.31% increase. HAP Personal Alliance HMO, HAP PA HMO Genesys Choice, and HMO PA HMO Henry Ford Choice.
McLaren Health Plan – 16.17% increase. McLaren Individual.
Meridian Health Plan – 5.18% increase. Ambetter, Ambetter Off-Exchange Only, Ambetter + Vision + Adult Dental, Ambetter Off-Exchange Only + Vision + Adult Dental, and Ambetter Virtual Access.
Molina – 5.82% increase. Molina Healthcare and Molina Healthcare + Vision.
Oscar– 3.91% increase. Oscar MI 007.
Physicians Health Plan– 7.15% increase. PHP Individual Exclusive and PHP Individual HDHP Exclusive.
Priority Health– 5.24% increase. MyPriority HMO.
UnitedHealthcare – 6.44% increase. Compass and IND HMO ADAV.
US Health And Life – 18.96% increase. Ascension Personalized Care.
Michigan Individual And Family Healthcare Plans
BCBS of Michigan and its HMO subsidiary Blue Care Network, have more than 170,000 members, and provide many affordable options, both subsidized and unsubsidized. More than 40 policies are available in all 83 state counties for both single-person and family households. Shown below are several of the most popular and affordable options from all available carriers. All policy details can be viewed in their entirety after you request a “Free Quote” at the top of the page.
Catastrophic Tier (Must Be Under Age 30)
Blue Cross Select HMO Value – $9,450 deductible with maximum out-of-pocket expenses of $9,450 and 0% coinsurance. $30 pcp office visit copay.
BCBS Premier PPO Value – $9,450 deductible with maximum out-of-pocket expenses of $9,450 and 0% coinsurance. $30 pcp office visit copay for first three visits.
McLaren Young Adult/Catastrophic – $9,450 deductible with maximum out-of-pocket expenses of $9,450 and 0% coinsurance. $0 copay for first three pcp visits.
Physicians Health Plan HMO Catastrophic – $9,450 deductible with maximum out-of-pocket expenses of $9,450 and 0% coinsurance. $0 copay for first three pcp visits.
Bronze Tier
Blue Cross HMO Local HMO Bronze Secure – $9,450 deductible with maximum out-of-pocket expenses of $9,450 and 0% coinsurance.
Blue Cross Local HMO Bronze Extra – $7,500 deductible with maximum out-of-pocket expenses of $9,400 and 50% coinsurance. $50 and $100 office visit copays. $75 Urgent Care copay. Generic and preferred brand drug copays are $25 and $50 ($75 and $150 mail order).
Blue Cross Select HMO Bronze Extra – $7,500 deductible with maximum out-of-pocket expenses of $9,400 and 50% coinsurance. $50 and $100 office visit copays. $75 Urgent Care copay. Preferred generic and non-preferred generic drug copays are $25 ($75 mail order).
Blue Cross HMO Bronze Saver HSA – HSA-eligible plan with $7,950 deductible and maximum out-of-pocket expenses of $7,950 and 0% coinsurance.
Blue Cross Select HMO Bronze – $9,150 deductible with maximum out-of-pocket expenses of $9,150 and 0% coinsurance. $30 pcp office visit copay. $10 copay for lab services. $40 Urgent Care copay. Preferred generic and non-preferred generic drug copays are $35 ($105 mail order).
Blue Cross Premier PPO Bronze Secure – $9,450 deductible with maximum out-of-pocket expenses of $9,450 and 0% coinsurance.
Ambetter Standard Expanded Bronze – $7,500 deductible with maximum out-of-pocket expenses of $9,400 and 50% coinsurance. $50 and $100 office visit copays and $75 Urgent Care copays. The preferred generic and generic drug copays are $25 ($62.50 for 90-day mail-order). Preferred brand and non-preferred brand drugs are subject to coinsurance and deductible.
Ambetter Everyday Bronze – $8,450 deductible with maximum out-of-pocket expenses of $9,250 and 0% coinsurance. $40 and $90 office visit copays. $50 Urgent Care copay. Preferred generic and generic drug copays are $3 and $30 ($7.50 and $75 mail order). $50 copay for lab and professional tests.
Ambetter Virtual Access Bronze – $7,000 deductible with maximum out-of-pocket expenses of $8,550 and 50% coinsurance. $65 (deductible does not apply) and $100 office visit copays and $60 Urgent Care copays. The preferred generic and generic drug copays are $3 and $30 ($7.50 and $75 for 90-day mail-order). Preferred brand and non-preferred brand drugs are subject to coinsurance and deductible. $75 copay for lab tests.
Ambetter Choice Bronze HSA – $7,250 deductible with maximum out-of-pocket expenses of $7,250 and 0% coinsurance. HSA-eligible.
Priority Health MyPriority Bronze 9100 – $9,100 deductible with maximum out-of-pocket expenses of $9,100 and 0% coinsurance. $30 and $90 office visit copays. Preferred generic and other generic drug copays are $5 and $20. $75 Urgent Care copay.
Priority Health MyPriority Standard Bronze 7500 – $7,500 deductible with maximum out-of-pocket expenses of $9,000 and 50% coinsurance. $50 and $100 office visit copays. Preferred generic and other generic drug copays are $25 Preferred brand and non-preferred brand drug copays are $50 and $100. $75 Urgent Care copay.
Priority Health MyPriority HMO HSA Bronze 7100 – HSA-eligible plan with $7,100 deductible and maximum out-of-pocket expenses of $7,100 and 0% coinsurance.
Oscar Bronze Simple Standard – $9,100 deductible with maximum out-of-pocket expenses of $9,100 and 0% coinsurance. $75 Urgent Care copay. $3 Tier 1A drug copay ($7.50 mail order).
Oscar Bronze Classic – $7,750 deductible with maximum out-of-pocket expenses of $9,100 and 50% coinsurance. $75 pcp office visit and Urgent Care copays. $3 Tier 1A drug copay ($7.50 mail order).
McLaren Bronze 6500 – $6,500 deductible with maximum out-of-pocket expenses of $9,100 and 50% coinsurance. Tier 1 and Tier 2 drug copays are $25 and $75. $10 copay for outpatient lab tests.
McLaren Bronze Standard – $9,100 deductible with maximum out-of-pocket expenses of $9,100 and 0% coinsurance.
UnitedHealthcare Bronze Standard – $9,100 deductible with maximum out-of-pocket expenses of $9,100 and 0% coinsurance.
UnitedHealthcare Bronze Virtual First – $7,500 deductible with maximum out-of-pocket expenses of $9,100 and 50% coinsurance. $100 pcp office visit copay. Tier 1 and Tier 2 drug copays are $3 and $35. $75 Urgent Care copay.
US Health And Life Acsension Personalized Care Balanced Bronze 2 – $9,100 deductible with maximum out-of-pocket expenses of $9,100 and 00% coinsurance. $25 pcp office visit copay and $15 generic drug copay.
Physicians Health Plan Sparrow PHP Exclusive Bronze 7500 – $7,500 deductible with maximum out-of-pocket expenses of $9,000 and 50% coinsurance. $50 and $100 office visit copays and $75 Urgent Care copays. The generic and generic drug copays are $25 and $50. Preferred brand and non-preferred brand drugs are subject to coinsurance and deductible.
Physicians Health Plan Sparrow PHP Exclusive Bronze 6500 – $6,500 deductible with maximum out-of-pocket expenses of $8,500 and 50% coinsurance. The preferred generic and generic drug copays are $15 and $40 ($30 and $80 for 90-day mail-order). Preferred brand and non-preferred brand drugs are subject to coinsurance and deductible.
Silver Tier
Blue Care Select HMO Silver Saver – $5,500 deductible with maximum out-of-pocket expenses of $8,000 and 20% coinsurance. $45 and $90 office visit copays and $45 Urgent Care copays. The preferred generic and non-preferred generic drug copays are $4 and $20 ($12 and $60 for 90-day mail-order). Preferred brand and non-preferred brand drug copays are $100 and $150 ($300 and $450 mail-order).
Blue Care Network Preferred HMO Silver Saver – $5,500 deductible with maximum out-of-pocket expenses of $8,000 and 20% coinsurance. $45 and $90 office visit copays and $45 Urgent Care copays. The preferred generic and non-preferred generic drug copays are $4 and $20 ($12 and $60 for 90-day mail-order). Preferred brand and non-preferred brand drug copays are $100 and $150 ($300 and $450 mail-order).
Blue Care Network Preferred HMO Virtual Primary Care Silver – $6,050 deductible with maximum out-of-pocket expenses of $9,100 and 20% coinsurance. $30 $1 virtual care) and $50 office visit copays with $40 Urgent Care copay. The preferred generic and generic copays are $4 and $20 ($12 and $60 for 90-day mail-order). Preferred brand and non-preferred brand drug copays are $100 and $150 ($300 and $450 for 90-day mail-order).
Blue Care Network Select HMO Silver – $4,650 deductible with maximum out-of-pocket expenses of $9,100 and 20% coinsurance. $30 and $50 office visit copays with $40 Urgent Care copay. The preferred generic and generic copays are $4 and $20 ($12 and $60 for 90-day mail-order). Preferred brand and non-preferred brand drug copays are $100 and $150 ($300 and $450 for 90-day mail-order).
Blue Care Network Select HMO Silver Extra – $5,800 deductible with maximum out-of-pocket expenses of $8,900 and 40% coinsurance. $40 and $80 office visit copays with $60 Urgent Care copay. The preferred generic and generic copays are $20 ($60 for 90-day mail-order). Preferred brand and non-preferred brand drug copays are $40 and $80 ($120 and $240 for 90-day mail-order).
Blue Care Network Preferred HMO Silver – $4,650 deductible with maximum out-of-pocket expenses of $9,100 and 20% coinsurance. $30 and $50 office visit copays with $40 Urgent Care copay. Preferred generic and generic drug copays are $4 and $20 ($12 and $60 mail-order). Preferred brand and non-preferred brand drug copays are $100 and $150 ($300 and $450 mail-order).
BCBS Premier HMO Silver Extra – $5,800 deductible with maximum out-of-pocket expenses of $8,900 and 40% coinsurance. Office visit copays are $40 and $80 with $60 Urgent Care copay. The preferred generic and generic copays are $20 ($60 for 90-day mail-order). Preferred brand and non-preferred brand drug copays are $40 and $80 ($120 and $240 for 90-day mail-order).
Molina Constant Care Silver 7 250 – $0 deductible with maximum out-of-pocket expenses of $8,550. Office visit copays are $30 and $90 with a $30 copay for Urgent Care. Generic and preferred brand drug copays are $30 and $100. $50 and $135 copays for blood work and x-rays.
Molina Constant Care Silver 2 250 – $5,200 deductible with maximum out-of-pocket expenses of $8,150 and 40% coinsurance. Office visit copays are $30 and $65 with a $30 copay for Urgent Care. Generic and preferred brand drug copays are $25 and $65. $40 copay for blood work.
Molina Constant Care Silver 4 250 – $7,450 deductible with maximum out-of-pocket expenses of $7,450 and 0% coinsurance. Office visit copays are $30 (no deductible) and $65 with a $30 copay for Urgent Care. Generic and preferred brand drug copays are $25 and $75.
Molina Constant Care Silver 1 250 – $0 deductible with maximum out-of-pocket expenses of $8,500. Office visit copays are $30 and $60 with a $30 copay for Urgent Care. Generic and preferred brand drug copays are $29 and $60. $45 and $80 copays for blood work and x-rays. $700 copay for imaging.
Ambetter Balanced Care 30 – $6,100 deductible with maximum out-of-pocket expenses of $6,100 and 0% coinsurance. $35 and $70 office visit copays. $55 Urgent Care copay. Generic and preferred brand drug copays are $25 and $60.
Ambetter Balanced Care 31 – $5,450 deductible with maximum out-of-pocket expenses of $6,450 and 10% coinsurance. $60 Urgent Care copay.
Ambetter Balanced Care 32 – $8,100 deductible with maximum out-of-pocket expenses of $8,700 and 50% coinsurance. $45 and $100 office visit copays. $60 Urgent Care copay. $50 copay for diagnostic tests. Generic and preferred brand drug copays are $5/$25 and $75.
Ambetter Virtual Access Silver – $7,200 deductible with maximum out-of-pocket expenses of $8,700 and 50% coinsurance. $40 and $100 office visit copays. $60 Urgent Care copay. $50 copay for diagnostic tests. Generic and preferred brand drug copays are $5/$25 and $75.
Priority Health MyPriority HMO Silver 5500 – $5,500 deductible and maximum out-of-pocket expenses of $8,500 and 30% coinsurance. $30 and $60 office visit copays with $75 Urgent Care copay. The preferred generic, generic, preferred brand, and non-preferred brand drug copays are $5, $20, $75, and $125.
Priority Health MyPriority HMO Silver 5500 – $5,500 deductible and maximum out-of-pocket expenses of $8,500 and 30% coinsurance. $30 and $60 office visit copays with $75 Urgent Care copay. No charge for virtual care visits. The preferred generic, generic, preferred brand, and non-preferred brand drug copays are $5, $20, $75, and $125. Note: a very similar plan is offered at a higher cost that does not require a referral when visiting a specialist.
McLaren Silver Exchange – $3,700 deductible with maximum out-of-pocket expenses of $8,150 and 20% coinsurance. Office visit copays are $30 and $65. The Urgent Care copay is $75. Tier 1, Tier 2, and Tier 3 drug copays are $10, $75, and $125.
Total Health Care Totally You Value – $5,000 deductible with maximum out-of-pocket expenses of $7,900 and 30% coinsurance. $20 pcp office visit copay and $10 generic drug copay ($20 mail order).
Total Health Care Totally You – $4,450 deductible with maximum out-of-pocket expenses of $8,550 and 30% coinsurance. $30 and $60 office visit copays with $70 Urgent Care copay.
Gold Tier
Priority Health MyPriority Gold Copay+ – $0 deductible and maximum out-of-pocket expenses of $8,550 and 50% coinsurance. $20 and $45 office visit copays and $75 Urgent Care copay. $45 copay for diagnostic tests at free-standing non-hospital facility. Preferred generic, generic, and preferred brand drug copays are $5, $20, and $75.
McLaren Gold 1400 – $1,400 deductible with maximum out-of-pocket expenses of $6,750 and 20% coinsurance. Office visit copays are $30 and $50. The Urgent Care copay is $60. Tier 1, Tier 2, and Tier 3 drug copays are $5, $65, and $125.
Blue Care Network Preferred HMO Gold – $850 deductible with maximum out-of-pocket expenses of $8,500 and 20% coinsurance. $30 and $50 office visit copays with $40 Urgent Care copay. The preferred generic and generic drug copays are $4 and $20 ($12 and $60 for 90-day mail-order). The preferred brand and non-preferred brand drug copays are $100 and $150 ($300 and $450 90-day mail-order).
BCBS Premier PPO Gold – $750 deductible with maximum out-of-pocket expenses of $7,200 and 40% coinsurance. $30 and $50 office visit copays with $75 Urgent Care copay. The generic drug copay is $15 ($45 for 90-day mail order). The preferred brand and non-preferred brand drug copays are $100 and $150 ($300 and $450 90-day mail-order).
Ambetter Base Gold – $3,500 deductible with maximum out-of-pocket expenses of $6,000 and 20% coinsurance. $10 and $50 office visit copays. $50 Urgent Care copay.Generic, preferred brand, and non-preferred brand drug copays are $7, $25, and $110 ($17.50, $62.50, and $275 mail order).
Ambetter Secure Care 5 – $1,450 deductible with maximum out-of-pocket expenses of $6,300 and 20% coinsurance. $15 and $35 office visit copays. $35 Urgent Care copay.Generic and preferred brand drug copays are $15 and $30 ($37.50 and $75 mail order).
Molina Confident Care Gold 1 – $2,925 deductible with maximum out-of-pocket expenses of $6,500 and 20% coinsurance. Office visit copays are $10 and $50 with a $10 copay for Urgent Care. Generic and preferred brand drug copays are $10 and $50. $15 diagnostic test copay.
Oscar Gold Classic – $2,500 deductible with maximum out-of-pocket expenses of $6,000 and 30% coinsurance. Office visit copays are $30 and $55 with a $75 copay for Urgent Care. Generic and preferred brand drug copays are $3 and $55 ($7.50 and $137.50 mail order).
Total Health Care Total HMO Standard – $1,500 deductible with maximum out-of-pocket expenses of $7,000. Office visit copays are $30 and $60 with a $60 copay for Urgent Care. Generic, preferred brand, and non-preferred brand drug copays are $25, $50, and $100. Diagnostic testing copay is $100.
Physicians Health Plan Sparrow PHP Gold 2000 Exclusive – $2,000 deductible with maximum out-of-pocket expenses of $6,800 and 30% coinsurance. Office visit copays are $30 and $60 with a $75 copay for Urgent Care. Tiers 1A, 1B, 2, 3, and 4 drug copays are $5, $10, $60, $80, and $160.
Health Savings Accounts
A Michigan HSA is a great cost-savings health care alternative that will allow you to take near complete-control over your medical treatment and take a tax-deduction for many health, dental and vision expenses. And yes…it really is considered qualified major medical insurance. An HSA is not a “discount plan.” Over time, the combination of tax deductions and premium savings can make a big difference in your pocketbook.
Many carriers in the state offer HSA options. Several different deductible and coinsurance combinations are also available. However, the higher deductible/0%-30% coinsurance plans are historically the most popular options. An optional 40% coinsurance will slightly lower rates, but also increase your out-of-pocket costs. There have been 50% options but the nominal savings is not worth the extra risk.
The Obamacare legislation has not impacted the tax deductibility of these plans. The actual savings account portion can still be picked by you. Chase, Wells Fargo, HSA Bank, Optum, and Bank of America are popular plan administrators, although many other institutions can be used. It’s wise to compare monthly fees and interest rates to help determine which bank is your best fit. Your personal bank that you have established a relationship with, may waive the fee of about $2-$4 per month. All Michigan HSA plans are listed below:
Ambetter Essential Care 2 HSA – $6,900 deductible with $6,900 maximum out-of-pocket expenses
Ambetter Balanced Care 25 HSA – $4,800 deductible with $4,800 maximum out-of-pocket expenses
BCBS Premier PPO Bronze HSA – $6,950 deductible with $6,950 maximum out-of-pocket expenses
BCBS Premier PPO Silver Saver HSA – $3,500 deductible with $6,950 maximum out-of-pocket expenses
Priority Health MyPriority HMO HSA Bronze 7000 – $7,000 deductible with $7.000 maximum out-of-pocket expenses
Oscar Bronze HDHP – $5,200 deductible with $7,000 maximum out-of-pocket expenses
Blue Care Network Select HMO Bronze Saver HSA – $6,950 deductible with $6,950 maximum out-of-pocket expenses
Blue Care Network Preferred HMO Bronze Saver HSA – $6,950 deductible with $6,950 maximum out-of-pocket expenses
McLaren Bronze Saver – $6,900 deductible with $6,900 maximum out-of-pocket expenses
Current Michigan Health Insurance Rates (Monthly)
Wayne County – 30 year-old with $32,000 household income
$40 – Blue Cross HMO Bronze
$40 – Priority Health My Priority HMO Bronze 8550
$46 – Total Health Care Total Saver Plus
$48 – Priority Health My Priority Health HMO Bronze 8550
$49 – Blue Cross HMO Bronze Saver HSA
$50 – Ambetter Essential Care 1
$55 – Total Health Care Bronze Saver Complete
Wayne County – 30 year-old married couple with $48,000 household income
$72 – Blue Cross HMO Bronze
$72 – Priority Health My Priority HMO Bronze 8550
$84 – Total Health Care Total Saver Plus
$88 – Priority Health My Priority Health HMO Bronze 8550
$89 – Priority Health My Priority Health HMO HSA Bronze 7000
$91 – Blue Cross HMO Bronze Saver HSA
$91 – Ambetter Essential Care 1
Oakland County – 40 year-old with $36,000 household income
$84 – Priority Health My Priority HMO Bronze 8550
$86 – Blue Cross HMO Bronze
$92 – Priority Health My Priority HMO Bronze 8550
$93 – Priority Health My Priority Health HMO HSA Bronze 7000
$93 – Total Health Care Total Saver Plus
$97 – Blue Cross HMO Bronze Saver HSA
$97 – Ambetter Essential Care 1
Oakland County – 40 year-old married couple with $52,000 household income
$114 – Priority Health My Priority HMO Bronze 8550
$118 – Blue Cross HMO Bronze
$131 – Priority Health My Priority HMO Bronze 8550
$132 – Priority Health My Priority Health HMO HSA Bronze 7000
$132 – Total Health Care Total Saver Plus
$139 – Blue Cross HMO Bronze Saver HSA
$139 – Ambetter Essential Care 1
Macomb County – 50 year-old with $38,000 household income
$179 – Meridian Healthy Bronze
$183 – Meridian HSA Savings Bronze
$184 – Total Health Care Total Saver Plus
$194 – Priority Health My Priority Health HMO Bronze 8150
$199 – Total Health Care Total Saver Complete
$201 – Blue Cross HMO Bronze
$299 – Meridian Healthy Saver
Macomb County – 50 year-old married couple and one child with $70,000 household income
$243 – Meridian Healthy Bronze
$253 – Meridian HSA Savings Bronze
$253 – Total Health Care Total Saver Plus
$279 – Priority Health My Priority Health HMO Bronze 8150
$290 – Total Health Care Total Saver Complete
$295 – Blue Cross HMO Bronze
$534 – Meridian Healthy Saver
Michigan Medicare Supplement Coverage
If you have reached age 65 (or earlier in some situations), you are probably eligible for Medicare benefits. A supplemental policy will help pay many of the expenses (copays, deductibles, and coinsurance) that are not covered by Original Medicare. Medigap plans typically cover “core” benefits, such as hospitalization (Part A), medical expenses (Part B),hospice coinsurance and three pints of blood. Companies authorized and licensed to offer coverage in the state are listed below:
Aetna
Alliance Health
American Continental
Bankers Fidelity
Blue Care Network Of Michigan
BCBS Of Michigan
Central States
Colonial Penn
Combined
Continental General
Continental Life
Equitable
Everence
Family Life
Gerber
Globe
Golden Rule
Government Personnel Mutual
Greek Catholic Union
Health Care Service
Humana
Loyal American
Manhattan Life
Medico
New York Life
Omaha
Order Of United Commercial Travelers
Oxford Life
Pekin Life
Priority Health
Reserve National
Royal Neighbors Of America
Standard Life And Accident
State Farm
Thrivent
Transamerica
United American
UnitedHealthcare
USAA
A Medigap subsidy is also available for eligible applicants. The MI Health Endowment Fund contributes funds directly to your Medicare Supplement insurer. To qualify for benefits, your income must be less than $17,820 ($24,030 for two persons), and the plan must be issued through an approved carrier.
Sample Medicare Supplement Rates
Shown below are estimated monthly premiums for various plans from several popular companies. Rates are provided for a 65 year-old male non-smoking applicant. Female rates are often lower. Although policies are standardized, proper comparisons should always be made. Not all plans are offered by each carrier in counties shown.
Wayne County Plan A
$72 – AARP-UnitedHealthcare
$105 – Paramount
$115 – Omaha Supplemental
$115 – National Health
$116 – BCBS Of Michigan
$120 – Philadelphia American
$125 – Medico
$126 – Cigna
$132 – SBLI USA Life
$133 – Accendo
$136 – Continental Life
$138 – Elips Life
$141 – Humana
$142 – AFLAC
$144 – Manhattan Life
$144 – United States Fire
$144 – Capitol Life
$148 – Cigna
$148 – Central States
$161 – Union Security
$162 – United American
$170 – Great Southern Life
$175 – Bankers Fidelity
$179 – Guarantee Trust life
$195 – Assured Life
$232 – Oxford Life
$235 – GPM Health
Wayne County Plan F
$154 – Accendo
$155 – Continental Life
$157 – BCBS Of Michigan
$159 – United World Life
$166 – Capitol Life
$168 – Humana
$170 – Great Southern Life
$171 – United States Fire
$176 – Philadelphia American
$177 – Union Security
$183 – Lumico Life
$195 – Assured Life
$253 – Cigna
$262 – Medico
$267 – Oxford Life
Wayne County Plan F (HD)
$53 – United World Life
$59 – Humana
$63 – Cigna
$66 – Medico
$74 – Aetna
Wayne County Plan G
$115 – AARP-UnitedHealthcare
$127 – Transamerica
$137 – Western United Life
$137 – Union Security
$140 – Humana
$141 – Guarantee Trust Life
$143 – Lumico Life
$144 – Continental Life
$145 – Aetna
$148 – Oxford Life
$157 – Great Southern Life
$162 – United World Life
$163 – Greek Catholic Union
$170 – Cigna
$172 – Medico
Oakland, Lapeer, Macomb, Washtenaw, Monroe, Livingston, Sanilac, Genesee, Tuscola, and Saint Clair Counties Plan F
$143 – AARP-UnitedHealthcare
$167 – Continental Life
$180 – Guarantee Trust Life
$183 – Union Security
$187 – Humana
$187 – Lumico Life
$189 – Western United Life
$192 – Great Southern Life
$223 – United World Life
Oakland, Lapeer, Macomb, Washtenaw, Monroe, Livingston, Sanilac, Genesee, Tuscola, and Saint Clair Counties Plan F (HD)
$53 – United World Life
$59 – Humana
$67 – Medico
$68 – Cigna
Oakland, Lapeer, Macomb, Washtenaw, Monroe, Livingston, Sanilac, Genesee, Tuscola, and Saint Clair Counties Plan N
$95 – AARP-UnitedHealthcare
$109 – Continental Life
$109 – Union Security
$115 – Western United Life
$116 – Transamerica
$118 – Humana
$120 – Guarantee Trust Life
$123 – Lumico Life
$124 – Greek Catholic Union
$126 – Assured Life
$131 – United World Life
$135 – Great Southern Life
$151- Medico
$168 – Cigna
$151 – Medico
$184 – Oxford Life
Kent, Lake, Missaukee, Grand Traverse, Antrim, and Wexford Counties Plan F
$137 – Continental Life
$141 – Humana
$147 – Lumico Life
$149 – Assured Life
$151 – Great Southern Life
$152 – AARP-UnitedHealthcare
$157 – Union Security
$164 – Western United Life
$169 – United World Life
$172 – Cigna
$192 – Transamerica
$214 – Oxford Life
$224 – Medico
Kent, Lake, Missaukee, Grand Traverse, Antrim, and Wexford Counties Plan F (HD)
$40 – United World Life
$45 – Humana
$47 – Cigna
$54 – Medico
Kent, Lake, Missaukee, Grand Traverse, Antrim, and Wexford Counties Plan N
$89 – Humana
$90 – Continental Life
$91 – Union Security
$92 – Assured Life
$95 – Transamerica
$96 – Lumico Life
$99 – United World Life
$100 – Western United Life
$106 – Great Southern Life
$108 – Guarantee Trust Life
$108 – Cigna
$122 – Medico
$143 – Oxford Life
Ingham, Eaton, Montcalm, Isabella, Gratiot, and Clinton Counties Plan F
$131 – Accendo
$132 – Continental Life
$138 – Philadelphia American
$147 – Great Southern Life
$151 – BCBS Of Michigan
$152 – AARP-UnitedHealthcare
$155 – Assured Life
$159 – Humana
$159 – Lumico Life
$161 – Union Security
$162 – United World Life
$179 – Cigna
$214 – Medico
$228 – Oxford Life
Ingham, Eaton, Montcalm, Isabella, Gratiot, and Clinton Counties Plan F (HD)
$38 – United World Life
$38 – Philadelphia American
$49 – Cigna
$52 – Medico
$60 – BCBS Of Michigan
Michigan Medicare Advantage Plans With Prescription Drug Benefits
Prices, benefits, and availability vary by county. The counties with the most available plans are Wayne (97), Oakland (95), Washtenaw (85), Genesee (84), Livingston (84), Macomb (83), Kalamazoo (76), Saginaw (73), Kent (72), Bay (71), Branch (71), Tuscola (71), Monroe (70), Calhoun (69), St. Clair (69), and Lapeer (69). Shown below are monthly rates and popular plan options (with prescription drug benefits) offered in Oakland County.
AARP Medicare Advantage from UHC M1-0001 – $0 premium with $0 deductible and $4,500 maximum out-of-pocket expenses. Inpatient hospital copay is $325 for the first 7 days, and outpatient hospital copay is $0-$325. Office visit copays are $0 and $0-$35, and ER and Urgent Care copays are $120 and $0-$40. The lab services and outpatient x-rays copays are $0 and $15. Outpatient mental health individual and group therapy copays are $0-$5. Rehabilitation therapy visits are subject to a $0-$20 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $30 (Tier 2), $141 (Tier 3), $300 (Tier 4), and n/a (Tier 5). 3,654 formulary drugs available.
AARP Medicare Advantage from UHC M1-0002 – $33 premium with $0 deductible and $3,800 maximum out-of-pocket expenses. Inpatient hospital copay is $290 for the first 7 days, and outpatient hospital copay is $0-$290. Office visit copays are $0 and $0-$30, and ER and Urgent Care copays are $135 and $0-$40. The lab services and outpatient x-rays copays are $0 and $15. Outpatient mental health individual and group therapy copays are $0-$5. Rehabilitation therapy visits are subject to a $20 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $8 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $24 (Tier 2), $141 (Tier 3), $300 (Tier 4), and n/a (Tier 5). 3,654 formulary drugs available.
Aetna Medicare Premier – $0 premium with $0 deductible and $3,900 maximum out-of-pocket expenses. Inpatient hospital copay is $300 for the first 7 days, and outpatient hospital copay is $0-$315. Office visit copays are $0 and $35, and ER and Urgent Care copays are $110 and $45. The lab services and outpatient x-rays copays are $0 and $10. Outpatient mental health individual and group therapy copays are $40. Rehabilitation therapy visits are subject to a $40 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $20 (Tier 2), $141 (Tier 3), $300 (Tier 4), and n/a (Tier 5). 3,597 formulary drugs available.
Aetna Medicare Premier Plus – $27 premium with $0 deductible and $4,500 maximum out-of-pocket expenses. Inpatient hospital copay is $260 for the first 5 days, and outpatient hospital copay is $0-$250. Office visit copays are $0 and $35, and ER and Urgent Care copays are $100 and $45. The lab services and outpatient x-rays copays are $0-$5 and $10. Outpatient mental health individual and group therapy copays are $40. Rehabilitation therapy visits are subject to a $35 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $20 (Tier 2), $141 (Tier 3), $300 (Tier 4), and n/a (Tier 5). 3,597 formulary drugs available.
Aetna Medicare Value – $0 premium with $0 deductible and $4,950 maximum out-of-pocket expenses. Inpatient hospital copay is $285 for the first 7 days, and outpatient hospital copay is $0-$350. Office visit copays are $0 and $45, and ER and Urgent Care copays are $100 and $60. The lab services and outpatient x-rays copays are $0-$10 and $30. Outpatient mental health individual and group therapy copays are $40. Rehabilitation therapy visits are subject to a $40 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $20 (Tier 2), $141 (Tier 3), $300 (Tier 4), and n/a (Tier 5). 3,597 formulary drugs available.
Ascension Complete Medicare Access – $0 premium with $0 deductible and $2,900 maximum out-of-pocket expenses. Inpatient hospital copay is $575 for the first 4 days, and outpatient hospital copay is 20%. Office visit copays are $0 and 20%, and ER and Urgent Care copays are $120 and $40. The lab services and outpatient x-rays copays are $0 and 20%. Outpatient mental health individual and group therapy copays are 20%. Rehabilitation therapy visits are subject to a 20% copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $5 (Tier 2), $37 (Tier 3), $90 (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $15 (Tier 2), $111 (Tier 3), $270 (Tier 4), and n/a (Tier 5). 3,430 formulary drugs available.
Ascension Complete Michigan Secure – $0 premium with $0 deductible and $2,900 maximum out-of-pocket expenses. Inpatient hospital copay is $295 for the first 6 days, and outpatient hospital copay is 20%. Office visit copays are $0 and $30, and ER and Urgent Care copays are $125 and $30. The lab services and outpatient x-rays copays are $0. Outpatient mental health individual and group therapy copays are $30. Rehabilitation therapy visits are subject to a $30 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $1 (Tier 2), $37 (Tier 3), $90 (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $3 (Tier 2), $111 (Tier 3), $270 (Tier 4), and n/a (Tier 5). 3,430 formulary drugs available.
Ascension Complete Michigan Reward – $0 premium with $480 deductible and $3,450 maximum out-of-pocket expenses. Inpatient hospital copay is $425 for the first 5 days, and outpatient hospital copay is $350. Office visit copays are $0 and $50, and ER and Urgent Care copays are $125 and $45. The lab services and outpatient x-rays copays are $35. Outpatient mental health individual and group therapy copays are $40. Rehabilitation therapy visits are subject to a $40 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $5 (Tier 2), $37 (Tier 3), $90 (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $15 (Tier 2), $111 (Tier 3), $270 (Tier 4), and n/a (Tier 5). 3,430 formulary drugs available.
BCN Advantage Prime Value – $0 premium with $50 deductible and $4,500 maximum out-of-pocket expenses. Inpatient hospital copay is $325 for the first 6 days, and outpatient hospital copay is $0-$275. Office visit copays are $0 and $45, and ER and Urgent Care copays are $90 and $0-$45. The lab services and outpatient x-rays copays are $0 and $20-$100. Outpatient mental health individual and group therapy copays are $40. Rehabilitation therapy visits are subject to a $30 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $11 (Tier 2), $42 (Tier 3), 50% (Tier 4), and 32% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $0 (Tier 2), $126 (Tier 3), 50% (Tier 4), and n/a (Tier 5).
BCN Advantage Community Value – $20 premium with $0 deductible and $4,500 maximum out-of-pocket expenses. Inpatient hospital copay is $300 for the first 6 days, and outpatient hospital copay is $0-$225. Office visit copays are $0 and $35, and ER and Urgent Care copays are $90 and $0-$45. The lab services and outpatient x-rays copays are $0 and $20-$100. Outpatient mental health individual and group therapy copays are $25. Rehabilitation therapy visits are subject to a $30 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $45 (Tier 3), 50% (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $0 (Tier 2), $135 (Tier 3), 50% (Tier 4), and n/a (Tier 5).
BCN Advantage HMO Connected Care – $58 premium with $0 deductible and $3,800 maximum out-of-pocket expenses. Inpatient hospital copay is $225 for the first 6 days, and outpatient hospital copay is $0-$225. Office visit copays are $0 and $40, and ER and Urgent Care copays are $90 and $0-$45. The lab services and outpatient x-rays copays are $0 and $20-$100. Outpatient mental health individual and group therapy copays are $40. Rehabilitation therapy visits are subject to a $30 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $42 (Tier 3), 48% (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $0 (Tier 2), $126 (Tier 3), 48% (Tier 4), and n/a (Tier 5).
BCN Advantage HMO-POS Classic – $129 premium with $0 deductible and $3,800 maximum out-of-pocket expenses. Inpatient hospital copay is $225 for the first 6 days, and outpatient hospital copay is $0-$225. Office visit copays are $0 and $35, and ER and Urgent Care copays are $90 and $0-$40. The lab services and outpatient x-rays copays are $0 and $20-$75. Outpatient mental health individual and group therapy copays are $35. Rehabilitation therapy visits are subject to a $30 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $7 (Tier 2), $38 (Tier 3), 45% (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $0 (Tier 2), $114 (Tier 3), 45% (Tier 4), and n/a (Tier 5).
HAP Senior Plus – $0 premium with $0 deductible and $5,000 maximum out-of-pocket expenses. Inpatient hospital copay is $295 for the first 6 days, and outpatient hospital copay is $260. Office visit copays are $0 and $40, and ER and Urgent Care copays are $90 and $65. The lab services and outpatient x-rays copays are $0 and $35. Outpatient mental health individual and group therapy copays are $0. Rehabilitation therapy visits are subject to a $30 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $42 (Tier 3), 48% (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $25 (Tier 2), $105 (Tier 3), 48% (Tier 4), and n/a (Tier 5).
HAP Senior Plus Option 1 (PPO) – $0 premium with $0 deductible and $6,000 maximum out-of-pocket expenses. Inpatient hospital copay is $295 for the first 6 days, and outpatient hospital copay is $260. Office visit copays are $0 and $50, and ER and Urgent Care copays are $90 and $65. The lab services and outpatient x-rays copays are $0 and $35. Outpatient mental health individual and group therapy copays are $0. Rehabilitation therapy visits are subject to a $30 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $42 (Tier 3), 48% (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $25 (Tier 2), $105 (Tier 3), 48% (Tier 4), and n/a (Tier 5).
HAP Senior Plus Option 1 (HMO-POS) – $85 premium with $0 deductible and $4,200 maximum out-of-pocket expenses. Inpatient hospital copay is $160 for the first 7 days, and outpatient hospital copay is $160. Office visit copays are $15 and $35, and ER and Urgent Care copays are $90 and $65. The lab services and outpatient x-rays copays are $0 and $35. Outpatient mental health individual and group therapy copays are $15. Rehabilitation therapy visits are subject to a $15 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $42 (Tier 3), 48% (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $25 (Tier 2), $105 (Tier 3), 48% (Tier 4), and n/a (Tier 5).
HAP Senior Plus Option 2 – $60 premium with $0 deductible and $5,000 maximum out-of-pocket expenses. Inpatient hospital copay is $200 for the first 7 days, and outpatient hospital copay is $235. Office visit copays are $20 and $40, and ER and Urgent Care copays are $90 and $65. The lab services and outpatient x-rays copays are $0 and $35. Outpatient mental health individual and group therapy copays are $20. Rehabilitation therapy visits are subject to a $20 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $42 (Tier 3), 48% (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $25 (Tier 2), $105 (Tier 3), 48% (Tier 4), and n/a (Tier 5).
HAP Senior Plus Option 3 – $160 premium with $0 deductible and $4,500 maximum out-of-pocket expenses. Inpatient hospital copay is $215 for the first 7 days, and outpatient hospital copay is $210. Office visit copays are $15 and $35, and ER and Urgent Care copays are $90 and $65. The lab services and outpatient x-rays copays are $0 and $35. Outpatient mental health individual and group therapy copays are $15. Rehabilitation therapy visits are subject to a $15 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $42 (Tier 3), 48% (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $25 (Tier 2), $105 (Tier 3), 48% (Tier 4), and n/a (Tier 5).
HAP Senior Plus Option 4 – $200 premium with $0 deductible and $4,000 maximum out-of-pocket expenses. Inpatient hospital copay is $135 for the first 7 days, and outpatient hospital copay is $160. Office visit copays are $10 and $30, and ER and Urgent Care copays are $90 and $65. The lab services and outpatient x-rays copays are $0 and $35. Outpatient mental health individual and group therapy copays are $10. Rehabilitation therapy visits are subject to a $10 copay. 30-day preferred pharmacy cost-sharing is $0 (Tier 1), $10 (Tier 2), $42 (Tier 3), 48% (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is $0 (Tier 1), $25 (Tier 2), $105 (Tier 3), 48% (Tier 4), and n/a (Tier 5).
Humana Gold Plus – $0 premium with $100 deductible and $5,200 maximum out-of-pocket expenses. Inpatient hospital copay is $299 for the first 7 days, and outpatient hospital copay is $50-$274. Office visit copays are $10 and $50, and ER and Urgent Care copays are $90 and $0-$50. The lab services and outpatient x-rays copays are $0-$35 and $0-$110. Outpatient mental health individual and group therapy copays are $40. Rehabilitation therapy visits are subject to $10-$40 copays. 30-day preferred pharmacy cost-sharing is $4 (Tier 1), $12 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 31% (Tier 5). 90-day preferred pharmacy cost-sharing is $12 (Tier 1), $36 (Tier 2), $141 (Tier 3), $300 (Tier 4), and n/a (Tier 5).
HumanaChoice – $19 premium with $195 deductible and $5,900 maximum out-of-pocket expenses. Inpatient hospital copay is $390 for the first 5 days, and outpatient hospital copay is $45-$365. Office visit copays are $20 and $45, and ER and Urgent Care copays are $90 and $20-$45. The lab services and outpatient x-rays copays are $0-$35 and $20-$110. Outpatient mental health individual and group therapy copays are $40. Rehabilitation therapy visits are subject to $20-$40 copays. 30-day preferred pharmacy cost-sharing is $2 (Tier 1), $8 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 29% (Tier 5). 90-day preferred pharmacy cost-sharing is $6 (Tier 1), $24 (Tier 2), $141 (Tier 3), $300 (Tier 4), and n/a (Tier 5).
PriorityMedicare Key – $0 premium with $100 deductible and $5,500 maximum out-of-pocket expenses. Inpatient hospital copay is $325 for the first 6 days, and outpatient hospital copay is $250. Office visit copays are $0-$10 and $0-$45, and ER and Urgent Care copays are $90 and $50. The lab services and outpatient x-rays copays are $10 and $35. Outpatient mental health individual and group therapy copays are $20. Rehabilitation therapy visits are subject to a $30 copay. 30-day preferred pharmacy cost-sharing is $4 (Tier 1), $15 (Tier 2), $42 (Tier 3), 45% (Tier 4), and 31% (Tier 5). 90-day preferred pharmacy cost-sharing is $12 (Tier 1), $45 (Tier 2), $126 (Tier 3), 45% (Tier 4), and n/a (Tier 5).
PriorityMedicare Ideal – $14 premium with $125 deductible and $6,000 maximum out-of-pocket expenses. Inpatient hospital copay is $300 for the first 6 days, and outpatient hospital copay is $250. Office visit copays are $0-$15 and $0-$50, and ER and Urgent Care copays are $90 and $50. The lab services and outpatient x-rays copays are $15 and $40. Outpatient mental health individual and group therapy copays are $20. Rehabilitation therapy visits are subject to a $40 copay. 30-day preferred pharmacy cost-sharing is $4 (Tier 1), $13 (Tier 2), $42 (Tier 3), 50% (Tier 4), and 30% (Tier 5). 90-day preferred pharmacy cost-sharing is $12 (Tier 1), $39 (Tier 2), $126 (Tier 3), 50% (Tier 4), and n/a (Tier 5).
PriorityMedicare Value – $42 premium with $75 deductible and $5,000 maximum out-of-pocket expenses. Inpatient hospital copay is $325 for the first 5 days, and outpatient hospital copay is $225. Office visit copays are $0-$5 and $0-$50, and ER and Urgent Care copays are $90 and $55. The lab services and outpatient x-rays copays are $20 and $35. Outpatient mental health individual and group therapy copays are $20. Rehabilitation therapy visits are subject to a $40 copay. 30-day preferred pharmacy cost-sharing is $2 (Tier 1), $10 (Tier 2), $42 (Tier 3), 50% (Tier 4), and 31% (Tier 5). 90-day preferred pharmacy cost-sharing is $6 (Tier 1), $30 (Tier 2), $126 (Tier 3), 50% (Tier 4), and n/a (Tier 5).
Michigan Medicare Part D Prescription Drug Plans
WellCare Value Script – $11.20 monthly rate with $505 deductible. 3.0 Plan Star Rating. 30-day supply cost-sharing copays are $0 (Tier 1) $5 (Tier 2), and $44 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $15 (Tier 2), and $132 (Tier 3). 322 and 400 Tier 1 and Tier 2 drugs offered.
WellCare Classic – $29.90 monthly rate with $505 deductible. 3.0 Plan Star Rating. 30-day supply cost-sharing copays are $0 (Tier 1) $4 (Tier 2), and $31 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $12 (Tier 2), and $93 (Tier 3). 129 and 421 Tier 1 and Tier 2 drugs offered.
WellCare Medicare Rx Value Plus – $71.30 monthly rate with $0 deductible. 3.0 Plan Star Rating. 30-day supply cost-sharing copays are $0 (Tier 1) $4 (Tier 2), and $47 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $10 (Tier 2), and $117.50 (Tier 3). 343 and 385 Tier 1 and Tier 2 drugs offered.
Cigna Saver Rx – $12.50 monthly rate with $505 deductible. 3.0 Plan Star Rating. 30-day supply cost-sharing copays are $0 (Tier 1) $10 (Tier 2), and $40 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $6 (Tier 2), and $120 (Tier 3). 232 and 359 Tier 1 and Tier 2 drugs offered.
Cigna Secure Rx– $29.90 monthly rate with $505 deductible. 3.0 Plan Star Rating. 30-day supply cost-sharing copays are $1 (Tier 1) $3 (Tier 2), and $20 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $0 (Tier 2), and $60 (Tier 3). 142 and 489 Tier 1 and Tier 2 drugs offered.
Cigna Extra Rx – $51.90 monthly rate with $100 deductible. 3.0 Plan Star Rating. 30-day supply cost-sharing copays are $4 (Tier 1) $10 (Tier 2), and $45 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $2 (Tier 2), and $135 (Tier 3). 175 and 583 Tier 1 and Tier 2 drugs offered.
Humana Walmart Value Rx Plan – $22.70 monthly rate with $480 deductible. 4.0 Plan Star Rating. 30-day supply cost-sharing copays are $1 (Tier 1) $4 (Tier 2), and 16% (Tier 3). 90-day supply cost-sharing mail-order copays are $3 (Tier 1), $12 (Tier 2), and 16% (Tier 3).
Humana Premier Rx Plan – $71.50 monthly rate with $480 deductible. 4.0 Plan Star Rating. 30-day supply cost-sharing copays are $1 (Tier 1) $4 (Tier 2), and $45 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $0 (Tier 2), and $125 (Tier 3).
Humana Basic Rx Plan – $31.00 monthly rate with $480 deductible. 4.0 Plan Star Rating. 30-day supply cost-sharing copays are $0 (Tier 1) $1 (Tier 2), and 19% (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $0 (Tier 2), and 15% (Tier 3).
AARP MedicareRx Walgreens – $33.40 monthly rate with $435 deductible. 3.5 Plan Star Rating. 30-day supply cost-sharing copays are $0 (Tier 1) $5 (Tier 2), and $40 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $15 (Tier 2), and $120 (Tier 3).
AARP MedicareRx Saver Plus – $29.20 monthly rate with $435 deductible. 3.5 Plan Star Rating. 30-day supply cost-sharing copays are $1 (Tier 1) $5 (Tier 2), and $26 (Tier 3). 90-day supply cost-sharing mail-order copays are $3 (Tier 1), $15 (Tier 2), and $78 (Tier 3).
AARP MedicareRx Preferred – $68.70 monthly rate with $0 deductible. 3.5 Plan Star Rating. 30-day supply cost-sharing copays are $5 (Tier 1) $10 (Tier 2), and $45 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $10 (Tier 2), and $120 (Tier 3).
SilverScript Choice – $30.20 monthly rate with $290 deductible. 4.0 Plan Star Rating. 30-day supply cost-sharing copays are $0 (Tier 1) $1 (Tier 2), and $47 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $3 (Tier 2), and $141 (Tier 3).
SilverScript Plus – $62.20 monthly rate with $0 deductible. 4.0 Plan Star Rating. 30-day supply cost-sharing copays are $0 (Tier 1) $2 (Tier 2), and $47 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $6 (Tier 2), and $141 (Tier 3).
Mutual Of Omaha Rx Value – $22.20 monthly rate with $435 deductible. 30-day supply cost-sharing copays are $0 (Tier 1) $2 (Tier 2), and $25 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $6 (Tier 2), and $75 (Tier 3).
Mutual Of Omaha Rx Plus – $52.60 monthly rate with $435 deductible. 30-day supply cost-sharing copays are $0 (Tier 1) $8 (Tier 2), and $42 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $24 (Tier 2), and $126 (Tier 3).
Prescription Blue Select – $35.90 monthly rate with $175 deductible. 4.0 Plan Star Rating. 30-day supply cost-sharing copays are $2 (Tier 1) $11 (Tier 2), and $42 (Tier 3). 90-day supply cost-sharing mail-order copays are $6 (Tier 1), $33 (Tier 2), and $126 (Tier 3).
Coverage For Less Than 12 Months
Often, benefits are only needed for a few months. In situations like this, and sometimes if the need for healthcare is between 6 and 12 months, a temporary plan is the best choice. Although office visits, prescriptions and pre-existing conditions are often excluded, rates are low and policies only take a few days (sometimes less) to approve. Typically, an online application takes less than 20 minutes to complete, and it is very easily underwritten. There are usually about six medical questions that will ask you about specific conditions and current medications.
Your Michigan Health Insurance Rate Can Be Cheaper With Available Federal Subsidy
While there are many acceptable options for temporary coverage, the Michigan policies that are among the most popular, include the UnitedHealthOne “Medical Value” plan and the UnitedHealthOne “Medical Plus” plan. Several other carriers offer policies, although their prices are generally higher. The maximum initial duration allowed on temporary plans is 185 days (during a 365-day period). Separate carriers may be used during this time. Additional insurers offering options include National General (Aetna PPO Network), Companion Life, Independence American, and Priority Health.
All of these companies are able to approve applications quickly and often issue policies within 24 hours. It generally takes about 20-30 minutes to complete the process, which allows the consumer time to determine what type of long-term coverage is best for them…an individual plan or an employer-sponsored contract. And yes…you can cancel the policy at any time, and the carrier will issue the appropriate refund.
Note: Temporary contracts do not meet federal qualification standards, but the 2.5% household income tax no longer applies, and renewal applications will also be medically underwritten. Marketplace plans should always be considered during the Open Enrollment period of November 1 to December 31. Since coverage is guaranteed, current (and past) medical conditions will be covered. Monthly costs of plans are listed below.
Michigan Short-Term Health Insurance Rates
30-Year-Old Female (Detroit)
$71 – $1 Million benefit with $10,000 deductible (Companion Life)
$84 – $1 Million benefit with $5,000 deductible (Companion Life)
$102 – $2 Million benefit with $5,000 deductible (Independence American)
$134 – $1 Million benefit with $2,000 deductible (Companion Life)
$157 – $2 Million benefit with $2,500 deductible (UnitedHealthcare)
40-Year-Old Male (Grand Rapids)
$69 – $1 Million benefit with $10,000 deductible (Companion Life)
$81 – $1 Million benefit with $5,000 deductible (Companion Life)
$97 – $2 Million benefit with $5,000 deductible (UnitedHealthcare)
$121 – $2 Million benefit with $2,500 deductible (UnitedHealthcare)
$129 – $1 Million benefit with $2,000 deductible (Companion Life)
45-Year-Old Female (Warren)
$106 – $1 Million benefit with $5,000 deductible (Independence American)
$141 – $1 Million benefit with $2,500 deductible (Independence American)
$141 – $1 Million benefit with $2,500 deductible (Independence American)
$223 – $2 Million benefit with $1,000 deductible (UnitedHealthcare)
50-Year-Old Male (Sterling Heights)
$136 – $1 Million benefit with $5,000 deductible (Companion Life)
$137 – $1 Million benefit with $5,000 deductible (Independence American)
$181 – $2 Million benefit with $2,500 deductible (UnitedHealthcare)
$227 – $1 Million benefit with $2,000 deductible (Companion Life)
What Is The Michigan Health Insurance Exchange?
It is the same thing as the “Marketplace” discussed earlier. The two terms are interchangeable. Government tax assistance is available to families and individuals with incomes below 400% of the Federal Poverty Level. The four available types of policies are Platinum, Gold, Silver and Bronze. “Catastrophic” plans, although cheap, are not eligible for federal aid. And often, Bronze-tier plans are cheaper than “catastrophic” options.
Approximately 13 companies offered policies to consumers in the first year of operation five years ago. Each year, the makeup of carriers changes. Several years ago, the number of available carriers began to decline. A complete list of companies was previously mentioned in this article. Also, “Essential Health Benefits” must be included in all plans. This includes coverage for maternity, office visits, prescriptions, mental illness, and many other items. Although you may not want or ever utilize several of these benefits, they still must be included. It’s the law!
Applying For A Policy
Once you have provided the information needed for the quote (at the top of the page), you will be presented with rate and coverage options from the top companies. At that point, if you wish to apply for a policy, the application process does not require that a complete physical or any medical information. There are several administrative questions to answer but you can easily enroll online, as opposed to visiting a physical office.
You are not required to keep your policy any longer than is needed. Almost all plans allow you to cancel your coverage with a phone call or letter in writing. And, of course, it is always a good idea to compare prices every year to ensure the rate you are paying for your benefits are still competitive and affordable. Typically, by October, new premiums are posted, and often, a different plan may offer better coverage at a lower price.
Older Updates:
Rate proposals have been submitted to the Mi. Department of Insurance. While Humana is requesting more than a 17% average increase, Molina is anticipating prices by an average of almost 22%. Blue Cross Blue Shield is asking for an increase just under 10%. Priority Health, a much smaller carrier, expects its prices to reduce by approximately 5%.
Because of the uncertainty of underwriting claim results, enrollment statistics and predicting how long consumers will keep their policies, it has been a challenge attempting to predict what the most appropriate rates should be. In future years, the process should become more predictable.
16 companies will offer Federally-Facilitated Marketplace plans in 2015. This makes the Michigan Exchange one of the largest in the US. There will be four new carriers and it’s expected that dozens of new and/or updated plans will be offered. Both subsidized and non-subsidized coverage will be offered.
Although applications are still accepted (with an SEP), it’s never too early to be thinking about 2016. Many carriers have requested rate increases that would be effective on January 1. Listed below are several of the more prominent companies and the affected plans. All price changes, before implemented, must be approved by the Department of Insurance.
37.9% – HealthPlus PPO Individual
20.49% – Consumers Mutual PPO Individual
17.18% – Healthplus HMO
12.39% – Blue Cross Blue Shield Detroit EPO Extra
11.78% – Blue Cross Blue Shield Individual
11.00% – Blue Cross Blue Shield Multi-State
The following companies will NOT be offering on-Exchange (Federally-Facilitated Marketplace) plans for 2016. It is possible, however, that they will offer plans “off-Exchange.”
Aetna, Celtic, Freedom Life, HealthPlus, Humana Insurance, UnitedHealthcare Life. NOTE: UnitedHealthcare Community Plan and Humana Medical Plan are actively offering policies.
Blue Care Network of Michigan requested (from the DOI) moderate Small Group rate decreases for many products with an effective date of July 1. Several of the HMO plans included were BCN Classic, Healthy Blue Living, BCN HRA, Blue Elect Plus Self-Referral Option, BCN HSA, and BCN Routine Care.