Affordable Michigan Individual Health Insurance and Medigap Coverage

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.

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

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. Several of the larger carriers are listed below:

Aetna, Bankers Life And Casualty, BCBS Of Michigan, Central States, Colonial Penn, Equitable, Genworth, Gerber Life, Humana, Medco, Mutual Of Omaha, New York Life, Oxford Life, Pacificare, Physicians Mutual, State Farm, Sterling Life, Thrivent, Transamerica, United American, and USAA. NOTE: Several of these companies, although licensed and approved, do not offer Senior coverage.

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 2019 effective dates, the new enrollment period began in November of 2018, 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 in 2019.

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 2019 (On-Exchange) coverage are  Blue Care Network, Blue Cross Blue Shield of Michigan,  McLaren Health Plan, Meridian, Molina, Physicians Health Plan, Priority Health, Oscar, and Total Health Care USA.  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. (Humana and Health Alliance Plan offer “off-Exchange” plans)

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: UnitedHealthcare, 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 (for 2018 policies).

Find low cost medical coverage in Michigan

Short Term Medical Coverage Is Often Approved Within One Day

 

Blue Cross Blue Shield Of Michigan And Other Carrier Individual And Family 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 options from BCBS and other 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 – $7,900 deductible with maximum out-of-pocket expenses of $7,900 and 0% coinsurance. $30 pcp office visit copay.

BCBS Premier PPO Value – $7,900 deductible with maximum out-of-pocket expenses of $7,900 and 0% coinsurance. $30 pcp office visit copay for first three visits.

McLaren Young Adult/Catastrophic – $7,900 deductible with maximum out-of-pocket expenses of $7,900 and 0% coinsurance.

Meridian Healthy Essentials – $7,900 deductible with maximum out-of-pocket expenses of $7,900 and 0% coinsurance. First three pcp office visits covered at 100%.

Oscar Simple Secure – $7,900 deductible with maximum out-of-pocket expenses of $7,900 and 0% coinsurance. First three pcp office visits covered at 100%.

Physicians Health Plan Sparrow PHP Healthy HMO – $7,900 deductible with maximum out-of-pocket expenses of $7,900 and 0% coinsurance. First three pcp office visits covered at 100%.

 

Bronze Tier

Blue Cross HMO Bronze Saver HSA – HSA-eligible plan. $6,700 deductible with maximum out-of-pocket expenses of $6,700 and 0% coinsurance.

Blue Cross HMO Bronze – $7,900 deductible with maximum out-of-pocket expenses of $7,900 and 0% coinsurance. $30 pcp office visit copay.

Blue Cross Select HMO Bronze – $7,900 deductible with maximum out-of-pocket expenses of $7,900 and 0% coinsurance. $30 pcp office visit copay.

BCBS Premier PPO Bronze Saver  – $7,900 deductible with maximum out-of-pocket expenses of $7,900 and 0% coinsurance.

BCBS Select HMO Bronze Saver HSA – $6,700 deductible with maximum out-of-pocket expenses of $6,700 and 0% coinsurance.

BCBS Premier PPO Bronze HSA – HSA-eligible plan with $6,700 deductible and maximum out-of-pocket expenses of $6,700 and 0% coinsurance.

Total Health Care Total Saver Plus – $5,500 deductible with maximum out-of-pocket expenses of $7,500 and 30% coinsurance. $15 generic drug copay.

Total Health Care Total Saver Complete – $7,150 deductible with maximum out-of-pocket expenses of $7,150 and 0% coinsurance.

McLaren Bronze 6500 – $6,500 deductible with maximum out-of-pocket expenses of $7,900 and 50% coinsurance. Tier 1, Tier 2, and Tier 3 drug copays are $30, $70, and $200. The specialty drug copay is $300.

Meridian Healthy Bronze – $7,900 deductible with maximum out-of-pocket expenses of $7,900 and 0% coinsurance. $50 pcp office visit copay.

Meridian HSA Savings Bronze – HSA-eligible plan with $5,500 deductible and maximum out-of-pocket expenses of $6,650 and 50% coinsurance.

Priority Health MyPriority HSA Bronze 6750 – HSA-eligible plan with $6,750 deductible and maximum out-of-pocket expenses of $6,750 and 0% coinsurance.

Oscar Simple Bronze – $7,900 deductible with maximum out-of-pocket expenses of $7,900 and 0% coinsurance. First three pcp office visits covered at 100%.

Oscar Classic Bronze – $4,500 deductible with maximum out-of-pocket expenses of $7,900 and 50% coinsurance. First three pcp office visits covered at 100%. $75 Urgent Care visit copay.

Physicians Health Plan Sparrow PHP Bronze 7300 Exclusive – $7,300 deductible with maximum out-of-pocket expenses of $7,900 and 50% coinsurance. $65 and $100 office visit copays with $125 Urgent Care copay. The generic drug copays are $35 and $70 (mail order).

 

Silver Tier

Blue Care Network Select HMO Silver Saver – $3,250 deductible with maximum out-of-pocket expenses of $6,550 and 30% coinsurance. $30 pcp office visit and $40 Urgent Care copays. The preferred generic and generic drug copays are $4 and $20 ($12 and $60 for 90-day mail-order).

Blue Care Network Select HMO Silver – $2,000 deductible with maximum out-of-pocket expenses of $7,350 and 30% coinsurance. $30 pcp office visit and $40 Urgent Care copays. The preferred generic and generic drug copays are $4 and $20 ($12 and $60 for 90-day mail-order).

Blue Care Network Select HMO Silver Extra – $3,500 deductible with maximum out-of-pocket expenses of $7,350 and 20% coinsurance. $30 and $65 office visit copays with $75 Urgent Care copay. The  generic and preferred brand drug copays are $15 and $50 ($45 and $150 for 90-day mail-order). Non-preferred brand drug copays are $100 and $300.

BCBS Premier PPO Silver Saver HSA – HSA-eligible plan with $3,100 deductible and maximum out-of-pocket expenses of $6,650 and 20% coinsurance.

BCBS Premier PPO Silver – $2,000 deductible with maximum out-of-pocket expenses of $7,350 and 20% coinsurance. Office visit copays are $30 and $50 with $75 Urgent Care copay. Generic drug copays are $15 and $45 (61-90 day mail-order).

BCBS Premier PPO Silver Extra – $3,500 deductible with maximum out-of-pocket expenses of $7,000 and 20% coinsurance. Office visit copays are $30 and $65 with $75 Urgent Care copay. The  generic and preferred brand drug copays are $15 and $50 ($45 and $150 for 90-day mail-order). Non-preferred brand drug copays are $100 and $300.

Molina Marketplace Silver 250 Plan – $4,950 deductible with maximum out-of-pocket expenses of $7,350 and 40% coinsurance. Office visit copays are $30 and $75 with a $75 copay for Urgent Care. Generic and preferred brand drug copays are $20 and $60.

Molina Marketplace Options Silver 250 Plan – $3,500 deductible with maximum out-of-pocket expenses of $7,350 and 20% coinsurance. Office visit copays are $35 and $65 with a $75 copay for Urgent Care. Generic and preferred brand drug copays are $15 and $50. Non-preferred brand drug copay is $100.

Meridian Healthy Silver – $6,000 deductible with maximum out-of-pocket expenses of $7,350 and 50% coinsurance. $25 and $50 office visit copays. Preferred generic and non-preferred generic drug copays are $0 and $10.

Meridian Smart Silver – $0 deductible with maximum out-of-pocket expenses of $7,350 and 50% coinsurance. $65 and $200 office visit copays. Preferred generic, non-preferred generic drug, preferred brand, and non-preferred brand drug copays are $15, $50, $125, and $200.

Meridian HSA Savings Silver – HSA-eligible plan with $4,000 deductible and maximum out-of-pocket expenses of $5,300 and 40% coinsurance.

Priority Health MyPriority Silver 3200 – $3,200 deductible and maximum out-of-pocket expenses of $7,350 and 30% coinsurance. $30 and $45 office visit copays with $75 Urgent Care copay. The generic, preferred brand, and non-preferred brand drug copays are $20, $75, and $100.

McLaren Silver Standard – $3,500 deductible with maximum out-of-pocket expenses of $7,350 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 $15, $50, and $100.

Total Health Care Totally You Value – $5,000 deductible with maximum out-of-pocket expenses of $7,350 and 30% coinsurance. $20 pcp office visit copay and $10 generic drug copay.

Total Health Care Totally You Complete – $3,750 deductible with maximum out-of-pocket expenses of $6,000 and 20% coinsurance. $20 pcp office visit copay and $25 generic drug copay.

 

Gold Tier

Priority Health MyPriority Gold 1100 – $1,100 deductible and maximum out-of-pocket expenses of $7,350 and 20% coinsurance. Office visits and Urgent Care subject to 20% coinsurance and deductible. Prescription drugs also subject to 20% coinsurance and deductible.

McLaren Gold Standard – $1,400 deductible with maximum out-of-pocket expenses of $5,000 and 20% coinsurance. Office visit copays are $20 and $50. The Urgent Care copay is $60. Tier 1, Tier 2, and Tier 3 drug copays are $10, $40, and $75.

Blue Care Network Select Preferred HMO Gold – $500 deductible with maximum out-of-pocket expenses of $5,500 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).

BCBS Premier PPO Gold – $500 deductible with maximum out-of-pocket expenses of $5,500 and 20% coinsurance. $30 and $50 office visit copays with $75 Urgent Care copay.  The generic drug copay is $15 ($45 for 90-day mail order).  All other drugs subject to coinsurance.

Meridian Healthy Gold – $2,200 deductible with maximum out-of-pocket expenses of $4,450 and 30% coinsurance. $25 and $50 office visit copays. Preferred generic and non-preferred generic drug copays are $0 and $10.

Molina Marketplace Gold Plan – $3,800 deductible with maximum out-of-pocket expenses of $7,350 and 20% coinsurance. Office visit copays are $10 and $35 with a $60 copay for Urgent Care. Generic and preferred brand drug copays are $10 and $50.

 

Low Cost Plan Choices

Listed below are several of the least-expensive Michigan Health Marketplace plans available. It’s important to take into consideration your subsidy-eligibility, since often, slightly more expensive policies (with cost-sharing), may provide lower deductibles and smaller out-of-pocket expenses. Qualified preventive benefits are provided at 100% coverage on all plans. NOTE: Not all plans are available state-wide.

Blue Cross Preferred Bronze – $5,950 deductible with $6,350 maximum out-of-pocket expense. Copays on many office visits and some prescriptions apply after the deductible is met.

Blue Cross Metro Detroit HMO Bronze – Very inexpensive option for the Detroit area. $5,950 deductible. Very similar to prior plan.

Blue Cross Partnered Bronze – $5,950 deductible although office visit and prescription copays must meet deductible first.

Humana Bronze 6300/Detroit HMOx – Another low-cost Detroit area option using Humana’s network.

Priority Health My Priority HMO HSA – HSA-eligible plan with $6,550 deductible and no coinsurance.

My Priority HSA Bronze 6300 – No coinsurance, so maximum out-of-pocket expense matches the deductible.

My Priority HSA Bronze 6000 – Similar to 6300 plan but a $25 copay on office visits is included and maximum liability is slightly higher ($6,600).

UnitedHealthcare Bronze Compass HSA 4900 – HSA-eligible plan from one of the nation’s largest carriers.

Molina Marketplace Bronze – $4,500 deductible (lower than most Bronze plans) and copays on office visits and generic prescriptions. A very economical plan.

Blue Cross Partnered Silver Extra – Attractive $2,000 deductible with $20 and $50 copays on doctor and specialist visits. Also, low $4 copay on generic drugs.

UnitedHealthcare Silver Compass HSA 2600 – Low $2,600 deductible HSA-eligible plan. Ideal for persons with no medical conditions that want affordable pricing with lower deductible and HSA-compatible.

Totally You (Total Health Care) – $3,000 deductible with $20 and $40 copays on pcp and specialist office visits. No deductible to meet on prescriptions.

 

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 one of those goofy “discount plans.” 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. The most competitively-priced Michigan HSA plans are listed below:

Humana Bronze 6450 – $6,450 deductible and 0% coinsurance.

Blue Cross Bronze Saver – Similar to previous plan although slightly more expensive. Same deductible and coinsurance.

HAP Personal Alliance 5000 – $5,000 deductible with 20% coinsurance. $6,450 maximum out-of-pocket expenses.

Blue Cross Select Bronze – $5,950 deductible with 40% coinsurance.

Blue Cross Preferred Bronze – $5,950 deductible with 40% coinsurance.

UnitedHealthcare Bronze HSA 100 – $6,500 deductible with 0% coinsurance.

Aetna Bronze Deductible Only – $6,450 deductible with 0% coinsurance.

Priority Health MyPriority  HMO HSA Bronze 6550 – $6,550 deductible with 0% coinsurance.

Priority Health MyPriority HMO HSA Silver 1500 – Low $1,500 deductible.

 

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

$71 – AARP-UnitedHealthcare

$112 – Transamerica

$135 – Guarantee Trust

$135 – Aetna

$140 – Equitable National Life

$141 – Liberty Bankers Life

$143 -Shenandoah Life

$143 – Individual Assurance

$145 – United American

$148 – Manhattan Life

$162 – Thrivent

$162 – Greek Catholic Union

$165 – Cigna

$167 – Medico

$167 – Pekin Life

$199 – Humana

$205 – Oxford Life

$224 – Gerber

 

Wayne County Plan F

$136 – AARP-UnitedHealthcare

$172 – Guarantee Trust Life

$175 – Equitable National Life

$176 – Transamerica

$177 – Liberty Bankers Life

$178 – Individual Assurance

$181 – Pekin Life

$198 – Shenandoah Life

$198 – Manhattan Life

$201 – Greek Catholic Union

$204 – Aetna

$206 – Cigna

$216 – Thrivent

$219 – Medico

$226 – Oxford Life

$244 – Humana

$247 – United American

$345 – Gerber

 

Wayne County Plan F (HD)

$36 – United American

$49 – Thrivent

$59 – Humana

$61 – Cigna

$64 – Medico

$82 – Aetna

 

Wayne County Plan G

$115 – AARP-UnitedHealthcare

$122 – Transamerica

$136 – Humana

$137 – Equitable National Life

$137 – Individual Assurance

$138 – Manhattan Life

$140 – Liberty Bankers Life

$143 – National Guardian Life

$145 – Pekin Life

$146 – Shenandoah Life

$148 – Oxford Life

$150 – Greek Catholic Union

$159 – Aetna

$162 – Transamerica

$164 – Cigna

$180 – Medico

$181 – Central States

$181 – Thrivent

$187 – United American

$243 – Gerber

 

Oakland, Lapeer, Macomb, Washtenaw, Monroe, Livingston, Sanilac, Genesee, Tuscola, and Saint Clair Counties Plan F (HD)

$36 – United American

$49 – Thrivent

$61 – Cigna

$64 – Medico

$69 – Humana

$82 – Aetna

 

Oakland, Lapeer, Macomb, Washtenaw, Monroe, Livingston, Sanilac, Genesee, Tuscola, and Saint Clair Counties Plan N

$95 – AARP-UnitedHealthcare

$112 – Transamerica

$114 – Western United Life

$116 – Equitable National Life

$116 – Pekin Life

$116 – Individual Assurance

$118 – Manhattan Life

$119 – Liberty Bankers Life

$120 – Guarantee Trust Life

$122 – National Guardian Life

$124 – Greek Catholic Union

$125 – Shenandoah Life

$135 – Aetna

$141 – Humana

$142 – Cigna

$151 – Medico

$157 – Oxford Life

$174 – United American

 

Kent, Lake, Missaukee, Grand Traverse, Antrim, and Wexford Counties Plan F

$133 – AARP-UnitedHealthcare

$135 – Cigna

$141 – Pekin Life

$143 – Individual Assurance

$147 – Aetna

$149 – Companion Life

$150 – United World Life

$150 – Greek Catholic Union

$152 – Shenandoah Life

$153 – Central States

$160 – Manhattan Life

$162 – Transamerica

$174 – Oxford Life

$179 – Medico

$185 – Equitable

$189 – Humana

$211 – United American

$234 – Gerber

 

Kent, Lake, Missaukee, Grand Traverse, Antrim, and Wexford Counties Plan F (HD)

$31 – United American

$40 – United World Life

$40 – Cigna

$52 – Medico

$53 – Humana

$59 – Aetna

 

Ingham, Eaton, Montcalm, Isabella, Gratiot,  and Clinton Counties Plan F

$133 – AARP-UnitedHealthcare

$151 – Cigna

$155 – Pekin Life

$157 – Individual Assurance

$160 – Companion Life

$163 – Greek Catholic Union

$164 – United World Life

$164 – Aetna

$165 – Shenandoah Life

$168 – Manhattan Life

$171 – Central States

$180 – Transamerica

$192 – Oxford Life

$192 – Medico

$207 – Equitable

$215 – Humana

$233 – United American

 

Ingham, Eaton, Montcalm, Isabella, Gratiot, and Clinton Counties Plan F (HD)

$35 – United American

$44 – United World Life

$45 – Cigna

$53 – Humana

$56 – Medico

$65 – Aetna

 

Michigan Medicare Advantage Plans With Prescription Drug Benefits

Prices, benefits, and availability vary by County. Shown below are monthly rates and plan options offered in Oakland County.

BCN Advantage HMO HealthyValue – $0 premium with $250 deductible and $4,700 maximum out-of-pocket expenses. Inpatient hospital copay is $285 for the first 7 days, and outpatient hospital copay is $0-$200. Office visit copays are $10 and $50, and ER and Urgent Care copays are $80 and $45. The lab services and outpatient x-rays copays are $20 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 $2 (Tier 1), $11 (Tier 2), $42 (Tier 3), 50% (Tier 4), and 28% (Tier 5). 90-day preferred pharmacy cost-sharing is  $6 (Tier 1), $33 (Tier 2), $126 (Tier 3), 50% (Tier 4), and n/a (Tier 5).

BCN Advantage HMO-POS Basic – $0 premium with $395 deductible and $4,700 maximum out-of-pocket expenses. Inpatient hospital copay is $285 for the first 6 days, and outpatient hospital copay is $0-$175. Office visit copays are $25 and $50, and ER and Urgent Care copays are $80 and $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 $3 (Tier 1), $11 (Tier 2), $42 (Tier 3), 50% (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy cost-sharing is  $9 (Tier 1), $33 (Tier 2), $126 (Tier 3), 50% (Tier 4), and n/a (Tier 5).

HAP Senior Plus – $0 premium with $0 deductible and $6,700 maximum out-of-pocket expenses. Inpatient hospital copay is $230 for the first 7 days, and outpatient hospital copay is $200. Office visit copays are $0 and $50, and ER and Urgent Care copays are $80 and $60. The lab services and outpatient x-rays copays are $15 and $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), $15 (Tier 2), $45 (Tier 3), $95 (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is  $0 (Tier 1), $37.50 (Tier 2), $112.50 (Tier 3), $237.50 (Tier 4), and 33% (Tier 5).

HAP Senior Plus Option 1 – $0 premium with $15 deductible and $5,500 maximum out-of-pocket expenses. Inpatient hospital copay is $250 for the first 6 days, and outpatient hospital copay is $200. Office visit copays are $35 and $50, and ER and Urgent Care copays are $80 and $5 0. The lab services and outpatient x-rays copays are $20 and $35. Outpatient mental health individual and group therapy copays are $35. Rehabilitation therapy visits are subject to a $40 copay. 30-day preferred pharmacy cost-sharing is 25% (Tier 1), 25% (Tier 2), 25% (Tier 3), 25% (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is  25%(Tier 1), 25% (Tier 2), 25% (Tier 3), 25% (Tier 4), and 33% (Tier 5).

Humana Gold Plus – $0 premium with $405 deductible and $6,700 maximum out-of-pocket expenses. Inpatient hospital copay is $285 for the first 6 days, and outpatient hospital copay is $285. Office visit copays are $10 and $50, and ER and Urgent Care copays are $80 and $10-$50. The lab services and outpatient x-rays copays are $0-$40 and $10-$95. 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 $6 (Tier 1), $15 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 25% (Tier 5). 90-day preferred pharmacy cost-sharing is  $18 (Tier 1), $45 (Tier 2), $141 (Tier 3), $300 (Tier 4), and n/a (Tier 5).

MeridianCare Enhanced – $0 premium with $0 deductible and $6,700 maximum out-of-pocket expenses. Inpatient hospital copay is $360 for the first 5 days, and outpatient hospital copay is $225. Office visit copays are $0 and $50, and ER and Urgent Care copays are $80 and $30. The lab services and outpatient x-rays copays are $0. 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 $4(Tier 1), $20 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5). 90-day preferred pharmacy cost-sharing is  $8 (Tier 1), $60 (Tier 2), $141 (Tier 3), $300 (Tier 4), and 33% (Tier 5).

MeridianCare Essential – $0 premium with $0 deductible and $4,250 maximum out-of-pocket expenses. Inpatient hospital copay is $250 for the first 5 days, and outpatient hospital copay is $175. Office visit copays are $0 and $40, and ER and Urgent Care copays are $80 and $0. The lab services and outpatient x-rays copays are $0. 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), $15 (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), $94 (Tier 3), $300 (Tier 4), and 33% (Tier 5).

PriorityMedicare Key – $0 premium with $150 deductible and $4,200 maximum out-of-pocket expenses. Inpatient hospital copay is $225 for the first 6 days, and outpatient hospital copay is $0-$150. Office visit copays are $0-$20 and $0-$45, and ER and Urgent Care copays are $80 and $50. The lab services and outpatient x-rays copays are $10 and $35. 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 $5 (Tier 1), $15 (Tier 2), $42 (Tier 3), 45% (Tier 4), and 35% (Tier 5). 90-day preferred pharmacy cost-sharing is  $15 (Tier 1), $45 (Tier 2), $126 (Tier 3), 45% (Tier 4), and n/a (Tier 5).

PriorityMedicare Ideal – $18 premium with $125 deductible and $6,400 maximum out-of-pocket expenses. Inpatient hospital copay is $260 for the first 6 days, and outpatient hospital copay is $0-$175. Office visit copays are $0-$20 and $0-$50, and ER and Urgent Care copays are $80 and $50. The lab services and outpatient x-rays copays are $10 and $35. 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 $4 (Tier 1), $13 (Tier 2), $42 (Tier 3), 45% (Tier 4), and 30% (Tier 5). 90-day preferred pharmacy cost-sharing is  $12 (Tier 1), $39 (Tier 2), $126 (Tier 3), 45% (Tier 4), and n/a (Tier 5).

 

Michigan Medicare Part D Prescription Drug Plans

 

EnvisionRxPlus – $14.50 monthly rate with $365 deductible. 2.0 Plan Star Rating.  30-day supply cost-sharing copays are $1 (Tier 1) $6 (Tier 2), and $32 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $6 (Tier 2), and $96 (Tier 3).

WellCare Value Script – $15.00 monthly rate with $415 deductible. 3.0 Plan Star Rating.  30-day supply cost-sharing copays are $0 (Tier 1) $6 (Tier 2), and $40 (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $15 (Tier 2), and $100 (Tier 3).

Aetna Medicare Rx Select – $17.10 monthly rate with $305 deductible. 3.0 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).

Journey Rx Value – $20.00 monthly rate with $415 deductible. 3.0 Plan Star Rating.  30-day supply cost-sharing copays are $0 (Tier 1) $1 (Tier 2), and 15% (Tier 3). 90-day supply cost-sharing mail-order copays are $0 (Tier 1), $3 (Tier 2), and 15% (Tier 3).

Cigna-HealthSpring Rx Secure Essential – $21.80 monthly rate with $415 deductible. 2.0 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 $2 (Tier 1), $6 (Tier 2), and 20% (Tier 3).

Express Scripts Medicare Saver – $24.00 monthly rate with $415 deductible. 3.5 Plan Star Rating.  30-day supply cost-sharing copays are $1 (Tier 1) $4 (Tier 2), and 18% (Tier 3). 90-day supply cost-sharing mail-order copays are $3 (Tier 1), $12 (Tier 2), and 18% (Tier 3).

Humana Walmart Rx Plan – $26.60 monthly rate with $415 deductible. 3.5 Plan Star Rating.  30-day supply cost-sharing copays are $1 (Tier 1) $4 (Tier 2), and 20% (Tier 3). 90-day supply cost-sharing mail-order copays are $3 (Tier 1), $12 (Tier 2), and 20% (Tier 3).

Journey Rx Standard – $27.20 monthly rate with $415 deductible. 3.0 Plan Star Rating.  30-day supply cost-sharing copays are $2 (Tier 1) $6 (Tier 2), and 15% (Tier 3). 90-day supply cost-sharing mail-order copays are $4 (Tier 1), $12 (Tier 2), and 15% (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.

Get Affordable Medical Coverage in Mi.

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 worth consideration are the UnitedHealthOne “Medical Value” plan, the Health Insurance Innovations “Med Plus STM” plan, the IHC Secure STM plan, and the UnitedHealthOne “Medical Plus” plan. Several other carriers offer policies, although their prices are generally higher.

All of these companies are able to approve applications quickly and 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.

Note: Since temporary contracts do not meet federal qualification standards, the 2.5% household income tax will apply, and renewal applications will also be medically underwritten. We recommend only keeping coverage in-force until January 1, when the new Open Enrollment period begins.

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 (2014).  Each year, the makeup of carriers changes. We anticipate that beginning in 2017, the number of available carriers will begin 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 for 2015 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 2015 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.