Michigan Health Insurance: 2021 Coverage Guide

Fran
Fran Majidi
November 3, 2020

If you live in Michigan and are looking into health insurance options, we want to help you find the right plan at the right price. To get the best value for a plan, you’ll need to gather some information and determine which type of plan and which level of coverage will save you the most money. Most importantly, it’s important to shop during the Open Enrollment period, unless you have a qualifying event. Otherwise, you may have to wait another year to get coverage.

When Is Open Enrollment in Michigan?

November 1, 2020 - December 15, 2020. The coverage begins in January 2021.

How to Get Health Insurance in Michigan

To determine which plan and which level of coverage will save you the most amount of money this year, it’s a good idea to consider how often you visited care providers, the tier level of coverage you had and the amount you paid in copays for these visits. You can then see if more coverage may save you money or not. Or you may decide you have more than enough coverage.

After you gather your information together, you can compare health insurance companies and health insurance quotes. After you submit a form with SmartFinancial, you’ll get several health insurance options to choose from, and we’ll connect you with an agent. You can buy coverage or ask just questions about the plan you’re considering.

What Types of Health Insurance Are Available in Michigan?

HMOs, EPOs, PPOs and POS plans are the most commonly purchased plans in Michigan. Choose health insurance plan type according to budget and whether or not you have certain doctors, who may or may not be in the plan’s network. With an HMO, for instance, you will not be covered if you see a doctor outside of a network of providers, but you’ll be covered with a PPO plan.

Does Health Insurance Cover Pre-existing Conditions?

Marketplace health plans cannot deny you health insurance coverage based on pre-existing conditions.

Compare Health Insurance Plans in Michigan

Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

  • If you lose a job, quit a job or started a new business, you are eligible to enroll in a health insurance plan outside the Open Enrollment Period. You are also eligible if you started a job that doesn’t offer health insurance.
  • If you turn 26 this year, and you get bounced off your parents’ health insurance plan, you can buy one outside the Open Enrollment Period.
  • If you move and lose health care coverage because you’re no longer in the coverage area, you may buy a new plan.
  • If you selected Cobra coverage and it reached the deadline, you can buy a new health insurance policy outside the Open Enrollment Period.
  • If you divorced and lose healthcare coverage, you can buy a new health plan outside the Open Enrollment Period.
  • If you marry, you can add a spouse to your plan or vice versa. You can also buy a new policy outside the Open Enrollment Period.
  • If you had a baby or adopted a child, you can insure that child outside the Open Enrollment Period.
  • If your spouse and partner passed away and you lost shared coverage, you can buy a new plan outside the Open Enrollment Period.
  • If a spouse or partner loses coverage due to a qualifying reason, you may buy new coverage together or separately outside the Open Enrollment Period.

Is Health Insurance Required in Michigan?

No, there is no tax penalty for being uninsured in Michigan. Even though it’s not required in this state, buying health insurance prevents medical bankruptcy.

How Much Is Health Insurance in Michigan?

The average cost of health insurance in Michigan for a 40 year old is about $416 a month. Health insurance is less expensive, the younger you are. Tobacco use increases health insurance rates.

How to Save on Health Insurance in Michigan

The best way to save on health insurance in Michigan is to compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs.

Medicare in Michigan

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Michigan?

21% of the people in Michigan are on Medicare.

How Much Is Medicare in Michigan?

If you do not qualify for Medicare, you can buy it for $458 a month for Part A in 2020 and a standard monthly premium for Medicare Part B was $144.60 for 2020. The premium rate may even be higher depending on income.

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $6,700 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Michigan

If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Louisiana?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Michigan State Health System Ranking

Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2020 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the Michigan Health System are listed below:

  • Michigan: Overall Ranking: 27 of 51
  • Michigan: Overall Performance: Above U.S. Average
  • Michigan: Access and Affordability: 11
  • Michigan: Prevention and Treatment: 13
  • Michigan: Avoidable Hospital Use and Cost: 39
  • Michigan: Healthy Lives: 37
  • Michigan: Health Care Disparities: 33
Find Affordable Health Insurance in Michigan

Michigan Health Insurance Coverage

The people of Louisiana have different kinds of health insurance while some Louisiana residents are not insured at all. See the breakdown below:

  • Private coverage: 51%
  • Medicaid: 22%
  • Medicare: 21%
  • Uninsured: 6%

Report: America's Health Insurance Plans

Michigan Health Insurance Companies

  • Priority Health
  • Blue Care Network of Michigan
  • Blue Cross Blue Shield of Michigan
  • Health Alliance Plan of Michigan
  • Physicians Health Plan
  • Alliance Health and Life
  • McLaren Health Plan Community
  • Priority Health Insurance Company
  • United Healthcare Services, Inc (Michigan)
  • UnitedHealthcare Insurance Company (Michigan)
  • Aetna Life Insurance Company (Michigan)
  • Total Health Care USA, Inc.
  • Compass Rose Health Plan

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