What You Need to Know
Sign-ups for 2021 individual coverage start on November 1, 2020 and end December 15, 2020.
Eleven insurers offer plans on and off the federal health insurance marketplace.
Average Obamacare premiums in Michigan are among the lowest in the country.
Nine Michigan carriers offer Marketplace plans in 2021. Average premium rates are slightly higher.
Michigan Health Insurance Overview
Michigan has a robust individual health insurance market for 2020. More than a quarter-million residents are enrolled in private Marketplace plans.1 Monthly premiums in Michigan are lower than most states. About eight in 10 enrollees get tax-credit subsidies that save money on premiums.2
Residents also have access to affordable health insurance through Medicaid and Medicare. About 4 million Michiganders receive coverage through these programs.
We cover more detail about Michigan health insurance below.
Michigan and the Affordable Care Act (ACA)
The number of Michiganders without health insurance has declined since the Affordable Care Act (Obamacare) was implemented in 2013. More than 1 million residents lacked coverage in 2013 compared to 526,500 as of 2018.
An important step in Michigan’s health insurance market is Medicaid expansion. The ACA gave states the option to expand eligibility to childless adults under 65 who earn up to 133% of the federal poverty level (amounts to 138% based on how the rate is calculated).
Buying Michigan Health Insurance for Individuals, Families, and Self-Employed Entrepreneurs
Michigan insurers offer several private health plans for individuals and families. This group includes self-employed entrepreneurs who have no employees.
You can buy an ACA plan through the federal exchange at Healthcare.gov. Companies also sell plans off the exchange. Plans provide major medical insurance that include essential health benefits, such as prescription drug coverage, hospitalization, and maternity care. All ACA policies are guaranteed issue and must cover preexisting conditions.
You can choose from plans in all metal levels: bronze, silver, gold, and platinum.5 Each level pays for a percentage of your care ranging from 60% to 90%. For instance, bronze coverage pays 60% and is usually the least expensive plan. Platinum coverage pays for 90% and is the most expensive plan.
Catastrophic Health Insurance in Michigan: An Alternative Option
Companies also offer catastrophic health insurance. This type of coverage is designed for adults under 30 who typically have fewer health issues. But it’s also available to older adults who qualify for a hardship exemption.
Catastrophic plans are ideal for situations that can result in high medical expenses, such as a serious illness or major accident. They’re not recommended for routine care. Plans offer low monthly premiums but have high deductibles.
More Time to Enroll
Michigan residents who did not enroll in a health plan have another opportunity to do so. The federal government reopened the federal Marketplace because of the coronavirus. The Special Enrollment Period lasts from February 15, 2021 through August 15, 2021.
Michigan Health Insurance Marketplace
The 2021 Open Enrollment Period starts on November 1, 2020 and ends on December 15, 2020. Coverage begins on January 1, 2021.
If you don’t sign up, you can still sign up if you have a qualifying life event, such as losing coverage or getting married. If not, you’ll have to wait until the next open enrollment starting on November 1, 2021.
Help with Premiums
Michigan residents who enrolled in Obamacare got an average subsidy of #388 in 2019.
Health Insurance Companies In Michigan
Nine Michigan health insurance companies sell plans on the exchange for 2020. Plans available include bronze, expanded bronze, silver, gold, and catastrophic. Not all companies offer each plan type, and options vary by region.
- Alliance Health and Life Insurance
- Blue Care Network of Michigan
- Blue Cross Blue Shield of Michigan
- Health Alliance Plan
- McLaren Health Plan Community
- Meridian Health Plan of Michigan
- Molina Healthcare of Michigan
- Oscar Insurance Company
- Physicians Health Plan
- Priority Health
- Total Health Care USA
Health Insurance Costs in Michigan
Marketplace premiums in Michigan are among the lowest in the country. The average benchmark premium in Michigan for 2020 is $360 a month compared to $462 for the U.S. average. The benchmark premium is based on the second-lowest-cost silver plan.
Premiums fell slightly in 2020 among bronze, silver, and gold plans. Here’s a look at the average monthly premiums in Michigan from 2019 to 2020:
- Average lowest-cost bronze premium: $255 in 2019; $251 in 2020
- Average lowest-cost silver premium: $367 in 2019; $348 in 2020
- Average lowest-cost gold premium: $400 in 2019; $382 in 2020
For 2021, the state approved a 1.34% increase on the average unsubsidized premium, or $5 more a month.7
Obamacare Subsidies for Low-Income Michigan Residents
Eighty-seven percent of Obamacare enrollees in Michigan received subsidies in 2019.8 Subsidies (called premium tax credits) lower your monthly payment on Marketplace plans.
You qualify if your income meets the federal poverty level (FPL), which is based on your household size. For example, a family of three earning between $21,720 and $86,880 in 2020 (100% to 400% of the FPL) can qualify.9
The average subsidy among Michigan enrollees was $388 in 2019.
Michigan’s Medicaid Program for Low-Income Adults and Children
Others who qualify for Medicaid in Michigan include:
- Pregnant women
- Low-income families
- Individuals under 21
- Adults 65 and older
- Childless adults who gained eligibility under Medicaid expansion
- Parents and caretakers of minor children
- Individuals who are blind or have disabilities
Each group has different income limits to qualify, for instance, childless adults and parents can earn up to 138% of the FPL ($17,609 for an individual in 2020). 12
Michigan’s Children’s Health Insurance Program
MIChild is the name of Michigan’s Children’s Health Insurance Program (CHIP). It covers uninsured children under 19 from low-income working families. Children get comprehensive health insurance that includes medical, dental, vision, and mental health care.
Families pay $10 per month to cover all enrolled children. There are no copayments for care. The maximum income to qualify is 212% of the FPL ($36,548 for a family of two in 2020).13
Michigan Medicare Plans for Seniors and Adults With Disabilities
You typically get Part D prescription drug coverage with Medicare Advantage. But companies also sell individual Part D plans, which are usually paired with Original Medicare. About 1.1 million Michigan beneficiaries bought these plans in 2018.15
You can also add a Medicare Supplement plan (or Medigap) to Original Medicare. Michigan offers 10 standard plans that cover out-of-pocket costs.
Buying Short-Term Health Insurance in Michigan
If you find yourself temporarily without insurance, consider a short-term health plan in the Great Lakes State. These plans are helpful for situations such as when:
- You’ve missed the annual enrollment period for Obamacare
- You’re in between jobs
- You’re waiting for benefits to start at a new job
You can get short-term coverage for up to 185 days in a 12-month period. Plans offer basic benefits, such as hospitalization, doctor visits, and urgent care. But they’re not the same as major medical coverage under the Affordable Care Act (ACA).
Benefits like maternity care, mental health services, and medications you fill at a pharmacy are not usually covered. Plus, short-term plans typically don’t cover preexisting conditions. You can also be denied a policy based on your health status.
Before you enroll, make sure you understand the policy’s limitations and exclusions. Michigan offers a variety of health insurance plans. So compare all your options to find the best fit for your needs.