Michigan health insurance Marketplace guide

You can purchase individual/family coverage in the Michigan Marketplace (exchange) if you meet these criteria:⁵

• You must be a resident of Michigan and lawfully present in the U.S.
• You must not have Medicare coverage.
• You must not be incarcerated.

Although most people are thus eligible to enroll in a Marketplace plan, there are additional criteria to qualify for financial assistance in the Marketplace. To be eligible for subsidies:⁶

• You must not have access to an affordable employer health plan. Use our employer health plan affordability calculator to see if you may be eligible for subsidies to offset the cost of a Marketplace plan.
• You must not be eligible for Medicaid/CHIP.
• You must not be eligible for premium-free Medicare Part A.⁷
• If you’re married, you must file a joint tax return.
• You must not be able to be claimed as a dependent on someone else’s tax return.

Subsidy eligibility is also based on how your income compares with the premium for the second-lowest-cost Silver plan in the Marketplace (for premium subsidies) and whether your income is more or less than 250% of the federal poverty level (for cost-sharing reductions).

In Michigan, the open enrollment period for 2026 individual and family insurance ended on January 15, 2026.

For 2026 coverage, enrollments or plan changes now require a special enrollment period (SEP). Most SEPs require a qualifying life event, but American Indians and Alaska Natives can enroll year-round without a qualifying event.

The next open enrollment period, for coverage effective in 2027, will run from November 1, 2026 to December 15, 2026. This will be a shorter enrollment period than the one used for the last several years, due to a federal rule change. And all plans selected during open enrollment will take effect January 1.

Michigan residents use HealthCare.gov to enroll in individual and family health plans. You can also sign up with a licensed agent/broker or a Navigator. There is also an option to enroll through various third-party websites authorized by the Centers for Medicare & Medicaid Services.⁸

In Michigan, consumers may find affordable health insurance by enrolling through the ACA Marketplace (HealthCare.gov).

More than eight out of ten people who enrolled through the Michigan Marketplace for 2026 were eligible for advance premium tax credits (APTC), which reduce the amount that they have to pay each month for their coverage. In 2026, the average premium subsidy in the Michigan Marketplace amounted to $536/month. Subsidy-eligible enrollees in Michigan paid an average net premium of $127/month after subsidies in 2025.¹

Michigan Marketplace enrollees can still qualify for APTC in 2026, but the benefits aren’t as robust as they were from 2021 through 2025. The “subsidy cliff” has returned, making premium subsidies unavailable to households earning more than 400% of the federal poverty level. And for those who are still subsidy-eligible, the subsidies don’t cover as much of the total premium as they did in 2025. These changes happened because Congress failed to extend the federal subsidy enhancements that expired at the end of 2025.

People with household incomes up to 250% of the federal poverty level also qualify for cost-sharing reductions (CSR) that may reduce your deductibles and out-of-pocket expenses when you buy a Silver plan.⁹

Both the premium tax credits and the CSR benefits are only available in Michigan if you enroll in a Marketplace plan.

Source: CMS.gov¹

Depending on your household income, you may be eligible for Medicaid/CHIP. Michigan is among the states where Medicaid has been expanded under the ACA, making it easier for low-income adults to qualify for coverage. Learn more about Michigan Medicaid.

For 2026 coverage, seven insurers offer Marketplace plans in Michigan.⁴

• Blue Care Network of Michigan
• Blue Cross Blue Shield of Michigan Mutual Insurance Company
• Oscar Insurance Company
• McLaren Health Plan Community
• Meridian Health Plan of Michigan, Inc.
• Priority Health
• UnitedHealthcare Community Plan, Inc.

As is the case in most states, carrier participation varies by area, as not all carriers offer plans in all areas of the state.

There were ten participating insurers for 2025, but as announced in late 2024, UM Health Plan/Michigan Care (formerly Physicians Health Plan or PHP) stopped offering coverage at the end of 2025.¹⁰

In addition, HAP CareSource and Molina exited the market in Michigan at the end of 2025.¹¹

The following average rate changes were approved for 2026 for Michigan’s Marketplace insurers,¹² amounting to an overall average increase of about 20% before any subsidies are applied.¹³ (As explained below, average after-subsidy premium increases were much larger, due to the expiration of the federal subsidy enhancements at the end of 2025.)

Source: Michigan Department of Insurance and Financial Services⁴

Your plan’s pre-subsidy premium change might be quite different from the average that applies to your insurer, as it also depends on where you live (rates vary by region for each carrier), the specific plan you have, and your age.

The average premium changes described above are for full-price (unsubsidized) premiums. However, most Marketplace enrollees qualify for subsidies, so they do not pay full price.¹⁴ For these enrollees, net premium changes depend on changes in their own plan’s price as well as changes in their subsidy amount from one year to the next.

It’s important to understand that because Congress allowed the federal subsidy enhancements to expire at the end of 2025, after-subsidy premiums increased sharply in 2026. So although the average pre-subsidy premium increase was about 20% in Michigan, the increase in after-subsidy premiums was much larger.¹³

Because the subsidy enhancements expired, the “subsidy cliff” returned in 2026, meaning subsidies are no longer available to households earning more than 400% of the federal poverty level.

And while subsidies are still available to those with income below that level, the subsidies don’t cover as much of the total premium as they did in 2025.

As a result of the expiration of the subsidy enhancements, here are some examples of after-subsidy premium increases in Detroit, Michigan:¹⁵

• 40-year-old earning $40,000:
  • Lowest-cost plan in 2025 was $78/month
  • Lowest-cost plan in 2026 is $128/month
• 60-year-old earning $63,000:
  • Lowest-cost plan in 2025 was $287/month
  • Lowest-cost plan in 2026 is $740/month (due to the subsidy cliff)

For perspective, here’s an overview of how average premiums have changed in Michigan’s individual/family market over the years:

• 2015: Average decrease of 1%.¹⁶
• 2016: Average increase of 6.5%.¹⁷
• 2017: Average increase of 16.7%.¹⁸
• 2018: Average increase of 26.9%.¹⁹
• 2019: Average increase of 1.7%.²⁰
• 2020: Average decrease of 2.1%.²¹
• 2021: Average increase of 1.1%.²²
• 2022: Average increase of 4.7%.²³
• 2023: Average increase of 5.5%.²⁴
• 2024: Average increase of 5.3%.²⁵
• 2025: Average increase of 10.5%.²⁶

497,064 people selected private health plans through the Michigan exchange during the open enrollment period for 2026 coverage.¹

This was a drop of about 6% from the year before, when a record-high 531,083 people signed up during the open enrollment period for 2025 coverage.²⁷

The enrollment in 2025 was a significant record high (see graph below for prior year enrollment totals). The increases in recent years were driven in large part by the subsidy enhancements created by the American Rescue Plan and Inflation Reduction Act. The expiration of those subsidy enhancements was the primary reason for the drop in enrollment for 2026.

The enrollment growth in 2024 and 2025 was also due in part to the fact that Medicaid disenrollments resumed in 2023, after being paused for three years during the pandemic (a process known as “unwinding” of the pandemic-era continuous coverage rule). CMS reported that 160,114 Michigan residents transitioned from Medicaid to Marketplace coverage during the unwinding process.²⁸

Source: 2014,²⁹ 2015,³⁰ 2016,³¹ 2017,³² 2018,³³ 2019,³⁴ 2020,³⁵ 2021,³⁶ 2022,³⁷ 2023,³⁸ 2024,³⁹ 2025²⁷ 2026¹

• Michigan health insurance Marketplace – HealthCare.gov (800) 318-2596
• Michigan Health Insurance Consumer Assistance Program (HICAP) – (877) 999-6442
• Michigan Department of Insurance and Financial Services – Serves as a resource for Michigan residents with questions or complaints related to health insurance.
• Arab Community Center for Economic & Social Services (ACCESS) – A federally funded Navigator organization that provides outreach and enrollment assistance to Michigan residents who need help obtaining health insurance.
• Michigan Medicare/Medicaid Assistance Program (MMAP) – A local service that provides health benefits counseling and assistance to Medicare beneficiaries, including those who are eligible for both Medicaid and Medicare.
• Medicare Rights Center – A nationwide service (website and call center) that can provide a wide variety of assistance to Medicare beneficiaries who have questions about enrollment, eligibility, benefits, and claims.