Frequently asked questions about health insurance coverage options in Michigan
Michigan has a state-federal partnership exchange, and residents use HealthCare.gov to enroll in individual and family health plans. These plans are used by people who have retired prior to age 65, people who are self-employed, and people who work for a small employer that doesn’t provide health insurance benefits.
Read more about the Michigan health insurance marketplace.
The open enrollment period for individual/family health coverage runs from November 1 to January 15 in Michigan. Enrollments completed by December 15 will take effect on January 1, while enrollments completed between December 16 and January 15 will take effect on February 1. Outside of open enrollment, a qualifying event is necessary to enroll or make changes to your coverage.
In Michigan, consumers may be able to buy affordable individual and family health insurance by enrolling through the ACA marketplace (HealthCare.gov). Nearly 90% of consumers who enrolled in 2022 coverage through their state exchange received premium subsidies.
Michiganders may also find affordable coverage through Medicaid if they’re eligible. See Medicaid eligibility guidelines in Michigan.
Short-term health insurance is also a lower-cost coverage option in Michigan, where six insurers offer short-term plans.
For 2022 coverage, there are ten insurers that offer exchange plans in Michigan. And all ten of them will continue to offer coverage in 2023. In most of Michigan, at least four insurers are offering plans, although there are just two participating insurers in upper Michigan.
The following insurers offer plans in the Michigan exchange as of 2022, with plan availability varying from one location to another:
- Blue Care Network
- Blue Cross Blue Shield of Michigan
- McLaren Health Plan
- Meridian (Ambetter as of 2021)
- Oscar Health
- Physicians Health Plan
- Priority Health (Priority Health has purchased Total Health Care, which was a separate exchange insurer in 2021; for 2022, they are one entity)
- US Health and Life Insurance Company (new for 2022)
- UnitedHealthcare (returned to the exchange as of 2022, after exiting at the end of 2016)
For 2022, the average rate increase in Michigan’s individual/family market was 4.7%. This included two insurers that offer plans outside the exchange, and eight insurers that already offered exchange plans in 2021. There are also two new insurers that joined the exchange for 2022: US Health and Life, and UnitedHealthcare.
For 2023, Michigan’s insurers (including the two that offer plans only outside the exchange) have proposed an overall average rate increase of 6.2%,
At the end of the open enrollment period for 2022 coverage, 85% of Michigan’s exchange enrollees were receiving premium subsidies that amounted to an average of $390/month (offsetting the majority of the average full-price premiums, which amounted to about $503/month in Michigan).
Premium subsidies are larger and more widely available through the end of 2022 as a result of the American Rescue Plan.
Premium subsidies are not available outside the exchange, so purchasing a health insurance policy directly from an insurance company (instead of through the exchange) is generally only a good option for people who know they won’t be eligible for a subsidy.
303,550 people enrolled in private health coverage through the Michigan exchange during the open enrollment period for 2022 coverage. This was the highest enrollment had been in Michigan’s exchange since 2017.
Michigan was considered a red state following the 2014 elections, and support for the Affordable Care Act has been mixed. But the tide has been turning more recently. Michigan’s state legislature is still GOP-dominated, but the margins are much smaller than they were. And in the 2018 election, Democrats were elected to serve as governor, secretary of state, and attorney general.
Sens. Carl Levin and Debbie Ann Stabenow, both Democrats, voted in favor of the Affordable Care Act in 2010. Levin retired in January 2015 and was replaced by U.S. Rep. Gary Peters, a Democrat. Peters voted for the ACA in the House in 2010.
Michigan’s delegation to the U.S. House of Representatives split along party lines in the 2010 ACA vote. Eight Democrats voted yes, while seven Republicans voted no. Michigan lost a House seat following the 2010 census. Republicans clinched a 9-5 majority following the 2014 elections, but the House representation as of 2021 includes seven Democrats and seven Republicans.
At the state level, Republicans control both the House and Senate, although their margins became smaller following the 2018 election. The legislature did not authorize a state-run health insurance exchange, despite former Gov. Rick Snyder’s preference for that approach. Michigan was among the handful of states that implemented a partnership exchange, which means the state oversees some aspects of the exchange, but the federal government’s HealthCare.gov enrollment platform and call center are used by Michigan residents.
Michigan did expand Medicaid under the Affordable Care Act, effective in April 2014.
Former Governor Rick Snyder, a Republican, pushed for an alternative approach to Medicaid expansion in Michigan and ultimately gained bi-partisan support for Healthy Michigan. Medicaid expansion in Michigan uses the ACA’s eligibility guidelines (ie, up to 138% of the poverty level), but the state obtained approval from the Obama administration to charge premiums for Medicaid plans when enrollees’ incomes are above the poverty level.
Medicaid expansion (called Healthy Michigan) took effect under the ACA on January 1, 2014, but Michigan was a few months behind due to the state’s waiver process. Enrollment began April 1, 2014, and 1,009,793 people were enrolled in Healthy Michigan as of July 2022. That was up from 645,504 in July 2019.
The growth in Medicaid coverage is not surprising, given the COVID-19 pandemic. And under the Families First Coronavirus Response Act, states cannot terminate a person’s enrollment in Medicaid until after the end of the COVID public health emergency, unless the person moves out of state or requests that their coverage be canceled.
Before the pandemic, however, the state sought to reduce enrollment in Medicaid plans with a work requirement. Michigan enacted legislation in 2018 directing the state to seek federal approval for a work requirement. The waiver proposal was submitted to CMS in September 2018, and was granted federal approval by the Trump administration in late 2018.
The work requirement took effect in January 2020, but was overturned by a federal judge in March 2020, just prior to the explosion of the COVID-19 pandemic and widespread job losses. The judge’s ruling was not surprising, given that work requirements in Kentucky, Arkansas, and New Hampshire had already been overturned in 2019.
In April 2021, President Biden officially rescinded Michigan’s Medicaid work requirement, although it had never been reinstated after being overturned more than a year earlier.
Read more about Medicaid expansion in Michigan.
Michigan regulations limit short-term health insurance plans to no more than 185 days in duration and prohibit renewal. An applicant can purchase additional short-term plans, but cannot have more than 185 days of short-term health insurance coverage from one insurer in any 365-day period.
Read more about short-term health insurance in Michigan.
Medicare enrollment in Michigan stood at more than 2.1 million people as of early 2022. Most are eligible for Medicare due to age, but 15% of Michigan Medicare beneficiaries are under 65 and eligible for Medicare because of a long-term disability, end-stage renal disease, or ALS.
Michigan has a Medigap subsidy program to help offset the cost of Medigap coverage for enrollees with modest income. But applications for the program were no longer accepted after early 2021, and the program itself will end in 2023 (it was temporary, and funding will not last beyond that point).
Michigan also protects access to certain Medigap plans for people who are disabled and enrolling in Medicare under the age of 65.
Read more about Medicare plans in Michigan.
- Michigan Department of Insurance and Financial Services — Regulates and licenses health insurance companies, brokers, and agents; serves as a resource for Michigan residents with questions or complaints related to health insurance.
- Arab Community Center for Economic & Social Services (ACCESS) — The federally-funded Navigator organization that can provide outreach and enrollment assistance to Michigan residents who need help obtaining health insurance. Navigators can assist with enrollment in Medicaid as well as a private health insurance plan through the exchange.
- 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 (in that case, Medicaid funds are used to offset some of the costs that a Medicare beneficiary would otherwise have to pay, including Medicare premiums and out-of-pocket medical costs).
- 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.