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.
Open enrollment for 2021 health plans ended on December 15, 2020, but there’s a one-time COVID-related enrollment window available in 2021, which continues through August 15. Michigan residents eligible to use the exchange (HealthCare.gov) can do so during this window, including people who are uninsured or underinsured, as well as current enrollees who would like to switch to a different plan. A qualifying event is not necessary in order to use the enrollment window that runs through August 15, 2021.
Open enrollment in Michigan for ACA-compliant coverage runs from November 1 through December 15. The open enrollment period is an opportunity to renew or change an existing plan for the coming year, or to newly enroll in individual market coverage. It’s also a good time to update financial information on file with the exchange, to ensure that premium subsidies are accurate for the coming year.
The November 1 – December 15 open enrollment period only applies to individual major medical health plans. It does not apply to health plans provided by an employer or to Medicaid or Medicare. Employers set their own open enrollment schedules, Medicaid enrollment is available year-round, and Medicare open enrollment (for Part D and Medicare Advantage plans) follows a different schedule.
In most of Michigan, at least four insurers are offering plans for 2021, although there are just two participating insurers in upper Michigan.
For 2021, Michigan’s insurers implemented average rate changes that ranged from a decrease of nearly 6% to an increase of 6%, with an overall average rate increase of just over 1%.
At the end of the open enrollment period for 2021 coverage, 81% of Michigan’s exchange enrollees were receiving premium subsidies that amounted to an average of $356/month (offsetting the majority of the average full-price premiums, which amounted to about $480/month in Michigan).
Premium subsidies soon became larger and more widely available as a result of the American Rescue Plan, which is not reflected in the subsidy numbers we saw at the end of open enrollment (the open enrollment window ended in December 2020, and the American Rescue Plan was enacted in March 2021; a COVID/ARP enrollment window continues through August 15, 2021, giving people an opportunity to take advantage of the new subsidies).
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.
267,070 people enrolled in plans through the Michigan exchange during the open enrollment period for 2021 coverage. That was up from just under 263,000 the year before, but still lower than 2019’s enrollment total, when about 274,000 purchased coverage.
During the first several weeks of the COVID/American Rescue Plan enrollment window in 2021, more than 12,000 people enrolled in plans through the Michigan exchange. That was nearly double the normal enrollment pace at that time of year, when a qualifying event would normally be necessary in order to enroll (a qualifying event is not needed during the COVID/ARP enrollment window). And that enrollment snapshot is only through the end of March, which is before the ARP’s new subsidy amounts were available on HealthCare.gov; enrollment has likely increased even more since the extra subsidies became available.
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. Following the 2018 election, Michigan’s state legislature is still GOP-dominated, but the margins are much smaller than they were. And 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.
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 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 905,780 people were enrolled in Healthy Michigan as of April 2021. That was up from 645,504 in July 2019 – a 40% increase. The growth in Medicaid coverage is not surprising, given that so many people have lost their jobs and incomes as a result of the COVID-19 pandemic (and until the end of the pandemic emergency period, states cannot terminate a person’s enrollment in Medicaid 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 February 2021. Most are eligible for Medicare due to age, but 17% 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. And the state 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.