Updated 11.10.18. We will continue to update this page are more pricing and carrier information comes in. Stay tuned!
Michigan residents shopping the health insurance marketplace this year have a few things to celebrate. For starters a new carrier, Oscar, will be entering the Detroit market. The other good news - premium increases are averaging around 2% across the state; a welcome change from the double digit increases of the last few years!
We pulled together this insider's guide to the Michigan market to help you better understand your options for 2019 and the key changes taking place in the market compared to last year.
What’s different this year?
- Availability of short term plans that can last a year. These short term, limited duration plans (STLDs) come with more restrictions, such as limits on preexisting conditions, and offer less coverage (i.e., good bye well-visits and maternity coverage), but their lower price point can be attractive to those that are relatively healthy and looking for more affordability.
- Premiums have stabilized. Premiums are predicted toincrease 2% in Michigan. In contrast to the startling jumps in premium pricing the past few years, Modern Healthcare reports that 16 states will see premium declines, two will see no change, and the rest see marginal, single digit increases. On average, CMS reports that rates are dropping 1.5 percent on average across the country.
- Individual mandate disappearing.Beginning in 2019, the Individual Mandate which fines Americans who skip out on health coverage will no longer be in effect. While some think this measure could send premium prices up as the markets adjust for an exodus of healthy young people, it might have less effect than people think.
- QSEHRAs are becoming more popular. For small companies and startups that can’t afford traditional group plans, QSEHRAs (aka Qualified Small Employer Health Reimbursement Arrangements) offer a new way to reimburse for premiums and medical expenses tax-free. In addition to being reimbursed for plans and alleviating the financial burden of individuals buying their own health insurance, employees can choose their own plan that works best for them instead of fitting into a one-size-fits-all group plan! If you or your employer wants to learn more about this, we have a first-of-its-kind QSEHRA guide that explains everything you need to know. Please note, if your employer sponsors a health reimbursement plan such as QSEHRA you will need to to purchase a health plan that meets Minimum Essential Coverage (MEC) to participate in the tax-free reimbursements.
What’s the same?
Despite a lot of talk in Washington, the Affordable Care Act (also known as Obamacare) is still intact.
- Doctor networks continue to stay small: An ongoing trend since the start of Obamacare, many plans will cover an increasingly smaller percentage of doctors in a given area. That leaves the consumer with fewer choices and a greater chance of having to go out of network to get the care they need. This is a strategy used by carriers to keep costs down, but it leaves consumers financially vulnerable for shouldering those scary and sky-high out-of-network costs. Even if your doctor is on your plan this year, it’s worth double checking for this coming year, since things might have changed. Our doctor search tool on our website is a simple way to do that!
- Shortened enrollment period: Just like last year, open enrollment is only 6 weeks—Nov 1 to Dec 15 for plans that start Jan 1, 2019.
- Outages: Just like last year, there are 60 hours of scheduled downtime for scheduled maintenance that could get in the way of individuals researching and signing up for plans. Take note that from 12 a.m. to 12 p.m. every Sunday, except for the last Sunday of open enrollment, you can’t access healthcare.gov.
Individual health insurance in Michigan for 2019
There are 9 carriers offering coverage to the individual market in Michigan for 2019.
We have rounded up the carriers below including on-exchange plans (the plans you can access through the Affordable Care Act's Marketplace, and off-exchange plans that aren't available on the Exchange and are purchased directly from the carrier or a broker. Remember: If you are eligible for a tax credit, purchasing an on-exchange plan is the only way to utilize it.
Use TakeCommandHealth.com to estimate your tax credit, search for your doctors, and compare on and off-exchange options in your zip code. If using a tax credit, we will automatically route your applications to healthcare.gov.
The rate changes indicated below were filed with the state.
Blue Cross Blue Shield: available both on and off exchange.
- 8 Bronze plans including PPO and HMO. Best if not needing frequent medical care.
- 12 Silver plans including PPO and HMO. Best for budgeting health care expenses.
- 2 Gold Plans including PPO and HMO. Best for frequent medicare care and paying less after premiums
- 2 Catastrophic Plans including PPO and HMO.
Offering 8 plans on exchange and one plan off exchange. Both HMO and PPO plans are available. BCBS requested a 4.2% premium increase for 2019. Blue Cross Blue Shield covered 52,332 individuals in Michigan for 2018.
Health Alliance Plan (HAP) available off exchange.
- Offers 4 plan types: full network HMO, HMO choice (2 options), PPO and Catastrophic.
Offers 11 plans off exchange, requested 0% rate increase for 2019. Health Alliance Plan covered 6,555 Michigan individuals for 2018.
McLaren Health Plan available both on and off the exchange.
- 3 Gold Plans on exchange
- 6 Silver Plans on exchange
- 4 Bronze Plans on exchange
- 1 Catastrophic Plan on exchange
McLaren Health Plan requested 11.1% rate increase for 2019. They will be offering 4 plans on exchange and 2 plans off exchange for individuals. In 2018, McLaren covered 5,864 individuals in Michigan.
Meridian Choice available on exchange.
- Healthy Essential Plan: coverage for under 30 with little medical needs.
- Bronze Plans: most affordable with higher out of pocket costs.
- Silver Plans: average premiums with moderate out of pocket costs.
- Gold Plans: higher premiums with most out of pocket benefit.
Meridian choice will have 8 plans available through the exchange this year. They requested a 7% premium increase for 2019. Meridian Choice covered 5,853 individuals in Michigan during 2018.
Molina available on exchange.
- Choice Bronze
- Choice Silver 100
- Choice Silver 150
- Choice Silver 200
- Choice Silver 250
- Choice Gold
Molina will have 2 plans available on the exchange for 2019. They have requested a 1.6% rate increase. Molina covered 6,679 individuals in Michigan during 2018.
Oscar plans available both on and off exchange.
- Simple Bronze “just in case” plan
- Simple Silver: generally healthy
- Classic Silver : great for families
Oscar is new to the market for 2019! They will have 8 plans on the exchange and 1 plan off the exchange. Plans will be available in the Detroit market. Oscar plans are available in other states nationwide.
Physicians Health Plan available both on and off exchange.
Physicians Health Plan has the second largest offering in the state with 18 plans available on exchange and 3 plans available off exchange for a grand total of 21 plans available to individuals. They have requested a 3% rate increase for 2019. Physicians Health Plan covered 7,891 individuals in 2018.
Priority Health plans are available both on and off exchange.
- HMO Silver Plan (multiple networks)
- HMO HSA Bronze Plan (multiple networks)
Priotiy Health has the largest offering of health plans in Michigan for 2019 with a total of 33 plans. 13 of those plans will be available on exchange and the rest will be available off exchange. In addition, Priority Health actually requested a 2.5% rate decrease for 2019. They covered 79,127 individuals in Michigan during 2018.
Total Health Care USA available on exchange.
Total Health Care USA will have 7 plans available on exchange for 2019. They requested a 7.6% rate increase. In 2018, Total Health Care USA insured 17,580 individuals in Michigan.
Affordable Alternatives You Should Know About
An increasing number of our customers are opting for alternatives to traditional insurance. Here’s a couple of our top picks. They might not be for everyone, but they are worth checking out and comparing to major medical plans on our platform.
Pivot short term plans: Pivot provides short term medical insurance solutions until a qualified major medical health plan is chosen, helping reduce your financial risk. Pivot plans are renewable 90 day plans which in most states can be automatically renewed 4 times without additional medical screening to provide up to 12 months of continuous coverage.
Faith-based: Faith-based Medi-Share has a state-wide PPO network available in 2019 managed by PHCS (Private Healthcare Systems, now owned by Multiplan). It’s smaller than some of the PPO networks in the past, but it does provide flexibility to see your doctors and will cover out-of-network expenses as long as it meets Medi-Share’s faith-based guidelines. Medi-Share won’t be for everyone, but is a worthy option to consider if it fits your personal convictions and lifestyle. Make sure to check out our Medi-Share review and compare it to other major medical plans on our website before you enroll.
Next steps: What's my best option?
While more choices are a welcome change, hunting down and comparing all of these options can feel overwhelming. However, at TakeCommandHealth.com we help you compare all of your options side-by-side including off-exchange plans, marketplace plans, and faith-based options. You can use our award-winning tools to search for your doctors, check your prescriptions, and even simulate conditions and health needs to make sure you get the most of your money.
A few other updates we'd like to tell you about:
We've expanded the capabilities of our doctor search tool to search doctor networks from all of the carriers above (no matter if the plan is off-exchange, on the marketplace, or faith-based).
We've negotiated some pretty awesome deals for our members. Call a doctor 24/7 for $0, enjoy medical bill negotiation support, a personal health advocate, dental, vision, and pharmacy discounts, etc. These really help save money with some of the higher deductible plans.
We're pretty confident we have the biggest, most complete line-up of plans in Michigan this year.
With growing demand, we've also put together a bigger support team ready to help you tackle any issue. You can get started by chatting with one of our licensed professionals on our website or emailing us at firstname.lastname@example.org.
Once open enrollment begins, you can visit our website and we'll walk you through your options. Our goal is to help you get the most out of your money and find the plan that really works for you and your family.
Remember you have until Dec 15th to select a plan that starts Jan 1st, 2019.