Best Health Insurance in Michigan

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Contributor, Benzinga
November 25, 2019

If you're looking for the most affordable health insurance in Michigan, getting several online quotes to compare is an easy first step to get health insurance. Benzinga has reviewed several insurance companies so you can find the most affordable options no matter where you live in the Wolverine State. 

What is Health Insurance? 

Health insurance is designed to provide financial coverage for injury, illness and treatments and can also help you manage chronic conditions. You'll pay a premium in exchange for coverage.

You can get affordable health insurance through your employer but you can also buy it on your own, whether directly through a provider or by using the ACA Marketplace. 

Important Health Insurance Terms to Know

You might wonder what certain complicated insurance terms mean. It’s a good idea to become familiar with these terms so you know what you’ll be responsible for when you seek treatment:

  • Premium: This is a monthly fee you pay to the insurance company to keep your account active.
  • Deductible: This is the money that you pay out of pocket before your insurance coverage takes over. Some plans have no deductibles at all. Instead, they have higher premiums or coinsurance. For example, let’s say you have a high deductible plan. You’ll pay lower premiums each month and vice versa. 
  • Copay: This is a small and generally inexpensive flat fee you pay to your doctor or for prescription drugs. Your copay does not count toward your deductible. 
  • Coinsurance: This is a percentage that is shared between you and the insurance company. For any given treatment, surgery or other covered procedure, you pay a certain percentage and the insurance pays the other. Common coinsurance amounts are 80/20 and 70/30. The insurance pays 80% or 70% and you pay 20% or 30%, respectively. 

Average Cost of Health Insurance in Michigan

You’ll pay an average of $1,230 per month for health insurance for a family of 3 in Michigan. But you may pay more for your health insurance if you have more children or you’re a smoker, overweight or have other health conditions. Many health insurance plans cover certain preventive screenings as well as health and wellness checkups. There are a couple of things you can do to help lower the amount you pay for health insurance:

  • Maintain a healthy body mass index (BMI). A high BMI can be a precursor to several preventable conditions, including heart disease, diabetes and high blood pressure. Health insurance providers look at BMI and other risk factors to determine how much you’ll pay for insurance.
  • Quit using tobacco. Smokers pay more for health insurance. A little over 20% of people in Michigan are smokers. 

There’s nothing you can do about your age, but it may be helpful to know that older people tend to have more health conditions. You’ll likely pay more for health insurance than someone who is 20 or 30. 

Changing your habits can help you save hundreds of dollars per year on your health insurance. Why not save money on health problems that could be prevented in the first place? 

Types of Health Coverage

There are several types of health insurance coverage in Michigan. The most common types are as follows: 

  • Health maintenance organization (HMO): An HMO is made up of predetermined physician networks. You’ll have a primary physician who is responsible for most of your care, and if you need to see a specialist, your primary care physician must refer you. However, in order for your specialist visit to be covered by the HMO, the specialist will also need to be in the network. HMO plans have very little paperwork to deal with and the amount you pay overall is lower, which makes an HMO a good option for cheap health insurance in Michigan. 
  • Preferred provider organization (PPO): A PPO offers a larger network of doctors and hospitals to choose from. You also don’t need a referral to see a specialist. If you do choose to see a doctor or visit a hospital outside of the PPO network, you’ll pay more of the cost and you may need to file a claim with the PPO in order to be reimbursed. 
  • Point of service (POS) plan: A POS plan offers a combination of HMO and PPO plans and you’ll enjoy the freedom to choose your own doctor. Like a PPO, you pay a portion of the bill and then file a claim with the POS plan to get some of your money back. There’s more paperwork to deal with for a POS plan but a larger degree of freedom to choose your own doctor. 

What Does Health Insurance Cover?

Health insurance covers a wide range of treatments and procedures for illnesses and injuries. Precisely what’s covered and what isn’t will depend on your specific health insurance plan. Health insurance generally covers some or all of the following:

  • Ambulance services
  • Emergency services
  • Hospitalization
  • Newborn and maternity care
  • Prescription drugs
  • Rehabilitative services
  • Laboratory services
  • Mental health care
  • Wellness checks
  • Pediatric care

What Isn't Covered by Health Insurance? 

Health insurance covers a wide range of procedures and treatments but there are some things that it does not cover, including:

  • Elective or cosmetic procedures
  • Long-term nursing home care
  • Infertility treatments
  • LASIK
  • Alternative therapies
  • Dental, vision and hearing

Cheapest Health Insurance Providers in Michigan

Getting the best health insurance in Michigan means you’ll need to know where to look. If you’re relatively healthy and you don’t go to the doctor often, you may not need as many services as someone who is dealing with a chronic illness or condition. No matter which health insurance provider you choose, you’ll want to make sure that your preferred doctor or hospital is included in the network so that you’ll save money on treatment. 

1. Priority Health

Priority Health offers both HMO and POS plans. This is one of the highest-rated insurance providers, according to the National Committee for Quality Assurance.

Priority Health offers a large network of providers across the state and excellent coverage for preventive care. Priority Health is an excellent choice for families and it’s equally excellent for anyone who needs coverage for cancer screenings or other preventive services. Priority Health received especially high marks for managing diabetes, asthma and heart disease.

2. Blue Care Network of Michigan

Blue Care Network, the HMO network of Blue Cross and Blue Shield, is ideal when you’re looking for cheap health insurance with a decent network of doctors and hospitals.

It received excellent ratings for cancer screenings, preventive services and being able to see a specialist when needed. The company follows up with users on relevant health promotion and education. Claims are handled quickly for the best care possible. 

3. Blue Cross and Blue Shield of Michigan

Blue Cross and Blue Shield of Michigan (BCBSM) offers a variety of PPO health plans, some of which include dental and vision.

There’s a wide range of plans available through BCBSM and you can find the perfect tier that offers the best balance of coverage for the price. Patient education and the company’s high encouragement of continued treatment is noted. BCBSM also excels at providing coverage for eye exams and dental care. 

4. Health Alliance Plan of Michigan

The Health Alliance Plan (HAP) of Michigan offers above-average coverage for individuals and families. You’ll find this plan especially beneficial if you take generic prescription drugs.

Your copay could be as low as $5 when you purchase this generic prescription at a participating pharmacy. Costs for a primary care physician visit and specialist visits are also low and an extensive network of participating doctors and hospitals is available online. 

5. Physicians Health Plan

This plan is highly rated for fast claims handling and the overall quality of the plan. Preventive care for children, adolescents and women scored well.

The high ratings make this a well-rounded choice for busy families who need affordable coverage for all ages. These plans scored high for the management and control of asthma and BMI assessments. It’s a good choice for individuals with preexisting or chronic health conditions. 

Get Affordable Health Insurance in the Wolverine State

Getting affordable health insurance coverage in Michigan is easy when you know where to look. Get a customized quote from each of the 5 companies profiled here and check them against your budget. It’s never been easier to get quality coverage without breaking the bank, so start today and learn more about your options.

Frequently Asked Questions

Q

Can I purchase temporary health insurance in Michigan?

A

Michigan allows short term health insurance plans with a coverage term of no greater than 185 days out of any 365 day period.

While these policies may be more affordable than traditional health insurance, be careful when purchasing — these plans are not required to be ACA-compliant and do not meet any legal requirements to have health insurance.

Q

Does Michigan use the federal or state marketplace for health insurance?

A

Michigan uses a hybrid model. Enrollees use the federal marketplace to sign up for and to purchase coverage but the state regulates plan management and options.