If you’re a Medicare beneficiary living in the state of Michigan, you may be eligible to enroll in a Medicare health insurance plan through the Medicare Advantage (Medicare Part C) program. Medicare Advantage plans provide another option for beneficiaries enrolled in Original Medicare, Part A and Part B, and are required by law to offer at least the same benefits as Original Medicare (with the exception of hospice, which is still covered under Part A).
Like residents of other states, Michigan residents enrolled in a Medicare Advantage plan get their benefits administered through the individual health plan and not the federal Medicare program, and their health plan options depend on the Michigan zip code in which they live.
Whether you’re new to Medicare or looking to explore your other coverage options, here’s an overview of how Medicare Advantage plans work in Michigan.
As mentioned, Michigan Medicare beneficiaries can sign up for Medicare Advantage plans as an alternative way to get their Original Medicare coverage. As in other states, Medicare Advantage plans in Michigan are available through Medicare-contracted private insurance companies, and they are required by law to offer at least the same coverage as Original Medicare. Medicare Advantage plans often offer additional benefits, including routine dental or vision, hearing, and prescription drug coverage.
In Michigan, as in other states, you can enroll in a Medicare Advantage plan if you meet all the following requirements:
Like other parts of Medicare, you can enroll in or make changes to your Medicare Part C coverage during certain times of the year. There are a couple of election periods for Medicare Advantage plans. Your first opportunity to enroll in Medicare Part C is during your Initial Coverage Election Period (ICEP):
You can also enroll in a Medicare Advantage plan, switch plans, or disenroll from your current plan during the Annual Election Period. Also called Open Enrollment Period for Medicare Advantage and Medicare prescription drug coverage, this period runs from October 15 to December 7 each year. If you enroll in or change Medicare Advantage plans during the Annual Election Period, in Michigan or anywhere else in the country, your new coverage generally begins on January 1 of the following year. You may also use this period to disenroll from your Medicare Advantage plan and go back to Original Medicare.
In certain cases, you can change Medicare plans during a Special Election Period, which can take place any time of the year that you have a qualifying situation. These circumstances include (but aren’t limited to) moving to a new address where your plan isn’t offered, losing current health coverage, qualifying for new coverage (such as Medicaid), or changes in your present plan that result in changes to your health benefits (for example, if Medicare terminates its contract with your Medicare Advantage plan). The dates and types of changes you can make vary according to the reason you qualify for a Special Election Period.
If you want to disenroll from your Medicare Advantage plan and switch back to Original Medicare, you can do so during the Medicare Advantage Disenrollment Period, which in Michigan (like the rest of the country) runs from January 1 to February 14 each year. Because Original Medicare doesn’t include prescription drug coverage, you can also enroll in a stand-alone Medicare Prescription Drug Plan during this period. These are the only types of changes you can make during this time frame.
As a Medicare Advantage beneficiary, you can choose from a variety of health plans. Be sure to understand exactly what each plan offers in order to select the one that’s best suited to your health and prescription drug needs:
Medicare beneficiaries enrolled in a Medicare Advantage plan have to stay enrolled in Original Medicare and continue paying the Medicare Part B premium.
It’s important for you to compare the benefits available under each Medicare Advantage plan in Michigan. Plans generally charge different costs and often have different rules regarding services depending on where you live and on your specific health needs. These rules can change on a yearly basis, so it’s crucial for you to stay up-to-date with your current plan’s policy.
Premiums for a Medicare Advantage plan with the same coverage and benefits can vary between different service areas within the state of Michigan. Some Medicare Advantage plans may offer premiums as low as $0, but do keep in mind that you must continue paying your Medicare Part B premiums, no matter which Medicare Advantage plan you choose. Also, remember to always consider all of the costs you may have with a Medicare Advantage plan; some plans that offer $0 premiums may offset the monthly premium cost by having higher copayments or deductibles.
You also need to decide whether or not you want prescription drug coverage with your Medicare Advantage plan through a Medicare Advantage Prescription Drug plan and if there are other benefits you’d like coverage for (such as routine vision or dental). With all these options, you can see why it can be important to compare plans with the benefits and costs best suited to your health needs.
View the following page for more information on other types of Medicare coverage in Michigan:
Would you like details about the Medicare plan options available to you? You can discuss your coverage needs with a licensed insurance agent by calling the phone number on this page. Or, if you’d prefer to browse plan options at your own convenience, just enter your zip code into the plan finder tool on this page to get started.
*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.