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What is Medicare Advantage in Michigan?

If you’re going to be eligible for Medicare soon or if you have recently enrolled in Medicare Part A and Medicare Part B, you are missing out if you haven’t yet done some research on some of the best Medicare Advantage plans in Michigan for 2022. Many people find that it is a mistake to rely on Original Medicare (Medicare Part A and Medicare Part B) alone since they can end up with so many copayments (copays), deductibles and coinsurance. Luckily, a Medicare Advantage plan in Michigan offer a great replacement.

What is Medicare Advantage in Michigan?

Medicare Advantage in Michigan, also known as Part C or MAPD plans, is a plan for individuals who need a prescription drug plan in addition to their hospital and medical insurance.

Medicare Advantage is made up of the following:

Medicare Part A (hospital insurance)
Medicare Part B (medical insurance)
Medicare Part D (prescription drug coverage).

Part A and Part B make up Original Medicare, whereas Medicare Part C is made up of A, B, and D and is the preferred all in one plan when compared to Original Medicare.

A Medicare Advantage plan in Michigan has additional coverage and benefits that are provided by private health insurance companies. Benefits include vision and hearing, dental coverage, gym expenses (silversneakers), delivery of meals, appointment transportation to the doctor, and an over the counter prescription allowance.

Medicare beneficiaries will have a network in their service area to choose their primary care physician, hospital, and any other facilities from.

To note, If you should have a disability or End-stage Renal Disease, you can enroll for a Michigan Medicare Advantage plan; even if you are under 65.

What is the Best Medicare Advantage plan in Michigan in 2022?

The Best for Network Freedom: Medicare Advantage PPO Plan

PPO Plans have larger networks and no referrals.

Monthly premiums: $0 to $100 per month

The Best for Lowest Out-of-Pocket: Medicare Advantage HMO Plan

HMO Plans have an HMO referral network. Because referrals are needed, monthly costs generally have $0 premiums.

Monthly premiums: $0

The Best for Low Income or Health Conditions: Medicare Advantage D-SNP

Dual eligible SNP is for those that have the following:

– You have Medicare and Medicaid
– You have a severe, disabling, or chronic condition
– You are entering a facility that qualifies you for SNP coverage, or you need nursing home care

This plan works with an individual’s Medicaid plan and helps with expenses related to Part B premium, copays, coinsurance, deductibles, and monthly premiums.

What Medicare Advantage plans are available in Michigan?

Local HMO plans: 46

Local PPO plans: 24

Regional PPO plans: 2

How much does Medicare Advantage in Michigan cost?

HMO plans and PPO plans in most states cost $0 per month. However, it’s more common to see PPOs with premiums. In Michigan, plans vary from one area to another.

Average Medicare Advantage plan with a prescription drug plan: $57 a month

Part D drug deductible: $68

When can you enroll in a Michigan Medicare Advantage plan?

Enrollment can only occur at certain points during the year.

Initial Enrollment Period

– Eligibility occurs at 65
– You can join Medicare Part A and Part B
– Enrollment occurs within three months of turning 65

Open Enrollment Period/Annual Election Period

Open Enrollment Period: October 15th until December 7th

During this time, you can:

– Join a plan
– Drop a plan
– Make changes to a plan

Coverage for Part C starts: January 1rst

Note: Plan must me completed by December 7th

Medicare Advantage Open Enrollment Period

Medicare Advantage Open Enrollment Period: January 1st through March 31st

During this enrollment period you can:

– Switch plans
– Join Original Medicare
– Join a Medicare Supplement plan

Special Enrollment Periods: Special Circumstances

Special circumstances could include address changes due to a move, your plan with Medicare changes, you lose your current coverage, or you are covered through your employer(VA/Tricare/PACE).

Other special considerations may include:

– Eligibility for both Medicare and Medicaid Extra Help
– Dropping a Medigap plan
– State Pharmaceutical Assistance Program enrollment
– Special needs or a disability

5-star Special Enrollment Period

5-star Special Enrollment Period: December 8th until November 30th

– This five star rating enrollment can only be used once
– Plans are rated with satisfaction surveys that compare plans based on quality and performance
– The 5-star rating is the highest given

Special Enrollment Periods if you get “Extra Help”

This enrollment applies if you are:

– Eligible for Extra Help
– Eligible for Medicare or Medicaid
– Enrollment into the State Pharmaceutical Assistance Program

When can I make changes to my Medicare Advantage plan?

Medicare Advantage Open Enrollment Period: January 1st through March 31st

During this enrollment period you can:

Switch plans
Join Original Medicare
Join a Medicare Supplement plan

Are Medicare Advantage plans in Michigan “bad”?

Medicare Advantage plans might not be for everyone, however, for many they are a great fit.  For this reason, they continue to gain popularity from year to year.  Medicare Advantage enrollment has increased by 10% from last year. Penetration in the state of Michigan is 51%, with a growth of 11% as of 2021.

1. Number of lives enrollment in Medicare Advantage in New York: 660,480

2. Number enrolled by plan, specifically the three plans below:

Local HMO: 271,496

Local PPO: 456,215

Regional PPO: 16,507

3. Percentage of Medicare beneficiaries enrolled in Medicare advantage in Michigan: 51%

4. Number of lives enrollment in Medicare Advantage nationwide: 24.1 million

5. Percentage of Medicare beneficiaries enrolled in Medicare advantage Nationwide: 39%

Related Topics

Michigan State Links

Michigan Medicare Resources

These resources can help you when you first sign up for Medicare. You may find that you qualify for extra help, too, if you’re a low-income individual:

Ready to learn more?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Give us a call today, or request a quote online to learn more about plan options.

Key Take Aways
  • In Michigan, PPO Medicare Advantage Plans are very popular for many Medicare beneficiaries.
  • You can make changes to your Advantage plan each year during the Annual Election Period.
  • You must continue to pay your Medicare Part B Premium with most Medicare Advantage plans.