Information about Medicare Advantage Plans in Michigan

Quick links:

• Average 2019 Costs
• Eligibility & Enrollment
• Finding Top-Rated Plans
• List of Plans Available
  • Plans by Carrier
  • Plans by County
  • Plans by Type
• Local Resources

39 percent of Medicare beneficiaries in Michigan were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.¹

There are 1,998 different Michigan Medicare Advantage plans in 2019.¹ Not every plan is available in each county, so it's important to find out which ones are offered where you live.

You can compare the availability, benefits and costs of Medicare Advantage plans in your area of Michigan with the help of a licensed insurance agent.

Read more below to learn more about Medicare in your state.

Average costs of Medicare Advantage in Michigan

The average Medicare Advantage plan premium in Michigan in 2019 was $52 per month.

There were 448 different plans across Michigan that offered $0 monthly premiums in 2019, and one out of five beneficiaries in the state were in enrolled in a $0 premium plan.

• Average monthly premium cost in 2019 (weighted): $52
• Average in-network out-of-pocket spending limit: $4,317
• Average deductible in 2019 (weighted): $51.90¹

The costs of a Medicare Advantage plan may vary depending on where you live and the plan you have.

Find the average 2019 Michigan Medicare Advantage monthly premiums listed by county below in this guide.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Eligibility & Enrollment

In order to enroll in Medicare Advantage in Michigan, you must be enrolled in Original Medicare (Part A and Part B) and reside in the area in which the plan is sold.

To be eligible for Original Medicare at age 65, you must meet the following requirements:

• You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.
  
  
• You or your spouse must have worked long enough to be eligible for Social Security or Railroad Retirement benefits.
  
  
• You or your spouse must be government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.

You may also be eligible for Medicare benefits under 65 if:

• You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.
  
  
• You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).
  
  
• You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

If you have ESRD, you may not qualify for most Medicare Advantage plans. You may be able to enroll in a Michigan Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to sign up for a Medicare Advantage Plan in Michigan

The first time you may be able to enroll in a Michigan Medicare Part C plan is during your Medicare Initial Enrollment Period (IEP).

Your Medicare IEP starts three months before your 65^th birthday, continues during the month of your 65^th birthday and then continues for another three months after your birthday.

Additional times at which you can enroll in a Medicare Advantage plan include:

Medicare Advantage Open Enrollment Period: January 1 – March 31

If you are already enrolled in a Medicare Advantage plan, you may switch Part C plans or disenroll in your current plan and return to Original Medicare during the Medicare Advantage Open Enrollment Period. This period lasts from January 1 to March 31 each year.

If you disenroll from your Medicare Advantage plan and return to Original Medicare during this period, you'll be able to join a Medicare standalone prescription drug plan (Medicare Part D).

Medicare Annual Enrollment Period (AEP): October 15 – December 7

From October 15 to December 7 every year, you may enroll in a Medicare Advantage plan or change from one Medicare Advantage plan to another.

You may also return to Original Medicare and drop your existing Medicare Advantage plan.

During AEP, you may also join, switch or drop a Medicare Part D plan. 

Medicare Special Enrollment Periods (SEP)

You may potentially be granted a Medicare Special Enrollment Period (SEP) at any time throughout the year for qualifying circumstances, such as moving to a new area, losing coverage through no fault of your own or moving out of a nursing home.

There are other potential circumstances that could qualify you for a Medicare SEP.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in Michigan 2020

Every year, the Centers for Medicare & Medicaid Services (CMS) publishes Star Ratings using a system of one to five stars for all Medicare Advantage plans in every state.²

Plans are graded using a star system and are re-evaluated every year, so a plan’s ratings can change annually.

In order for a Medicare Advantage plan to be considered a top-rated plan, it must have four or more stars out of five stars.

There are 929 top-rated 2019 Medicare Advantage plans in Michigan that are rated four stars or higher.

Medicare Advantage plans are rated in the following five categories:

• Preventive care and health maintenance (screenings, tests, vaccines, etc.)
• Management of chronic conditions
• Member experiences and ratings of the plan
• Member complaints, problems receiving services and member retention
• Customer service

The information for the star ratings is gathered from member surveys, information that is submitted to Medicare and Medicare’s regular monitoring activities.

List of Medicare Advantage Plans Available in Michigan in 2020

To view a list of plans offered in your area within Michigan, use our plan comparison tool.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in Michigan

Several insurance companies may offer Medicare Advantage plans in Michigan, though the variety of plans available where you live can vary.

Private insurance companies offer Medicare Advantage plans that may be unique to the plan area they serve.

Call to speak with a licensed insurance agent who can help you compare Mihcigan Medicare Advantage plans that are sold by insurance companies where you live.

You can compare plans from several different carriers and use some of the following information as you shop for Medicare Advantage plans in Michigan:

• The Medicare Star Ratings can give you an idea of a plan’s overall quality.
  
  
• Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.
  
  
• Websites such as the Better Business Bureau and Consumer Reports can teach you about a company’s reputation among its customers.
  
  
• You can read through Medicare Advantage plan reviews and testimonials from customers.

MI Medicare Advantage plans by county

Learn more about Medicare Advantage plans in some of Michigan's most populous counties.

• Wayne County Medicare Advantage plans
• Macomb County Medicare Advantage plans

The chart below illustrates some of the costs and enrollment information for 2019 Michigan Medicare Advantage plans by county.¹

• Oakland County had 20 plans in 2019 that were top-rated Medicare Advantage plans (four stars or higher), which was the most out of any county in the state.
  
  
• Oakland County, Macomb County and Wayne County each offered 14 $0 premium plans in 2019.

MI Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 Michigan Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.¹

The major types of Medicare Advantage plans include:

• HMO
  A Health Maintenance Organization (HMO) usually requires patients to use health care providers and pharmacies that are part of the plan’s network (except in the case of emergencies) while also typically requiring a referral from a primary care doctor in order to see a specialist.
  
  
• PPO
  Medicare Advantage beneficiaries in a Preferred Provider Organization (PPO) are able to see providers outside of their plan’s network, often at a higher cost.
  
  Beneficiaries in this type of plan typically pay less out of pocket if they choose to receive medical services from providers within their plan’s network.
  
  PPO plans typically do not require patients to acquire a referral before visiting with a specialist.
  
  
• PFFS
  A Private Fee-For-Service (PFFS) plan determines how much it will pay to health care providers and how much the patient will pay when care is received.
  
  With a PFFS plan, you can typically receive care from any doctor, hospital or health care provider that accepts your plan’s terms. Not all providers will accept these terms, however.
  
  
• SNP
  A Special Needs Plan (SNP) is a type of Medicare Advantage plan limited to people with certain chronic conditions and other specific characteristics.
  
  Typically, you must receive care from health care providers and hospitals within your SNP network, except for in cases when you need emergency or urgent care and when someone who has End-Stage Renal Disease (ESRD) needs out-of-area kidney dialysis.

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 Michigan Medicare Advantage plans that are available where you live.

Local health insurance resources in Michigan

• The Medicare/Medicaid Assistance Program offers free benefit counseling services to Michigan residents with Medicare or Medicaid insurance. Beneficiaries may contact SHINE at 800-803-7174 for help with questions about their Medicare coverage or costs.    
  
  
• You can also explore more information about the insurance industry in Michigan by visiting the state’s Department of Insurance website.
  
  
• Michigan Prescription Drug Assistance Programs
  The state of Michigan has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.

¹ MedicareAdvantage.com's The Best States for Medicare in 2021 report. (Oct. 27, 2020).

² Medicare evaluates plans based on a 5- star rating system.