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Michigan State FlagMedicare Advantage Plans in Michigan

Thanks to expanding benefits and more plans becoming available, Medicare Advantage (MA) grows more popular every year. More than 22 million people had an Advantage plan in 2019, accounting for over one-third of all Medicare beneficiaries. This page explains Medicare Advantage plans in Michigan and how to compare your options to ensure you get the best plan for your unique needs.

What Is Medicare Advantage in Michigan?

Also known as Medicare Part C, every Medicare Advantage plan must provide the same coverage you get with Original Medicare. This includes:

  • Medicare Part A, hospital insurance (inpatient services)
  • Medicare Part B, medical insurance (outpatient services)

Prescription drug coverage is available via standalone Medicare Part D plans. It is also included with around 90 percent of Advantage plans.

Medicare Advantage Plans with Prescription Drug Coverage in Michigan

Medicare Advantage Prescription Drug plans (MA-PD) combine the benefits of Medicare Parts A, B, and D.

Many Advantage plans – with or without prescription drug coverage – also offer additional benefits. Common items include:

  • Routine vision care
  • Routine dental care
  • Hearing aids
  • Fitness programs

Private insurance companies provide Medicare Advantage plans, which means that coverage and costs will vary depending on which plan you choose.

Who Is Eligible for Medicare Advantage in Michigan?

If you have Medicare Parts A and B, you're eligible for Medicare Advantage in Michigan.

American citizens and permanent legal residents aged 65 and older qualify for Medicare. For those who began collecting Social Security benefits at least 4 months before their 65th birthday, enrollment in Parts A and B is automatic. Everyone else must apply for Medicare.

You're also eligible for Medicare if you collect Railroad Retirement Board (RRB) or Social Security disability benefits for 24 months. Enrollment occurs automatically in month 25.

When Can You Sign Up for a Medicare Advantage Plan in Michigan?

You may join a Medicare Advantage plan in Michigan during specific enrollment periods.

Your Initial Enrollment Period (IEP) begins 3 months before your Medicare eligibility month and lasts for a full 7 months. For example, if your 65th birthday or 25th month of collecting disability occurs in February, your IEP starts on November 1 and ends on May 31.

If you fail to sign up for Part A and/or Part B during your IEP, you may do so during the General Enrollment Period from January 1 until March 31. You may then join a Medicare Advantage plan from April 1 until June 30.

You may also sign up for an Advantage plan during Medicare's Annual Enrollment Period (AEP), which runs runs from October 15 through December 7.

The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 and is for people currently enrolled in Part C. Options are limited to joining a new MA plan or returning to Original Medicare. You may also enroll in a standalone Part D plan if making that change causes you to lose your prescription drug coverage.

If you experience certain life changes, you can sign up for Part C during a Special Enrollment Period. Find the full list of qualifying circumstances on Medicare.gov.

Types of Medicare Advantage Plans in Michigan

The four main types of Medicare Advantage plans in Michigan are:

  • Health maintenance organizations: HMO plans require plan members to choose a primary care doctor and get a referral to see a specialist. They also have a provider network that may include any entity you rely on for healthcare services. Treatment received from an out-of-network provider is rarely covered by an HMO except in cases of emergency.
  • Preferred provider organizations: PPO plans also have provider networks, but they allow members to go outside the network for a higher copay. PPO plan members also don't need a primary doctor or specialist referrals.
  • Private fee-for service: PFFS plans establish cost guidelines for covered services, including what plan members pay. Most PFFS plans have a provider network but allow members to use an out-of-network provider for a higher cost. You also don't need a primary doctor or referrals to see a specialist.
  • Special needs plans (SNPs) are limited to people who meet certain criteria. Guidelines vary by plan, but expect one of the following: having a chronic condition, living in an institution or requiring home-based care, or qualifying for both Medicare and Medicaid. Most SNPs also require beneficiaries to choose a primary doctor. If you qualify for an SNP, you may join the plan at any time.

How to Choose a Medicare Advantage Plan in Michigan

When comparing your Medicare plan options, consider the following:

  • Costs: These may include an annual deductible, monthly premiums, and copays or coinsurance.
  • Coverage: Benefit vary widely, so compare your options carefully. Don't forget the drug formulary for MA-PD plans.
  • Network: Providers may include doctors, hospitals, labs, pharmacies, durable medical equipment (DME), and more.
  • Ratings: Medicare rates plans on a 5-point scale and releases their findings every fall to help members compare their options during AEP.

It's easy to compare Medicare Advantage plans in Michigan with our Find a Plan tool. Just enter your location information and estimated coverage start date to review the Medicare plan options in your area.

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The MedicareUSA website is operated by HealthPlanOne, LLC a licensed health insurance agency based in Connecticut; in California d/b/a HPOne Insurance Agency, license #OF30784. HealthPlanOne, is a licensed and certified representative of Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal.

For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

PLEASE NOTE: Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease.

The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.

Medicare supplement plans are not connected with or endorsed by the U.S. Government or the federal Medicare program.

The Centers for Medicare and Medicaid Services (CMS) does not review or approve Medicare Supplement plan information.


Last Updated 01/13/2021