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Medicare Advantage in Michigan

Michiganders in Medicare generally have two options for their coverage: Traditional Medicare or Medicare Advantage.

Medicare Advantage is the alternative to the government-provided Medicare program. With Medicare Advantage (sometimes referred to as “Part C”), beneficiaries opt-in to comprehensive health plans managed by private insurance companies. Medicare Advantage plans are a lot like plans employers provide to workers, with out-of-pocket limits and (usually) managed health networks.

Seven insurance companies sell Medicare Advantage plans in the state of Michigan.¹ In total, these seven insurers provide 74 Medicare Advantage plans statewide.² However, if you live in Michigan, your Medicare Advantage plan selection will depend on your county of residence.

In 2020, 42% of Michigan beneficiaries elected to receive their Medicare coverage through some type of Medicare Advantage plan.³

Medicare Advantage plan benefits

With Medicare Advantage, you receive the same benefits as Original Medicare—that is, Part A and Part B. However, most Medicare Advantage plans cover far more benefits than just Part A and Part B. Here are some of the benefits you’ll likely see in a Michigan Medicare Advantage plan:

Prescription drug coverage
Eye exams and glasses
Dental coverage

Fitness programs
Hearing aids
Over-the-counter allowances

For Michigan residents with chronic illnesses, Medicare Advantage plans could provide extra benefits also—benefits to help with daily activities such as meal delivery, transportation, home modifications for mobility, and even pest control.⁴

Medicare Advantage plan costs in Michigan

Michiganders may pay varying premiums for a Medicare Advantage plan, depending on which plan they select and where on the “mitten” they call home. It’s not unheard of to have a $0 premium plan, but on average a Medicare Advantage plan in Michigan costs around $84 a month.


Average annual cost	$5,817.10
Average monthly premium	$84.40
Average drug deductible	$110.59
Annual max out-of-pocket	$4,693.70

Table created from data at https://www.healthmarkets.com/content/medicare-advantage-costs-index. Data as of 6/2/2020.

Medicare Advantage insurers in Michigan

There are seven insurance providers that provide Medicare Advantage plans in Michigan:

Aetna
Blue Cross Blue Shield (BCBS)
HAP Senior Plus
Humana

Priority Health Medicare
Reliance
WellCare

Top-rated Medicare Advantage providers

When looking for a Medicare Advantage plan, you may notice a star rating by the plan name. The Centers for Medicare and Medicaid Services (CMS) rates Medicare Advantage plans on a 5-star scale, with 1 star representing a low score and 5 representing the highest. A 5-star rating is hard to come by: only 1 out of every 20 Medicare Advantage plans nationwide receives CMS’ highest rating.⁵

None of Michigan’s Medicare Advantage plans got a 5-star rating from CMS. However, most plans in Michigan are still above average, with a 3.5-to 4-star rating across the whole state—including the Upper Peninsula.⁵

Find the Medicare Advantage plan that fits you best

HMO
Low premiums
Must stay in-network
Must choose a primary care physician
Referrals required to see a specialist

PPO
More expensive premiums
Can go out-of-network at a higher cost
May or may not choose a primary care physician
No referrals needed to see specialists

PFFS
May or may not have a network
In-network expenses lower than out-of-network
Plan is accepted by any doctor who agrees to the plan’s terms
Need written acceptance for coverage before each service

Statewide, Michigan has a total of 74 Medicare Advantage plans. A vast majority (46) are local HMO plans. Michigan also has 24 local (and 2 regional) PPO plans, as well as 2 PFFS plans.²

If you're looking for a Michigan Medicare Advantage plan, give us a call. A licensed Medicare insurance agent can help you find the best plan for your area—and your health needs.

Local resources in Michigan

Michigan Medicare/Medicaid Assistance Program (MMAP): MMAP helps older or disabled Michiganders navigate their health-care decisions.

Michigan Department of Insurance and Financial Services: The official government website for Michigan’s insurance and financial services department.
Michigan Department of Health & Human Services: Offering assistance and education for many areas of health including aging and adult services.

1. Medicare, “Find a Medicare Plan.” Accessed July 21, 2020.

2. Kaiser Family Foundation, “Medicare Advantage Plans, by Plan Type.” Accessed July 21, 2020.

3. Meredith Freed, Anthony Damico, and Tricia Neuman, Kaiser Family Foundation, “A Dozen Facts about Medicare Advantage in 2020,” April 22, 2020. Accessed July 21, 2020.

4. Joanna Young, Sean Creighton, Thomas Kornfield, Shruthi Donthi, Avalere, “Medicare Advantage Beneficiaries Will Again See a Jump in Supplemental Benefit Offerings in 2020,” November 19, 2019. Accessed July 21, 2020.

5. Centers for Medicare and Medicaid Services, “Fact Sheet – 2020 Part C and D Star Ratings.” Accessed July 21, 2020.

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