Medicare plays a key role in providing health and financial security to beneficiaries residing in Michigan. With more than two million Michigan beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in Michigan. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in Michigan?

Medicare covers most Michigan residents who are 65 or older, and it also covers disabled Michigan residents. In general, Medicare enrollment in Michigan works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, it will help cover 80% of your health care costs.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

Michigan Medicare Enrollments

1,090,641

Original Medicare Plans
(Part A and B)

997,931

Medicare Advantage & Other Health Plans

1,072,494

Stand-alone Medicare
Part D (Drug plans)

2,088,572

Total Medicare Beneficiaries
in Michigan

Michigan Medicare Advantage Plans (Part C)

Nearly 42% of Michigan Medicare beneficiaries select Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in Michigan who already enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare.

As of 2020, 156 Medicare Advantage plans are available in Michigan. The average monthly Medicare Advantage premium changed to $56.07 in 2019 to $49.35 in 2020. $0 is the lowest monthly premium for a Medicare Advantage plan in Michigan.

According to the Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are 997,931 beneficiaries enrolled in Medicare Advantage and other plans in Michigan. Nearly 42% of Michigan Medicare beneficiaries were enrolled in a private Medicare Advantage plan in 2019. 100% of people with Medicare have access to a Medicare Advantage plan.

Michigan Medicare Supplement (Medigap) Insurance Plans

Michigan requires Medigap insurers to make Medigap Plans A and C continuously guaranteed-issue for Medicare beneficiaries under age 65.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

There is a Michigan Medigap Subsidy program that helps pay for Medigap coverage. If you qualify, you’ll pay less for Medigap coverage. The program pays part of your premium and you pay the rest. The Michigan Medigap Subsidy program is expected to continue until 2021, or when funding is exhausted.

As of 2020, there are 44 insurers that offer Medigap plans in Michigan. Since Michigan doesn’t dictate how insurers adjust premiums based on enrollees’ ages, insurers are able to use attained-age rating, issue-age rating, or community-rating. Michigan has rules in place to ensure access to at least some Medigap plans for people under age 65.

Current rules in Michigan require Medigap insurers that also sell major medical health insurance must make Medigap Plans A and C continuously guaranteed-issue for Medicare beneficiaries under age 65. However, the insurers can charge these enrollees higher premiums.

Michigan Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of 2020, there are 1,072,494 Medicare beneficiaries in Michigan enrolled in stand-alone Part D prescription drug plans and 609,258 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 30 stand-alone Part D plans available in Michigan, with premiums ranging from about $15 to $89 per month. About 24% of people with a stand-alone Medicare prescription drug plan get Extra Help (also called the low-income subsidy, or LIS).

When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call.

Local Medicare Health Plan Resources in Michigan

  • Michigan Medicare/Medicaid Assistance Program (MMAP): MMAP is a free health-benefit counseling service. Our goal is to help you find your way through the health benefits maze. MMAP accomplishes its mission through MMAP sites housed in regional Area Agencies on Aging, County Departments on Aging, Senior Services Agencies, Commissions on Aging, and other similar organizations located throughout Michigan.
    Contact: Call 800-803-7174. Alternatively, regional contact information can be found on the MMAP website.

  • Health Insurance Consumer Assistance Program (HICAP): HICAP offers free help to Michigan residents who need assistance with their health insurance. Seniors can receive assistance with finding a health care plan, switching plans, and filing complaints. Additional information is available on the HICAP website, including information about health insurance for people with Medicare, long-term care insurance, and Medicare supplements.
    Contact: Call 877-999-6442 or email [email protected].

  • Elder Law of Michigan (ELM): ELM is a nonprofit charitable organization that promotes and protects the rights, health, and economic well-being of older adults and people with disabilities by providing information, advocacy, and professional services.
    Contact: Call 877-664-2233 to find your nearest MiCAFE Network site for assistance with applications. For other services and information about advocacy, ELM can be reached at 866-400-9164.

  • The Senior Alliance is a non-profit 501(c)(3) agency established in 1980 and designated as the Area Agency on Aging for the 34 communities of Southern and Western Wayne County in Michigan. The Senior Alliance serves as the focal point for older adults in the region, by funding and administering a network of services. The Senior Alliance also arranges for services to qualified older adults and individuals living with disabilities as part of the MI Choice Waiver program in Michigan.
    Contact: Call 800-815-1112

  • Kalamazoo County Older Adult Services Division: Kalamazoo County’s AAA is housed in the Kalamazoo County Government under the Older Adult Services Division. Programming assists older adults and their caregivers access services, participate in health education classes, provide support for individuals living at home independently, advocacy, elder abuse prevention, and more.
    Contact: Call 269-373-5173. The agency can also be contacted via its website.

  • Valley Area Agency on Aging provides answers, action, and advocacy on care for the elderly and disabled adults of Genesee, Lapeer, and Shiawassee Counties, by enhancing lives, empowering choice, sustaining independence and supporting caregivers and families. Its Information & Assistance program makes certified resource specialists available to provide information about resources in the area.
    Contact: Call 810-239-7671 or make a referral by filling out the form on the program’s website.

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of Michigan. Our process makes it easier for you to access your Medicare eligibility in Michigan so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 327‑0148 anytime to get a free quote or to ask any questions.

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