Health Insurance Plans in Michigan

The state of Michigan presents its residents with a number of public health insurance options for certain qualifying individuals and families based on medical need and income. In addition, the state is fully compliant with the provisions of the Affordable Care Act, which requires special government-organized private insurance pools for those with existing medical conditions, as well as those who purchase health insurance individually apart from an employer's group health insurance plan.

Medicaid

• Like every other state, Michigan participates in the federal Medicaid program--government-subsidized health coverage that provides benefits to certain categories of low-income and medically needy enrollees without imposing a monthly health insurance premium. In Michigan, the Medicaid program accepts qualifying applicants who are children, pregnant women, the caretakers of children, disabled, destitute, elderly or those in need of help to pay for necessary medical bills.

  The state accepts individuals and families from each of those categories based on income; the guidelines change depending on the applicant's category and household size. For example, an individual without children must have a household income at or below 57 percent of the federal poverty limit, while pregnant women and infants under age 1 qualify with household income of up to 185 percent of the federal poverty limit.

MIChild

• Michigan children under age 19 from households with incomes too high to qualify for Medicaid but less than 200 percent of the federal poverty limit may instead qualify for MIChild, which is Michigan's version of the federal Children's Health Insurance Program. Children cannot have existing insurance coverage in order to apply, and they must be legal Michigan residents with a valid Social Security number. Families who enroll their children pay a $10 a month total premium for benefits that cover vaccinations, dental care, vision services, well-child visits, physician services, ambulatory transfers, hospital inpatient and outpatient care, emergency care and diagnostic lab and X-ray tests.

State PCIP

• The Affordable Care Act of 2010 requires that each state either organize and sponsor its own pre-existing condition insurance pool or else opt to participate in the federal pre-existing condition insurance pool, or PCIP. Michigan offers its own PCIP to residents who reside in the U.S. legally and have an existing medical condition for which they were previously denied health insurance coverage. Residents must be uninsured for a minimum of six months prior to applying for coverage through the state PCIP but if accepted will receive comprehensive health benefits without exclusions or limitations. Individuals enrolled in the Michigan PCIP can choose among three insurance options with deductibles that range from $1,000 to $3,500 and monthly premiums that vary between $104 and $687 per month.

State Exchange

• Michigan accepted a $1 million federal grant to help establish a state private health insurance exchange by January 2014. The exchange will be competitive among health insurers, and individuals and small businesses will be able to choose insurance through the state-run health exchange to find more affordable prices, including access to the same health insurance that members of Congress will choose from. Individuals who purchase private health insurance through the Michigan exchange that have household incomes at or below 400 percent of the federal poverty limit will also qualify for tax credits to help make the insurance premiums even more affordable.