If you’re relatively young and healthy, going without health insurance might not seem like such a big deal. But for people who have health issues or who otherwise want to stay on top of their own health and wellness, finding an affordable health care plan can be a stressful nightmare. That’s where we come in. You have more options than you think – and many of them are highly affordable, especially for hard-working families. But the laws can be confusing, and it’s hard to know exactly what will work best for you. We will discuss several different health insurance options that you, as a resident of Michigan, can choose from – including major medical coverage from the ACA, short-term health insurance, health share plans, and more.
Major Medical Insurance in Michigan
Some people may find it hard to believe, but the Patient Protection And Affordable Care Act, aka the ACA or Obamacare, has been around for a whole decade as of this writing. One very significant consequence of this law passing into being was the creation of the Health Insurance Marketplace and ACA-compliant major medical coverage. This new classification of medical insurance has helped millions of Americans afford the health care that they and their families need to thrive and live their life to the fullest.
If you’re unfamiliar with how the marketplace works, it’s actually pretty straightforward. All you have to do is go to HealthCare.gov and apply during the Open Enrollment period between November 1st and December 15th each year. Once you create an account (or once you login if you already have an account), you answer a few simple questions about your income and your household and you will receive a very quick response about whether or not you are eligible for coverage, as well as whether or not you are eligible for financial assistance.
As far as most medical experts are concerned, major medical coverage through the ACA is hands-down some of the best medical insurance you can get in America today. There are a few very important reasons for this. First and foremost is the fact that these are guaranteed issue policies. When you apply for coverage for guaranteed issue insurance, you cannot be rejected – not even if you have pre-existing conditions. And you cannot be charged more for your monthly premiums based on pre-existing conditions, either. In fact, these four factors below are the only things that an insurance company can use in order to legally justify charging you more money:
- Your age
- Your location
- Your use of tobacco products
- Whether you are applying for an individual policy or a family policy
Another reason people like ACA major medical coverage is because of how comprehensive it is. One part of the Affordable Care Act which the federal government made the law of the land is that all major medical insurance must include the following 10 guaranteed Essential Health and Wellness Benefits, or it cannot be legally classified as qualifying coverage. Those health benefits are:
- Ambulatory/outpatient services
- Emergency services
- maternity/newborn care
- Mental health and substance abuse
- Prescription drugs
- hab/rehab services and devices
- Lab tests
- Preventive and wellness services and chronic disease management
- Pediatrics (including oral and vision)
Although that might seem like a lot of coverage to some, having a Comprehensive Health insurance policy and taking advantage of the preventive care that these policies offer can help delay the onset of age-related disease, make the diseases you have much more manageable and less costly, or help you avoid getting sick with certain diseases in the first place. Speaking of costing less, most people can afford these insurance policies because the federal government has set aside funding to give tax credits to those who are making at least 138% of the federal poverty limit. Determining whether or not you meet this threshold is based on both your annual income and your total household size. The chart below can help you figure out which side of this threshold you and your household fall on.
|Household Size||Annual Income (138% of FPL)|
If you make less than 138% of the poverty limit, then you’re in luck – Michigan accepted federal funding to expand the Medicaid program to qualifying individuals who are below the 138% threshold limit. Although starting in 2020, the state government is planning to try and implement a work requirement for individuals receiving Medicaid benefits. It is not yet in force, however. For more information on Medicaid in Michigan and how to apply, you should visit the MIBridges website.
Short Term Health Insurance in Michigan
There are some basic federal rules and regulations which apply to short-term health insurance – and then there are state rules and regulations which slightly change the way this type of coverage works within the state of Michigan. Why should you consider short-term health insurance? Because an ACA health insurance policy may not be for everyone. Some people might not qualify for a subsidy, while others might also not qualify for Medicaid based on things like a lack of a disability status or an inability to meet the upcoming work requirement. Either way, it’s helpful to educate yourself about short-term health insurance in Michigan so that you know what all of your available options are.
One of the most attractive options about short-term health insurance in general is that it can cost around one-third less than an unsubsidized major medical policy – and that can be really helpful for individuals and families who don’t qualify for a federal tax credit. Short-term health insurance can be combined with things like indemnity plans or supplemental coverages like vision and dental in order to get as many of your health care needs met as possible. You don’t have to apply for short-term health insurance through the exchange – you can approach your insurance company directly and apply through them instead. And because you will have a legitimate legal contract between you and your health insurance provider, you have consumer protections on your side which will allow you to sue them and take them to court if they fail to honor your contract and refuse to pay out on medical claims.
So those are the bright spots of short-term health insurance in Michigan. But there are some downsides you should know about, as well. Short-term plans are as affordable as they are because they pass more of the total medical costs on to you – starting with a $5,000 deductible that you must meet before your insurance company will start paying out claims. After that, you may face annual and lifetime benefit caps if your medical care becomes too expensive. In the state of Michigan, you might not hit any of these caps compared to other states – but that’s only because Michigan specifically limits short-term health insurance to 185 days and prohibits you from renewing with the same company. When you apply for this type of coverage, you will also have to undergo medical underwriting – which means no guaranteed issue coverage. Companies can reject you for coverage if they think you are too sick and therefore too expensive to insure, or they can charge you exorbitantly high premiums for the same reasons. Lastly, most short-term health insurance companies try to save money by offering you fewer benefits than what you would get through an ACA policy. At the end of the day, though, having short-term health insurance can save you a ton of money over having no insurance whatsoever in the event that an unexpected medical catastrophe befalls you or your family.
Christian Health Plans/Health Share Plans in Michigan
Christian health plans – also known as health share plans – work similarly to short-term health insurance, but there are also some important differences. A few years ago, the most important difference was that a Christian health plan could grant someone a religious exemption to the individual mandate; people applying for short-term health insurance did not have that luxury. But now that the individual mandate is no longer a federal requirement nor is it state law within the borders of Michigan, the biggest appeal for Christian health plans is no longer that much of an issue.
That doesn’t mean you should forego coverage altogether, though, if your main choices are between that or signing up for a health share plan. In order to help you make that choice, let’s start by talking about what Christian health plans and short-term health insurance have in common:
- These plans are not guaranteed issue
- They come with unlimited out-of-pocket costs
- There are lifetime and annual benefit caps
- You won’t get all of the ACA Essential Health Benefits
- Plans require a less costly “monthly share amount” than an unsubsidized ACA monthly premium
- They’re not considered to be a “real” health insurance plan by major organizations and care providers
When it comes to the differences between these two types of coverage, however, the religious exemption to the (now non-existent) individual mandate is not the only one. With a Christian health plan, you will have to adhere to participation guidelines which may ask you to do things like declare a specific (and usually Christian) faith, refrain from tobacco use, and more. There’s no contract between you and your healthcare plan provider like there is with short-term health insurance; so if they decide not to pay out on your claims like they promised, you might not have legal recourse. The lingo is a little bit different because in addition to paying a “monthly share amount” instead of a premium, you’ll be paying your deductibles, co-pays, and coinsurance in the form of a “personal responsibility amount” or “an unshared amount”. That being said, most Christian health plans try to foster a strong sense of community in the areas where they operate, and do their best to provide members with health and wellness resources to help them live their best. These plans can also be a good shield from unexpected medical emergencies, even if you feel like you are perfectly healthy.
Fixed Indemnity Plans in Michigan
Fixed indemnity plans, while not very adequate as health care coverage by themselves, can be a great way to supplement whatever other type of health coverage you have, whether it be a major medical policy through the ACA, short-term health insurance, or a health share plan. Fixed indemnity plans don’t provide all of the Essential Health and Wellness Benefits that the ACA mandates, and they have the same lifetime and annual benefit caps that short-term health insurance and health share plans do. What’s more is that they don’t cover a fixed percentage of your total medical costs the way Marketplace insurance does – rather, they pay out a fixed amount, and you make up the rest. This fixed amount is paid out on a per day, per week, per month, per visit, or per event basis depending on the details of your plan.
Fixed indemnity plans can offer you benefits for hospital procedures and visits, doctor visits, or even things like dental. But like many of the other options we have discussed, you will have to undergo medical underwriting. And you may get rejected for coverage or charged a significantly higher premium for pre-existing conditions. But regardless of whether you have coverage or not, indemnity plans can still help you lower your total medical costs if you get one. It can also help protect you from catastrophic medical emergencies eating away at your life savings.
Discount Cards in Michigan
A medical discount card is a service that you usually pay a membership fee – either monthly, or yearly – in order to receive. When you sign up, you get a card in the mail that you must present at participating providers in order to get discounts on medical products and services. But medical discount cards are not health insurance, and they will not adequately cover your health care expenses the way health insurance would. But many people find value in them because they can help supplement whatever insurance coverage you do have to lower your total out-of-pocket costs.
Just make sure you choose carefully When shopping around for a medical discount card provider. Because these discount cards are not insurance, they’re not as closely regulated. this leaves wiggle room for unscrupulous actors to make lofty or outright false claims about the benefits they offer in order to stimulate business. Thankfully, it’s not difficult for you to make a few calls and double-check with participating providers on their list to see if what they’re advertising is true. If it is, and if you feel that the membership fee you are paying is equal to or less than the amount of money you could save with a medical discount card, then it’s certainly an option worth considering – even if you already have fairly comprehensive coverage. For more information, take a look at the summary and frequently asked questions about medical discount cards provided for free by the Michigan Department of Insurance and Financial Services.