Health insurance is an important purchase, undoubtedly. Although purchasing health insurance in Michigan is not compulsory, it is wise and prudent to have one. Health insurance secures the policyholder and his finances in the event of any health issue.
There are quite a number of ways to obtain health insurance in Michigan. You can get coverage from your employer, or the Michigan healthcare marketplace, or you could buy directly from an insurance provider.
Most residents in Michigan get their health insurance through their employers. Employers offer health coverage to their workers as part of their benefits.
If you are self-employed you could get yours either through an insurance broker or agent, directly from an insurance company, or from the Michigan insurance marketplace.
Some Factors That Determine Your Premium In Michigan
There are some factors that health insurance providers use to ascertain how much you’d pay for health insurance in Michigan. These factors can either raise your rates or lower them significantly. Some of them are stated below:
Body Mass Index( BMI)
The body mass index is a measure of a person’s weight to height. It’s used to calculate body fat and to see if a person is of healthy weight. Your body mass index plays an important role in determining how much you pay for health insurance.
Having a high BMI is detrimental to health and increases your chances of contracting some serious diseases.
Some of them include type 2 diabetes, osteoarthritis, cardiovascular diseases, certain types of cancer, high blood pressure, depression, etc. for this cause, health insurers charge individuals with a high BMI higher rates to secure their health.
Being able to maintain a healthy body mass index would not only save you some cash on premiums, but it would also improve your health and boost your self-confidence.
Your age greatly affects your premium rates. How much you pay for health insurance is directly proportional to your age. Older people are more likely to fall sick and need medical care and attention. As you continue to age, your premiums steadily increase.
Smoking/ Tobacco Use
Health insurance companies in Michigan weigh risks when deciding your premium amount. The damages smoking causes to an individual’s health cannot be overemphasized.
Smoking raises the risk of contracting many deadly diseases like diabetes, lung disease, cancer, stroke, heart disease, and chronic obstructive pulmonary disease.
Typically in Michigan and in other states, smokers pay higher premiums than non-smokers. If you want to save money on premiums as a smoker, it’d be ideal to quit the habit. That way, you would not only save money but also improve your health.
In Michigan, there are 83 counties and these counties have different rating systems. These rating systems used by healthcare providers affect the rate you pay on monthly premiums.
This is also a determinant. Our occupation exposes us to different kinds and levels of dangers and hazards. Health insurance providers in Michigan weigh the risks you are exposed to and the likelihood of being involved in accidents and injuries when deciding how much you pay. For instance, a builder is more likely to pay more on health insurance than a school teacher.
Some other factors include the type of policy you choose, policy duration, and co-insurance features.
Health Insurance By Metal Tier In Michigan
Health insurance companies in Michigan use a metal tier system to categorize plans and the coverage they offer.
The tier system includes catastrophic, bronze, expanded bronze, silver, gold, and platinum. These tiers have different monthly premiums and out-of-pocket maximums.
The lower tiers have lesser monthly premiums and higher out-of-pocket maxes while the upper tiers have higher monthly premiums and lesser out-of-pocket maxes and deductibles.
Below we’ve provided a breakdown of these tiers:
The catastrophic tier is the lowest tier among the metal tiers. It has the least monthly premiums, and the most out-of-pocket maximums, and deductibles. This plan/tier is not available to everyone. Only people under the age of 30 and who have hardship exceptions are eligible to purchase this plan.
The bronze plan covers up to 60% of your medical cost or expenses. This plan also has low monthly premiums and high out-of-pocket maxes and deductibles.
It is the next cheapest after the catastrophic plan. This plan is usually best and ideal for healthy and young individuals who do not visit the doctor often and do not need medical attention frequently.
Although this plan is cheap, in the case of emergencies, you may have to spend more on medical services.
The expanded bronze plan was designed to extend the coverage of the bronze plan. It offers coverage of up to 65% of your medical expenses while you pay 35%. Its premium is slightly higher than the bronze and catastrophic plans.
Silver plans are the perfect balance between the high out-of-pocket maximums of the bronze and catastrophic plans and the high monthly premiums of the gold and platinum plans. It’s a great choice for individuals with moderate income. Silver plans offer coverage of up to 70% of your medical costs/expenses while you pay 30%.
Silver plans also qualify for cost-sharing reductions and premium tax credits that further cut your costs on premiums. If you are looking for a plan, we recommend you start your search from the silver plans.
The gold plans gave high monthly premiums but it also has low out-of-pocket maximums and deductibles. These plans cover up to 80% of the policyholders’ medical expenses.
For individuals who have expensive prescriptions, who see the doctor often and expect high medical costs, this could be the just-right option for you.
Platinum plans are the most expensive in the Michigan marketplace. While having the least out-of-pocket maximums and deductibles, it has the most expensive monthly premiums.
This plan offers coverage of up to 90% of your medical costs. Just like the gold plan, it’s most probably the best choice for you if you need constant medical care and attention.
The more you keep paying for visits to the doctor, the sooner you hit your out-of-pocket limit and your insurer begins to pay for your medical expenses.
Below are an average monthly premium for each tier in the Michigan healthcare marketplace:
- Catastrophic: $271 per month
- Bronze: $312 per month
- Expanded Bronze: $314 per month
- Silver: $422 per month
- Gold: $477 per month
- Platinum: $612 per month
Most Affordable Health Insurance In Michigan By County
Health insurance rates in Michigan vary. These rates are unique to the rating area in your county falls. Michigan, having 83 counties, is divided into 16 rating areas. Health insurance companies use these rating areas when estimating premiums.
Wayne is the largest county in Michigan. The most affordable Silver plan -Totally You- Value is offered by Total Health Care USA, Inc. it costs on average $305 per month.
Most Affordable Health Insurance In Michigan With High Out-of-Pocket Maxes
For younger people in Michigan with little or no medical costs, a low-cost plan with high out-of-pocket maxes may be ideal. Although these plans have low premiums, it is important to bear in mind that you’ll be paying more in the event of any health emergency.
In Michigan the cheapest health insurance with high out-of-pocket maxes for a 26-year-old is Blue Cross® Select HMO Value from Blue Care Network of Michigan. It costs $226 per month on average.
Most Affordable Health Insurance In Michigan With Low Out-of-Pocket Maximums
Residents in Michigan that expect high medical costs are advised to purchase plans with low out-of-pocket maxes.
This is so that they can reach their maximum limit sooner and in turn, your insurer steps in and begins to pay for your medical expenses.
The cheapest health insurance plan with low out-of-pocket maxes in Michigan is the Sparrow PHP Platinum 500 Exclusive policy provided by Physicians Health Plan and it costs, on average, $546 per month for a 40-year-old.
Most Affordable HMO/EPO/PPO Health Insurance Plan In Michigan
It is important to consider your needs and preferences when searching for a plan type. HMO (Health Maintenance Organisation), PPO( Preferred Provider Organisation) and EPO ( Exclusive Provider Organisation) is the most common health insurance plans in Michigan.
HMOs are the cheapest among other types of plans but it requires policyholders to stay within their provider network to access health services and it requires referral to see a specialist.
PPOs, although more expensive than HMOs, have a broader network and do not require a referral to see a specialist.
Similar to the HMOs, the EPOs are cheap and also require you to stay within your network provider nut with EPOs you may not always require a referral to see a specialist
The following are the cheapest Silver plans for each plan type:
- Cheapest HMO Silver Plan: Totally You – Value provided by Total Health Care USA, Inc. at an average cost of $305 per month.
- Cheapest PPO Silver Plan: Blue Cross® Premier PPO Silver Saver HSA from Blue Cross Blue Shield of Michigan Mutual Insurance Company at a $523 monthly premium.
- Cheapest EPO Silver Plan: Oscar Silver Saver 2 through Oscar Insurance Company priced at $346 per month.