Paul Sanchez
Health insurance in Michigan offers a range of options, from Medicaid to private insurance. The cost of health insurance depends on several factors, including age, income, location, and tobacco use. In Michigan, a family of four with two 40-year-old adults and two children under 14 can expect to pay $1,793 per month before discounts for a Silver health plan. The Healthy Michigan Plan offers low-cost healthcare benefits to individuals, while Blue Care Network of Michigan provides affordable rates and high-quality service. Medicaid is an option for those with lower incomes, with comprehensive services for adults and children.
| Characteristics | Values |
|---|---|
| Health insurance rates from 2024 to 2025 | Increased by 9% on average |
| Silver health plans | 13% more expensive |
| Catastrophic and Gold plans | 7% more expensive |
| Blue Care Network of Michigan | Affordable rates and high-quality service |
| Priority Health | 42% fewer complaints than average |
| Medicaid eligibility | Less than $21,000 per year income for a single person |
| Medicaid eligibility | Less than $44,000 per year income for a family of four |
| Medicaid eligibility | Pregnant women with an income of less than $30,000 per year |
| Medicaid eligibility | Children under 18 with an income of less than $32,000 per year |
| Average monthly cost per child under 18 | $336 |
| Average monthly cost for a family of four | $1,793 for a Silver health plan |
| Bronze plans | $2,912 higher deductibles than Silver plans |
| Catastrophic plan eligibility | Under 30 years old or qualifying for a special hardship exemption |
| Average monthly premium for an individual health insurance plan | $456 |
| Average monthly cost for a family plan for a 40-year-old married couple with two kids | $1,483 (without government financial aid) |
| Average monthly cost for an individual policy in 2022 | $111 |
| Average monthly cost for a family policy in 2022 | $509 |
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What You'll Learn
Medicaid and income
In Michigan, Medicaid is available to people with low incomes. The state offers traditional Medicaid (TM) and the Healthy Michigan Plan (HMP). Each has different income and asset limits, and these limits vary depending on the category. For example, there is no asset limit for TM categories for eligible children, pregnant women, and some families with minor children. Most other TM categories have asset limits. HMP does not have asset limits, but there are income limits.
TM has many categories or sub-programs for eligible children, families, and adults. Each category has income limits, and some have asset limits. The limits vary depending on the category. For instance, a single Nursing Home Medicaid applicant in Michigan is eligible if they meet the following criteria:
- Income under $2,901/month
- Assets under $9,660
- Require a Nursing Home Level of Care
However, it is also possible for persons over the income limit to qualify for Medicaid-funded nursing home care via MO Medicaid’s Spend-down program. This allows one to “spend down” their “excess” income on nursing home expenses each month to qualify.
For HMP, the Michigan Department of Health and Human Services (MDHHS) will look at the money you get from sources such as work, investments, retirement accounts, and life insurance policies. If you earn a substantial income from work, you may have to pay a premium (monthly payment) on your coverage. The premium amount increases the more money you make.
There are also specific programs for children and pregnant women. For instance, Under 21 Medicaid is available to eligible persons under 21. There is an income test and an asset test for this program. If income is over the income limit, the person is assigned a deductible. Persons may incur medical expenses that equal or exceed the deductible and still qualify for this program. Similarly, Medicaid is available to pregnant women with income over the limit for the Pregnant Women program. They are assigned a deductible and may still qualify for the program if their medical expenses equal or exceed the deductible.
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Marketplace vs. employer-sponsored plans
In Michigan, the cost of an individual health insurance plan can vary depending on several factors, including your zip code, age, gender, and the plan's metal level. The average monthly premium for a plan offered by eHealth in Michigan is $469.93 per person. However, prices can differ based on specific circumstances.
When considering health insurance options, individuals often compare plans offered by employers with those available on the Health Insurance Marketplace. The Marketplace is a federally operated platform where individuals and families can purchase and compare health plans from various insurers. It offers a wide range of options, including Qualified Health Plans (QHPs) that provide essential health benefits and follow established limits on cost-sharing. The Marketplace also provides access to catastrophic health plans for eligible individuals, which typically have lower premiums and higher deductibles.
Employer-sponsored health insurance plans, on the other hand, are group coverage plans offered by employers to their employees. Large employers or government agencies often provide self-funded or self-insured plans, which allow them to directly manage and pay for medical claims. Small businesses with 50 or fewer employees are not required to provide health coverage but must inform their employees about the Marketplace options. Michigan Planners, for instance, is a company that assists small and large businesses in offering affordable and comprehensive healthcare coverage to their employees.
There are several key differences between Marketplace and employer-sponsored plans. Firstly, Marketplace plans are purchased individually, allowing for customization based on personal needs and preferences. Individuals can choose from various metal levels, including platinum, gold, silver, bronze, and expanded bronze, each indicating the percentage of expected healthcare costs covered by the plan. On the other hand, employer-sponsored plans are typically standardized, and employees may have limited choices regarding their coverage options.
Another distinction lies in the eligibility and enrollment processes. Marketplace plans have specific open enrollment periods, such as from November 1 to January 15, during which individuals can enroll in their desired plans. Special enrollment periods may also be available for those who experience qualifying life events, such as childbirth, marriage, or changes in employment. In contrast, employer-sponsored plans usually have a 90-day waiting period for new employees to become eligible for health coverage.
Lastly, cost-sharing and out-of-pocket expenses may differ between Marketplace and employer-sponsored plans. Marketplace plans have established limits on cost-sharing, including deductibles, co-payments, and out-of-pocket maximum amounts. Meanwhile, employer-sponsored plans may vary in their cost-sharing structures, with some offering wellness programs that provide incentives for employees to maintain or improve their health.
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Plan categories
The cost of health insurance in Michigan depends on the plan category. For example, the average cost of health insurance in Michigan is $561 per month at full price, but only $98 per month for discounted rates. Discounted rates are available to those who qualify based on their income. The size of your family also affects the cost of health insurance, as each child under 18 added to a plan incurs an average additional cost of $336 per month.
There are also different tiers of health insurance plans in Michigan, such as Silver, Catastrophic, and Gold. The monthly cost of a Silver plan for a family of four with two 40-year-old adults and two children under 14 is $1,793 before discounts. Higher-tier plans tend to have more expensive monthly rates but cover a larger portion of medical bills, while lower-tier plans have cheaper rates but result in higher out-of-pocket costs for medical care.
In addition to the plan tiers, there are also different types of insurance providers and networks in Michigan. For example, Blue Care Network of Michigan offers affordable rates and high-quality service, while Priority Health receives fewer complaints compared to similar-sized companies. Blue Cross Blue Shield of Michigan offers more flexible PPO (preferred provider organization) plans, allowing you to choose your own doctor. UnitedHealthcare also offers ACA Marketplace plans with affordable and reliable coverage options, and their Health ProtectorGuard fixed indemnity insurance plan pays set benefits for covered medical services like doctor visits and prescriptions.
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Family plans
The cost of health insurance in Michigan varies depending on the type of plan chosen, family size, and geographic location. Blue Cross Blue Shield of Michigan, the state's largest health insurance company, offers individual and family plans with coverage options to fit different budgets.
For family plans, the cost of health insurance in Michigan can vary depending on the specific plan chosen and the number of family members covered. On average, a family of four with two 40-year-old adults and two children under 14 can expect to pay around $1,793 per month before discounts for a Silver health plan. This includes the cost of coverage for each additional child, which averages $336 per month for those under the age of 18.
It is important to note that health insurance rates in Michigan have been increasing. From 2024 to 2025, rates rose by an average of 9%, with some plan tiers experiencing larger increases. For example, Silver health plans became 13% more expensive, while Catastrophic and Gold plans increased by 7%.
To save on health insurance costs, Michigan residents can consider Medicaid if they meet the income requirements. For a family of four, the income threshold is approximately $44,000 per year to qualify for Medicaid. Alternatively, a Silver health plan offers discounts and cost-sharing reductions (CSRs) for those with incomes below $78,000 per year. With CSRs, the government provides financial assistance to help cover costs such as medical expenses before reaching the deductible, copayments, and coinsurance.
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Blue Care Network of Michigan
The cost of medical insurance in Michigan varies depending on the insurance provider and the specific plan chosen. One of the insurance providers in Michigan is Blue Care Network of Michigan (BCN), a non-profit health maintenance organization (HMO) and an affiliate of Blue Cross Blue Shield of Michigan. BCN offers a range of health insurance plans for individuals and families, with various benefits and coverage options.
BCN has a vast provider network, including many of the state's leading hospitals and over 22,000 doctors to choose from. They offer coverage for a wide range of medical services, including high-risk pregnancy, neo-natal care, organ transplant, oncology, emergency room intervention, and serious illness. BCN also provides prescription drug coverage, dental benefits, and vision benefits for adults.
One of the key features of BCN is its flexibility. Members have the option to receive care in-network or out-of-network. However, it is important to note that receiving care in-network provides the highest level of benefits, as certain services are only covered when received from an in-network provider. BCN also offers a Point of Service (POS) plan, Blue Elect Plus, which allows members to work closely with a primary care physician while also having the flexibility to seek care from other physicians and specialists without a referral.
In addition to medical coverage, BCN places an emphasis on wellness and prevention. They provide resources and tools to help members build healthy habits and improve their overall health. BCN also offers online access to plan information and services through their website and mobile app, making it convenient for members to manage their health care needs.
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Frequently asked questions
Medicaid is the best option if you qualify. In Michigan, you can go on Medicaid if you make about \$21,000 per year or less as a single person or \$44,000 per year or less as a family of four. Blue Care Network of Michigan also offers Michigan residents affordable rates and high-quality service.
The cost of health insurance depends on your age, income, location, and whether you use tobacco. The average monthly premium for an individual health insurance plan purchased from the HealthCare.gov marketplace is \$456. A family of four with two 40-year-old adults and two children under 14 can expect to pay \$1,793 per month before discounts for a Silver health plan.
The price of health insurance depends on the level of coverage you choose (catastrophic, bronze, silver, gold, or platinum). It also depends on whether you choose a Health Maintenance Organization (HMO) plan or a Preferred Provider Organization (PPO) plan. HMO plans restrict you to a specific network of doctors and typically have lower premiums, while PPO plans offer more flexibility but are more expensive.
