Introduction to Medicare Advantage in Michigan (Part C)

Have you heard of Medicare Part C? It is more popularly referred to as a Medicare Advantage policy. It is also sometimes called a “Medicare replacement” policy due to the nature of how it works. Most supplements work by adding a separate private health insurance policy to your existing Medicare benefits. This helps protect you from expensive gaps which exist in Original Medicare (Medicare Parts A & B) coverage. But Medicare Advantage effectively replaces your Original Medicare, and also provides for extra coverage options to protect you against Medicare’s gaps.

Federal Regulations for Medicare Advantage

Signing over your federal Medicare benefits to be managed by a private company is a tricky business. To protect seniors, federal laws closely regulate Medicare Advantage policies. This ensures that you get the medical coverage which you are entitled to after retirement. By law, your Advantage plan must provide as much or better coverage than Original Medicare. Many Advantage providers actually go above and beyond, offering you as many medical benefits as you can afford on your policy.

Medicare Advantage Enrollment In Michigan

Michigan is a hot spot for seniors who prefer Medicare Advantage to any other type of supplement policy. Approximately 30% of Medicare recipients who live in Michigan are signed up for Medicare Advantage. This is high when compared to the national average. But keep in mind that not all Medicare Advantage plans are the same. The different types of plans, by popularity, can be found in the chart below:

Plan Type Enrollment Percentage
HMO Plans 59%
Local PPO Plans 13%
Special Needs Plans 11%
Regional PPO Plans 9%
Private Fee-For-Service Plans 5%
Other (Cost Plans, MSA’s, etc.) 3%

Plan Coverage & Cost

Tobacco users, older seniors, and anyone who did not enroll in Medicare within their Initial Enrollment Period (more on that later) might expect to pay a substantially higher rate for their Advantage plan. In the chart below, you can see a list of estimated price quotes for seniors in your area:

Most Popular Medicare Advantage Plans in Michigan

Medicare Advantage insurance policies have so many different components that each one will be tailored specifically to you, and your medical needs. First, your plan will vary based on your provider. Next, your plan will vary based on your provider network (HMO, PPO, PFFS, etc). Lastly, your plan will vary based on what sort of ancillary coverages, if any, you decide to add. All of these features will influence the overall cost of your plan.

Helpful Medicare Advantage Tips & Tricks

Doctor/Provider Network Restrictions

One unique feature of Medicare Part C, which is different from most other supplements, is the provider network to which you are assigned when you enroll in a policy. Restrictive networks, such as HMOs, tend to give you fewer choices when it comes to getting medical care. They can also impose harsher restrictions towards getting that care. But HMO plans are usually the cheapest plans available. PPOs or PFFS plans, on the other hand, give you more choice with fewer restrictions – for a substantially higher price.

Doctor/Providers List

Drug, Vision and Dental Coverage

Sadly, neither Original Medicare nor many of the available Medicare supplements allow for ancillary coverage options, such as dental or vision care. And seniors who want prescription drug coverage usually have to enroll in Medicare Part D in order to get it. But with a Medicare Advantage policy, you can easily manage prescription drug benefits (a MAPD plan), vision, dental, and more. And you can do it conveniently all under the same policy. However, you should keep in mind that the more coverage you add, the more you will have to pay each month for your policy.

Enrollment Options & Best Time To Enroll

Medicare Advantage policies can, under certain circumstances, be harder to obtain than Original Medicare or other forms of Medicare supplement insurance. Some providers may want to know more about your health history and current health status before approving you. Others may reject you based on serious pre-existing conditions (ESRD, for example). Even if you are rejected at first, you have options. Your state department of insurance has information on getting covered in the event that your pre-existing condition makes it difficult. You can also visit our Medicare Advantage Enrollment Options page for more information.

  • Initial Enrollment Period: Within your first 6 months of Medicare enrollment, you can enroll in a Medicare Advantage policy.
  • Annual Enrollment Period (AEP): From October 15th through December 7th each year, you are free to change or cancel your Medicare Advantage and part D drug plan.
  • Special Enrollment Period (SEP): Any sort of special circumstance in which you may need to change or get new coverage outside of a regular enrollment period, such as moving out of your service area, losing your employer/plan coverage, or your provider ceasing coverage in your area.

What Medicare Advantage Plan Is Best For Me?

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