Beginner’s Guide to Michigan Medicare
Medicare is the federal health insurance program for people with certain disabilities and for people over the age of 65. While the program is federally funded, each state may have different plan selections available. In fact, every single zip code in your state might have different plans available.
Click below to learn more about Michigan Medicare:
- Who is eligible for Medicare in Michigan?
- What Does Michigan Medicare Cost?
- What Does Medicare Cover in Michigan?
- Michigan Medicare Plan Finder
- Finding Medicare Doctors in Michigan
- MMAP and Medicare Resources in Michigan
- Getting both Medicare and Medicaid in Michigan
- How to Apply for Medicare in Michigan
Who is Eligible for Medicare in Michigan?
You can qualify for Medicare in Michigan by:
- Turning 65
- Getting diagnosed with ALS
- Getting diagnosed with ESRD
- Entering your 25th month of SSDI
What Does Michigan Medicare Cost?
The federal Medicare program generally pays for 80% of most covered services, leaving you with the other 20%. There are plans you can purchase, called Medicare Supplements, that can cover some or all of the remaining 20%.
Additionally, you may be required to pay a deductible and a premium for your Medicare parts A and B.
Part B has a yearly deductible of $185 (2019), and $1,364 (2019) for Part A hospital benefits. Part B has a premium ranging from $135.50 per month to $460.50 per month (2019) depending on your income. The Medicare Part A premium can range from $0 for people who have worked and paid taxes for most of their lives to $437 per month (2019) for people that did not pay Medicare taxes.
What Does Medicare Cover in Michigan?
Always keep in mind that Original Medicare coverage is different from private Medicare plan coverage. Original Medicare consists of Part A, hospital coverage, and Part B, medical coverage. Part A covers things like hospital visits, hospice, and some home health services. Part B covers things like preventative wellness, mental health, lab tests/X-rays, durable medical equipment, and emergency transportation.
If you want more coverage for services and goods such as prescription drugs, dental, and vision, you’ll need to invest in another form of coverage.
Michigan Medicare Plan Finder
If you’re looking for coverage beyond Original Medicare (parts A and B), you’ll need to compare Medicare Advantage, Medicare Supplements, and Prescription Drug Plans. We have a Medicare Plan Finder tool that can help you get started.
Medicare Advantage (MA)
Eligible Michigan residents may have a choice between several different Medicare Advantage plans. Medicare Advantage plans are able to cover benefits that Original Medicare can’t. We commonly see MA plans with prescription drug coverage, fitness benefits, dental and vision, and more. Some MA plans are available for a $0 premium, but others will have a premium that you will have to pay on top of your Original Medicare premiums.
Medicare Supplements (Medigap)
If Medicare Advantage isn’t right for you, consider Michigan Medigap plans. Medigap plans, or Medicare Supplements, do not usually add health benefits in the way that MA plans can. Instead, they offer more financial protection. You will owe a monthly premium for your Medigap plan, but that premium can go towards making sure you do not owe copayments when you visit the doctor (that is just one example). There are many different types of Medigap plans that cover different types of costs. Use our Medicare plan finder comparison tool to decide which cost coverage you need and which plan is best for you.
Prescription Drug Plan (PDP)
If you don’t want a Medicare Advantage plan with prescription drug coverage, you can enroll in a private prescription drug plan instead. You cannot have both Medicare Advantage and Medicare Supplements at the same time, but you can have both Medicare Supplements and a PDP at the same time. A PDP is a separate plan that you can have in addition to Original Medicare. You’ll pay a separate premium for it, with different copayments and deductibles according to your plan.
Finding Medicare Doctors in Michigan
A great way to find doctors in Michigan who accept Medicare is by visiting Medicare.gov’s provider finder tool. However, remember that while a lot of doctors may accept Medicare, not all doctors will be a part of your private plan network. That means that if you have a Medicare Advantage plan, for example, you will want to see if your plan carrier has its own doctor finder tool. For example, Aetna’s Medicare website has its own doctor and pharmacy finder tool.
MMAP and Medicare Resources in Michigan
MMAP is the Michigan Medicare/Medicaid Assistance Program. They are operated through the Area Agencies on Aging, a group dedicated to helping older adults as they age. MMAP offers counseling services to people with questions about Medicare and Medicaid.
Michigan also has other resources available for aging adults, like:
Area Agency on Aging 1-B: The Michigan Area Agency on Aging can help you find home care programs, wellness classes, meals on wheels, transportation, and more. They also support caregivers who dedicate their time and energy to taking care of loved ones.
Medicare Plan Finder: Medicare Plan Finder has licensed agents who can help you sort through your Michigan Medicare options and enroll in the best plan for you.
Michigan Senior Resources: The Michigan Senior Resources program can help you find high-quality nursing homes and home care services in your area.
MI Health Link Ombudsman: Offers free problem solving for people enrolled in MI Health Link, such as filing appeals and addressing poor care concerns.
Senior Resources: The Senior Resources organization is a West Michigan Area Agency on Aging for Muskegon, Oceana, and Ottawa counties. They can help you get the resources you need to live at home and can help coordinate your home care. They also offer classes for fitness, diabetes management, and more.
Getting both Medicare and Medicaid in Michigan (MI Health Link)
If you qualify for both Medicare and Medicaid, you may be able to enroll in a Medicare Advantage Dual-Eligible Special Needs Plan. These plans generally have very low or no costs and provide benefits for Medicare and Medicaid covered services. Medicaid qualifications are based on income and other Michigan state regulations.
Additionally, Michigan has a “MI Health Link” program allowing you to have one plan and one card for both your Medicare and Medicaid needs. It can be used for behavioral healthcare, home and community-based services, nursing home care, and prescriptions. MI Health Link is available in Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, Macomb, St. Joseph, Van Buren, Wayne and Upper Peninsula counties. To be eligible, you must be over the age of 21, not in hospice, and enrolled in both Medicare and full Medicaid.
For help with finding plans in your area, call 833-438-3676.
How to Apply for Medicare in Michigan
If you receive benefits from the Railroad Retirement Board or Social Security, you may automatically be enrolled in Original Medicare when you become eligible. If you are not automatically enrolled, you can enroll through the Social Security website, in-person at a Social Security office, or by calling 1-800-772-1213.
To enroll in Part D, Medicare Advantage, or Medicare Supplements, start searching here or get in touch with an agent, here. You can also call 833-438-3676 to get started.