Michigan Health Care

Michigan Health Care

Michigan Health care will available on Nov. 01, 2015.  The federal government will operate the Michigan Health Insurance Marketplace, also called the exchange. This will be an online marketplace that will provide policies that should be more affordable for families and individuals. Various insurance companies will be offering as many as 150 plans.

Michigan health care plan options

  • Platinum plans, the most expensive plans, will pay about 90% of medical expenses.
  • Gold plans will cover about 80% of medical costs
  • Silver plans will cover about 70% of medical costs.
  • Bronze plans about 60% of medical costs.
  • Catastrophic health coverage, available to people under 30, is not standard policy but will satisfy the requirements of the federal healthcare law. These policies will probably have the lowest premiums and the highest deductibles and co-pays. The deductibles may be as high as $6,850, so you’d have to spend that much before the plan pays for health care. This plan will provide coverage largely in cases of a catastrophic injury, such as a major accident.

With these plans the lower the premiums that are paid up front the higher, the costs will be at the time that health care service is needed.

When will Michigan health care plans be available?

You must enroll by Dec. 15 for policies to be effective Jan. 1. Enrollment will continue until January 31, but there will be a delay on the effective dates for the policies. After January 31, you can buy policies on the exchange only in special circumstances or life events. These policies are available within 30 days following certain life events. Examples are a change in family size due to marriage, birth or adoption. A change in legal status to U.S. citizen or legal immigrant will also qualify as a special circumstance.

Everyone enrolled can change policies annually during a limited enrollment period. Starting in 2016, the open enrollment period will go from November 01, 2016 to January 31, 2017.

Small businesses — those with 50 or fewer full-time employees — will be able to access the policies also at www.healthcare.gov.  Options available to small business will be available under the Small Business Health Options Program Marketplace, or small businesses can call 800-706-7893.

Open enrollment for small businesses also begins October 1 and continues year-round.

Who can buy Michigan health care insurance on the exchange?

Anyone who lives in the U.S. legally — including those with green cards and worker or student visas — and is not in jail can buy insurance on the exchange.

U.S. citizens living in a foreign country are not required to get health insurance coverage under the Affordable Care Act.

Michigan health care exclusions:

Applicants can’t be denied insurance based on pre-existing conditions. Insurers also cannot set limits on 10 essential benefits listed below.

  • Outpatient Care
  • Emergency Room Services
  • Hospitalization
  • Preventive and wellness visits
  • Maternity and Newborn Care
  • Mental and Behavioral Health Treatment
  • Prescription drugs
  • Services and devices to help people with injuries, disabilities, or chronic conditions
  • Lab tests
  • Pediatric care

Where to buy Michigan health care plans:

The exchange starts Oct. 1. Consumers will be able to compare Michigan health care plans at www.healthcare.gov or call 800-318-2596. Start a policy can on this site.  You can also apply by mail or in person, but online will be the most efficient way to apply.

What do you need to enroll in a Michigan health care plan?

  •  Social Security number (or document numbers such as those on green cards).
  •  Employer and income information for each family member who needs coverage (such as a W-2 or a paystub).
  •  Policy numbers for any current insurance.
  •  Information on employer coverage

What happens if you do not purchase a Michigan health care plan?

If you don’t have Michigan health coverage in 2016, you’ll pay the higher of these two amounts:

  • 2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,150 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
  • $695 per person for the year ($347.50 per child under 18). The maximum penalty per family using this method is $2085.

How to pay Michigan Health care penalty:

You’ll pay the fee on the federal income tax return you file for the year you don’t have coverage. Most people will file their 2016 returns in early 2017.

More details on what the Michigan Affordable Care 2016 tax penalties are can be found at this link Michigan Affordable Care Penalties.