Under the law, qualified health coverage means either of the following: Health and accident coverage that does not exclude or limit coverages for injures related to auto accidents and has an annual individual deductible of $6,000 or less; or Coverage under both Medicare Parts A and B. If so, the employee and any covered family members may be in a position to opt out of or substantially reduce PIP medical coverage offered by the auto insurer. The changes could affect employers health plan costs for Michigan residents. endobj Explore Mercers latest thinking to see how were helping to redefine the world of work, reshape retirement and investment outcomes, and unlock real health and well-being. UnitedHealthcare exited the individual market in Michigan at the end of 2016, as was the case in most of the states where they offered plans in the exchange in 2016. Would love your thoughts, please comment. The Department of Insurance and Financial Services (DIFS) can also help answer your questions. Individuals attempting unauthorized access will be prosecuted. But that hope was short-lived. In order for the policyholder to qualify, they must be enrolled in Medicaid, and any resident relatives or spouse must also have Medicaid, PIP coverage through a different policy, or any other qualified health coverage. * This tool provides ACA premium subsidy estimates based on your household income. Members should direct specific questions about PIP coverage to their auto insurer. We provide health insurance in Michigan. It is not minimum essential coverage as defined by the Affordable Care Act (ACA) and may not cover all Essential Health Benefits in your state. This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. $158 per month) Eligibility: All MSU students, Law students, Visiting scholars, and more, including spouse and children of a student enrolled in the plan. Qualified health coverage means either coverage under both Medicare Parts A and B, or . That bill had not advanced as of July 2022. 2007-2022 Michigan Auto Law. Health insurance for individuals who are65 or older, or those under 65 who may qualify because of a disability or another special situation. Past results are no guarantee of future results. Therefore, we can bet that our health insurance costs will go up and that employers who provide health insurance will likely be passing these increased costs onto the rest of us. Harbor Health Plan exited the exchange at the end of 2016. % Your health insurer should provide you with a document that tells you if your policy is con There are several ways you can request a QHC letter. A statement: (a) as to whether the coverage provided constitutes "qualified health coverage" as defined in MCL 500.3107d(7)(b)(i), or (b) that the coverage: o Does not exclude coverage for motor vehicle accidents and . (MCL 500.3107c(1)(a)) That means that if a drivers spouse or family does not have Medicaid or No-Fault or insurance, through a private plan or through Medicare, that meets requirements of qualified health coverage under the new Michigan No-Fault insurance law, then the driver cannot select the $50,000 level. It is health or accident coverage that does not exclude or limit coverage for injuries related to motor vehicle accidents and its annual deductible for coverage must be $6,000 or less per individual. (MCL 500.3107d(7)(b)(i)), Or it is Medicare coverage. They may also qualify for a zero-dollar premium bronze plan (after tax credits). This coverage is only available if . You can log in to your online member account to see if you have a QHC letter to download. Ultimately, the Trump administration cut off funding for CSR in October 2017, and insurers implemented the rates based on that scenario, with the cost of CSR added to silver plan premiums. 2 0 obj Outside of open enrollment, a qualifying event is necessary to enroll or make changes to your coverage. These are the relevant coverage levels and requirements: Additionally, QHC plays a role in a new arrangement for the coordination of health and No-Fault coverage: Qualified health coverage is important because without it drivers will not be able to take advantage of the insurance options under the new Michigan No-Fault insurance law that politicians have promised will save them money. Unlimited coverage, the default option. healthinsurance.org. How much could you save on 2023 coverage? Youll have the option of choosing from different levels of personal injury protection coverage. Their rate filing from earlier in the summer (when they were still planning to participate in the exchange) said that it would impact 17,000 members, but those with off-exchange coverage were able to keep their plans for 2018 if they wished to do so (HAP had 650,000 members in total in 2017, virtually all of whom had Medicare, Medicaid, or employer-sponsored coverage and were therefore not affected at all by the insurers decision to exit the exchange). 60 0 obj <> endobj Subsidies are based on the cost of the benchmark plan, so they rose modestly in 2017 in Michigan. To ensure your health plan meets the requirements of the new law it must not exclude or limit coverage for car accident-related medical care. 2018: Average rate increase of 25.5%. Michigan State University 1407 S. Harrison, Suite 110 East Lansing, MI48823 517-353-4434 Fax: 517-432-3862 hr.msu.edu These plans meet the requirements to be considered qualified health coverage under the Michigan no-fault law because (1) the plans do not exclude or limit <> This option may be appealing for folks on limited income. They are required to prepare and provide this documentation. Premium subsidies vary by address and subject to eligibility. There are several ways you can request a QHC letter. Your health plan is not considered qualified health coverage and you cannot opt out of PIP as part of your auto insurance policy. The most important car insurance advice for young drivers in Michigan includes: (1) a DETROIT615 Griswold St, Suite 402Detroit, MI 48226, GRAND RAPIDS212 Cesar E Chavez Ave SWSuite 105Grand Rapids, MI 49503, FARMINGTON HILLS 30101 Northwestern Hwy Farmington Hills, MI 48334, ANN ARBOR 122 S. Main Street, Suite 220 Ann Arbor, MI 48104, STERLING HEIGHTS | WARREN 44444 Mound Road, Suite 100 Sterling Heights, MI 48314. Important Legal and Privacy Information|Important Information About Medicare Plans|Privacy Practices Michigan residents who use the spend-down program must resubmit medical expenses every month to requalify for Medicaid benefits. This site is intended to provide accurate and timely legislative information to the citizens of the State of Michigan and other interested parties. The Michigan law (Mich. Comp. (MCL 500.3107d(1)), A driver who chooses the $250,000 coverage level for No-Fault PIP medical benefits under MCL 500.3107c(1)(b) can coordinate his or her No-Fault insurance with his or her health insurance in return for a 100% reduction on his or her PIP medical premium, but only if (1) the driver has private health insurance that meets the laws requirements and (2) the drivers spouse or family members have QHC through a private health plan or through Medicare. PIP is the part of an auto insurance plan that covers the health care costs from a car accident. Which insurers offer coverage in the Michigan marketplace? Qualified Health Coverage Documents DIFS Bulletin 2020-01-INS advises health plans should develop a document that indicates whether a person's coverage is "qualified health coverage" or QHC for purposes of the new no-fault law. . Bipartisan legislation (HB6112) was introduced in 2022 that would direct the state to conduct a study on the impacts of switching to a fully state-run exchange, and potentially make that move at some point in the future. Humanadropped their individual PPO plans in Michigan at the end of 2016, but that only impacted the off-exchange market, as Humanas on-exchange plans were already HMOs. You can opt out of, or cut your level of medical benefits, under the auto plan. I recommended him to all my friends and neighbors." 1 0 obj Short term health insurance is medically underwritten and does not cover preexisting conditions. If youre self-employed or without insurance from your employer in other words, youre looking for individual or family health insurance in Michigan you might be looking for Affordable Care Act insurance, what's often called Obamacare. Health insurers and self-insured group health plan sponsors should be prepared to provide documentation to Michigan drivers (and any family members) indicating whether the health plan is QHC and, if so, confirming their coverage under the health plan. For 2023, the states insurers (including two that only offer coverage outside the exchange) have implemented an overall average rate increase of 5.5% (slightly lower than insurers initially proposed), with the following rate changes for each insurer: Alliance Health & Life, and Health Alliance Plan, both of which only offer coverage outside the exchange in Michigan, have average rate increases of 10.3% and 2%, respectively. 01:30 Option four: up to two hundred fifty thousand dollars in coverage, with some or all persons excluded from PIP medical. A letter showing proof that you meet the requirements for qualified health coverage or QHC may be asked for by your auto insurer. Create your account today for an optimal, personalized experience. Aetna Better Health of Michigan regularly updates its Member Handbook and Certificate of Coverage (COC). Laws 500.3107d) allows a car owner to opt out of purchasing personal injury protection (PIP) medical coverage if he or she and all family members residing in the same home have QHC. An appointment with your doctor to fill out the forms. Go to My Forms & Documents and then click My Letters to generate your letter. qualified health coverage. The Video could not be loaded because the privacy settings are disabled. endstream endobj 61 0 obj <. Some plans may require copayments, deductibles and/or coinsurance for these benefits. Proof of qualified health coverage or another policy will also be required if a PIP exclusion is desired. In other words, if a driver or a family member does not have health insurance that qualifies, then a driver will be locked out of any savings that the politicians promised would be available to drivers under our new auto law. Eventually, the state moved ahead with a state-federal partnership. This right type of health insurance is what the No-Fault law refers to as qualified health coverage. Michigan has a state-federal partnership exchange; the state oversees plan management, but HealthCare.gov is used for enrollment. Once logged in, navigate to the QHC letter in the Proof of Insurance section at the bottom of the page. Coverage under both Medicare Parts A and B also constitutes qualified health coverage. Register Now. I also found very useful information about the new auto law. Individuals attempting unauthorized access will be prosecuted. These same medical services and medical treatments that are excluded or limited by health insurance were being paid by No-Fault as long as they were reasonably necessary to a car accident victims care, recovery or rehabilitation which is the legal threshold requirement for a medical service to be paid by your auto No-Fault insurance. These plans are certified by the Health Insurance Marketplace and provide minimum essential coverage (MEC). endstream endobj startxref Please review plan details to learn more. Michigan is responsible for plan management, but left all other functions to the federal government. To ensure your health plan meets the requirements of the new law it must not exclude or limit coverage for car accident-related medical care. To confirm that your health insurance coverage meets the requirments under the No-Fault law, ask for documentation from your health insurer. Eff. Between the two of them, they have about 5,000 enrollees (the total individual market in Michigan has about 360,000 enrollees, so the ten exchange insurers have virtually all of the market share, although some of their enrollees do have off-exchange coverage). The law defines QHC as coverage under Medicare or an accident or health policy with a deductible of $6,000 or less per individual and no coverage limits for injuries caused by car accidents. Three of the available options require that drivers and/or any spouse and resident relatives have . Very professional and prompt! For 2023, state regulators approved premiums that amount to an overall average rate increase of 5.5% for Michigans individual market insurers. Health insurance is perceived as less costly than No-Fault. endobj %PDF-1.6 % Proof of qualified health coverage is required for each household member that is excluded. implied. To be eligible to completely opt out of PIP coverage, the Michigan Department of Insurance and Financial Services states that the "qualified health coverage" other people in a household would need to have is defined as: Both Medicare Part A and Part B, or

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