Compare Macomb County Michigan
Medicare Advantage Plans

A Medicare Advantage Plan in Macomb County, MI can provide additional benefits above and beyond Original Medicare. There are 70 Medicare Advantage Plans (Part-C) available in Macomb County from 16 different health insurance providers to compare in 2023. 39 of these Medicare Advantage Plans offer additional gap coverage to help avoid the “donut hole”. The plan with the lowest out-of-pocket expense is $2900 and the highest out-of-pocket is $8300. Macomb County Michigan qualifying beneficiaries can also pick from 16 Medicare Special Needs Plans. The highest rated Medicare Advantage Plan in Macomb County Michigan received a 5 overall star rating from CMS.



Most Popular Plans by Enrollment in Macomb County, Michigan

Plan Name Plan ID Marketing Name Monthly
Premium
Enrollment
HAP Senior Plus (HMO)
H2354-015
HAP Senior Plus $0 23219
Wellcare No Premium (HMO-POS)
H5475-026
Wellcare $0 15480
Molina Dual Options (Medicare-Medicaid Plan)
H7844-001
Molina Healthcare of Michigan $0 13057
Aetna Medicare Premier (HMO-POS)
H3192-003
Aetna Medicare $0 10584
Humana Gold Plus H8908-004 (HMO-POS)
H8908-004
Humana $0 10336


2023 Medicare Advantage Plans in Macomb County, MI

(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)


Name ⇅ Monthly
Premium
Deductible MOOP Gap 2023 Plan
Stars
Rating
Wellcare No Premium Open (PPO)
(H2117-001)

$0 $0 $5,000 YesToo New
Wellcare No Premium (HMO-POS)
(H5475-026)

$0 $0 $5,500 No
Wellcare Low Premium (HMO-POS)
(H5475-024)

$15.00 $0 $5,000 No
Wellcare Giveback (HMO)
(H5475-031)

$0 $505.00 $7,550 No
Wellcare Community Assist (PPO)
(H2117-004)

$32.70 $380.00 $5,000 NoToo New
Wellcare Assist (HMO)
(H5475-038)

$11.90 $505.00 $5,000 No
PriorityMedicare Vital (PPO)
(H4875-022)

$0 $350.00 $4,900 No
PriorityMedicare Value (HMO-POS)
(H2320-029)

$34.00 $75.00 $4,900 No
PriorityMedicare Select (PPO)
(H4875-017)

$212.00 $0 $3,500 No
PriorityMedicare ONE (HMO-POS)
(H2320-030)

$0 $0 $4,300 No
PriorityMedicare Merit (PPO)
(H4875-016)

$96.00 $0 $4,100 No
PriorityMedicare Key (HMO-POS)
(H2320-022)

$0 $0 $5,000 No
PriorityMedicare Ideal (PPO)
(H4875-018)

$25.00 $125.00 $5,800 No
PriorityMedicare Edge (PPO)
(H4875-020)

$0 $0 $5,300 No
PriorityMedicare + Kroger (PPO)
(H4875-023)

$0 $0 $4,900 No
PriorityMedicare (HMO-POS)
(H2320-028)

$61.00 $0 $4,500 No
Molina Medicare Choice Care Select (HMO)
(H5926-007)

$0 $375.00 $8,300 No
Molina Medicare Choice Care (HMO)
(H5926-006)

$0 $125.00 $8,300 No
Molina Dual Options (Medicare-Medicaid Plan)
(H7844-001)

$0 $0 $- YesNA
MeridianComplete (Medicare-Medicaid Plan)
(H0480-001)

$0 $0 $- YesNA
Medicare Plus Blue PPO Vitality (PPO)
(H9572-002)

$75.00 $0 $5,000 Yes
Medicare Plus Blue PPO Signature (PPO)
(H9572-001)

$133.00 $0 $4,700 Yes
Medicare Plus Blue PPO Essential (PPO)
(H9572-004)

$0 $0 $5,200 Yes
Medicare Plus Blue PPO Assure (PPO)
(H9572-003)

$283.00 $0 $3,425 Yes
McLaren Medicare Inspire Plus (HMO)
(H6322-002)

$25.00 $0 $3,500 YesToo New
McLaren Medicare Inspire Flex (HMO-POS)
(H6322-003)

$0 $0 $3,800 YesToo New
McLaren Medicare Inspire (HMO)
(H6322-001)

$0 $0 $4,200 YesToo New
HumanaChoice R3887-002 (Regional PPO)

$87.00 $505.00 $4,500 No
HumanaChoice H5216-306 (PPO)

$0 $350.00 $6,550 Yes
HumanaChoice H5216-287 (PPO)

$0 $0 $4,900 Yes
HumanaChoice H5216-133 (PPO)

$17.00 $0 $6,400 No
HumanaChoice H5216-011 (PPO)

$99.00 $0 $5,900 No
Humana USAA Honor with Rx (PPO)
(H5216-305)

$0 $350.00 $6,550 Yes
Humana Gold Plus H8908-004 (HMO-POS)

$0 $0 $4,500 Yes
Humana Gold Plus H8908-001 (HMO-POS)

$45.00 $0 $3,900 Yes
HAP Senior Plus Option 4 (PPO)
(H2322-004)

$180.00 $0 $4,000 Yes
HAP Senior Plus Option 3 (PPO)
(H2322-008)

$165.00 $0 $5,000 Yes
HAP Senior Plus Option 2 (PPO)
(H2322-012)

$70.00 $0 $5,500 Yes
HAP Senior Plus Option 2 (HMO-POS)
(H2354-022)

$190.00 $0 $4,000 Yes
HAP Senior Plus Option 1 (PPO)
(H2322-011)

$0 $0 $6,000 Yes
HAP Senior Plus Option 1 (HMO-POS)
(H2354-021)

$99.00 $0 $5,000 Yes
HAP Senior Plus Henry Ford Tiered Access (HMO)
(H2354-018)

$99.00 $0 $4,750 Yes
HAP Senior Plus (HMO)
(H2354-015)

$0 $0 $4,500 Yes
HAP Primary Choice Medicare (HMO)
(H2354-024)

$0 $0 $5,000 Yes
HAP MSUHC Medicare (HMO)
(H2354-028)

$0 $0 $5,000 Yes
HAP Medicare Flex (PPO)
(H2322-014)

$0 $505.00 $8,300 Yes
HAP Empowered MI Health Link (Medicare-Medicaid Plan)
(H9712-001)

$0 $0 $- YesNA
CCA Medicare Ultima (HMO)
(H9861-002)

$40.00 $0 $4,500 YesNA
CCA Medicare Excel (HMO)
(H9861-001)

$0 $0 $4,500 YesNA
BCN Advantage Local (HMO)
(H5883-015)

$0 $0 $4,500 No
BCN Advantage HMO-POS Prime Value (HMO-POS)
(H5883-014)

$0 $0 $4,500 Yes
BCN Advantage HMO-POS Prestige (HMO-POS)
(H5883-003)

$263.00 $0 $3,400 Yes
BCN Advantage HMO-POS Community Value (HMO-POS)
(H5883-012)

$17.00 $0 $4,300 No
BCN Advantage HMO-POS Classic (HMO-POS)
(H5883-002)

$127.00 $0 $3,800 Yes
BCN Advantage HMO ConnectedCare (HMO)
(H5883-007)

$56.00 $0 $3,800 Yes
Ascension Complete Michigan Secure (HMO)
(H0482-004)

$0 $0 $2,900 YesNA
Ascension Complete Michigan Reward (HMO)
(H0482-003)

$0 $480.00 $3,450 NoNA
Ascension Complete Michigan Access Plus (PPO)
(H7512-001)

$0 $0 $3,450 NoToo New
Ascension Complete Michigan Access (PPO)
(H7512-002)

$0 $0 $2,900 NoToo New
AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid Plan
(H0192-001)

$0 $0 $- YesNA
Aetna Medicare Value (PPO)
(H5521-214)

$0 $0 $4,950 Yes
Aetna Medicare Premier Plus (PPO)
(H5521-217)

$27.00 $0 $4,500 Yes
Aetna Medicare Premier (HMO-POS)
(H3192-003)

$0 $0 $3,900 Yes
Aetna Better Health Premier Plan (Medicare-Medicaid Plan)
(H8026-001)

$0 $0 $- YesNA






Michigan Part-C Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP 2023 Plan
Stars
Rating
Wellcare Patriot Giveback Open (PPO)
(H2117-003)

$0 LocalPPO* $5,000Too New
HumanaChoice R3887-001 (Regional PPO)
(R3887-001)

$0 RegionalPPO* $5,500
Humana Honor (PPO)
(H5216-190)

$0 LocalPPO* $5,500
HAP Senior Plus Medical Only (HMO)
(H2354-019)

$0 LocalHMO* $4,500
BCN Advantage Elements (HMO-POS)
(H5883-001)

$0 LocalHMO* $4,500
Aetna Medicare Eagle (PPO)
(H5521-286)

$0 LocalPPO* $4,390





Medicare Special Needs Plans in Macomb County Michigan

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special
Needs
Type
2023 Plan
Stars
Rating
Wellcare Dual Access Open (PPO D-SNP)
(H2117-002)
   $18.30 $505.00  No Dual-EligibleToo New
Wellcare Dual Access (HMO-POS D-SNP)
(H5475-001)
   $27.90 $505.00  No Dual-Eligible
PriorityMedicare D-SNP + Kroger (HMO D-SNP)
(H8379-002)
   $32.70 $505.00  No Dual-Eligible
PriorityMedicare D-SNP (HMO D-SNP)
(H8379-001)
   $32.70 $505.00  No Dual-Eligible
Molina Medicare Complete Care Select (HMO D-SNP)
(H5926-005)
   $32.70 $505.00  No Dual-Eligible
Molina Medicare Complete Care (HMO D-SNP)
(H5926-001)
   $32.70 $505.00  No Dual-Eligible
McLaren Medicare Inspire Duals (HMO D-SNP)
(H6322-004)
   $32.60 $505.00  No Dual-EligibleToo New
Longevity Health Plan (HMO I-SNP)
(H7557-001)
   $23.50 $505.00  No InstitutionalNA
Humana Gold Plus SNP-DE H8908-005 (HMO D-SNP)
(H8908-005)
   $30.50 $505.00  No Dual-Eligible
HAP Medicare Complete Duals (HMO D-SNP)
(H2354-025)
   $32.70 $505.00  Yes Dual-Eligible
CCA Medicare Maximum (HMO D-SNP)
(H9861-003)
   $32.70 $505.00  No Dual-EligibleNA
Ascension Complete Michigan DSNP (HMO D-SNP)
(H0482-006)
   $17.00 $350.00  No Dual-EligibleNA
Align Thrive (HMO I-SNP)
(H6832-001)
   $32.70 $505.00  No InstitutionalNA
Align Kidney Care (HMO C-SNP)
(H6832-003)
   $32.60 $505.00  No Chronic or Disabling ConditionNA
Align Connect (HMO C-SNP)
(H6832-002)
   $0 $505.00  No Chronic or Disabling ConditionNA
Aetna Medicare Assure Premier (HMO D-SNP)
(H3192-007)
   $20.20 $505.00  No Dual-Eligible



Types of MA Plan in MI


HMO - Health Maintenance Organization. A Health Maintenance Organization manages your Part A and Part B health insurance benefits. In most cases you need to choose a primary care doctor. Health Maintenance Organization's offers services through a network of contracted hospitals, doctors and other providers, and the plan pays the providers directly. You generally must receive all Healthcare from the plan providers or through referrals from the plan provider. Emergency care, and out-of-area urgent care is still covered. An HMO-POS plan allows you to get some services out-of-network.

PPO - Preferred Provider Organization. A Preferred Provider Organization offers a network of doctors, hospitals, and other providers you can choose from. Because providers are preferred, you can save money by using in network providers or usually pay a higher cost to use out-of-network providers. A primary care doctor is not required.

PFFS - Private Fee For Service. A Private Fee For Service plan allows you greater flexibility in choosing a Michigan provider. You may obtain covered services from any Medicare eligible provider who is willing to accept the plan's terms. The Healthcare provider must agree to accept the plan's terms before each visit. Some of these plans have a network of approved providers that have agreed to treat plan members.

SNP - Special Needs Plan. A Special Needs Plan is for individuals who receive Medicare and Medicaid, have specific severe or disabling chronic conditions or reside in a licensed nursing home or skilled facility. SNP plans must provide prescription drug coverage to Macomb County Michigan residents.

Cost - Cost Plan. A cost plan doesn't replace your Original Medicare. It offers additional benefits to Original Medicare. If the cost plan doesn't include prescription drug coverage, you can enroll in a Part-D plan separately.





Can I get help in the coverage gap in Macomb County, MI?


Yes. 39 Medicare Advantage Plans in Macomb County offer additional gap coverage. Once in the coverage gap, you’ll pay no more than 25% of the cost for brand-name and generic prescription drugs. If you choose a drug plan that includes coverage in the gap, you may get a discount applied to the drug's price.

Are there Medicare Advantage Plans in Macomb County, MI?


There are 70 Medicare Advantage Plans available in Macomb County, Michigan from 16 different health insurance providers. These plans offer additional benefits that aren't available through Original Medicare. Medicare beneficiaries who are interested in a Part-C policy may choose among many plans to compare versus Manistee County Medicare Advantage Plans.



How much is a Medicare Plan in Macomb County, MI?


Individuals who are interested in a Medicare Advantage Plan in Michigan may choose among many cost options depending on your necessary benefits. The lowest plan premium is $0 and the highest premium is $283. The deductibles in Macomb County range from $0-$505. The plan with the lowest out-of-pocket (MOOP) expense is $2900 and the highest out-of-pocket is $8300.



Things to consider when choosing a MA Plan in Macomb


  • Are you eligible for a Medicare Advantage Plan?

  • How much are the premiums, deductibles, and other costs?

  • Is there a yearly limit on what you could pay out-of-pocket?

  • Does the plan cover your prescription drugs?

  • Will you hit the prescription drug coverage gap?

  • Is your pharmacy in the plan’s network?

  • Will your prescription drugs require prior authorization?

  • How well does the plan cover the services you need like vision, hearing, or dental?

  • Are your doctors in-network?

  • Will you need to be referred to see a specialist?

  • Does the plan cover services from out-of-network providers?

  • How does the plan compare to your current coverage?

  • Do you want to juggle multiple Medicare plans?


Special Needs Plan in Macomb County Explained


C-SNP - Chronic Condition SNP. These plans help individuals receive customized care to fit their unique health care needs. You may qualify for C-SNP if you have one or more specific severe or disabling chronic conditions like:

  • Stroke
  • Certain neurologic disorders
  • Certain chronic and disabling mental health conditions
  • HIV/AIDS
  • Certain chronic lung disorders
  • Diabetes mellitus
  • End-Stage Renal Disease (ESRD)
  • End-stage liver disease
  • Certain severe hematologic disorders
  • Chronic alcohol and other drug dependence
  • Certain cardiovascular disorders
  • Cancer
  • Chronic heart failure
  • Certain autoimmune disorders
  • Dementia

I-SNP - Institutional SNP. These plans require 90 days or longer stay in a facility, or are expected to need the level of services provided in a long-term care (LTC) skilled nursing facility (SNF), a LTC nursing facility (NF), an intermediate care facility for individuals with intellectual disabilities, or an inpatient psychiatric facility.

D-SNP - Dual Eligible SNP. Michigan Medicare and Medicaid enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket medical expenses from Medicaid. Eligibility is based on a percentage of Federal Poverty Levels.


When to sign up for a Michigan Medicare Advantage Plan?


Below mentioned are the types of the enrollment period, along with the instructions on what to do during this period:

Initial Enrollment Period (IEP). This period starts 3 months prior to the month you will turn 65. It ends after 3 months you have turned 65. At this stage, you can sign up for a Michigan Medicare Advantage Plan.

Annual Enrollment Period (AEP). Also known as the Open Enrollment Period, it starts on the 15th of October and ends on the 7th of December. At this stage, you can either sign up for the plan, switch or leave your current plan.

Special Enrollment Period (SEP). This enrollment period depends on the personal circumstances of the beneficiaries, like if you move or lose insurance coverage. Check to determine if you qualify to modify your plan.

Open Enrollment Period. Jan 1 – Mar 31. If you’re enrolled in a Michigan Medicare Advantage Plan, you can switch to a different Medicare Part-C Plan in Macomb County, MI or switch to Original Medicare once during this time.

5-star Special Enrollment Period. Dec 8 - Nov 30. If a Centers for Medicare and Medicaid Services (CMS) 5-star plan is available in your area you can switch to the 5-star plan once during this period.



Check for CMS Star Ratings

Centers for Medicare & Medicaid Service (CMS) assesses the quality of medical services of Medicare Advantage Plan using a 5-star rating system. A report is released yearly for the public to assess the quality of healthcare services. Thus, if you are searching for the highest Medicare Advantage Plan in your state, research the CMS ratings and costs of the plans report for further information.


Can I get a Medicare Advantage Plans in Macomb County, MI?

Yes. There are 70 Medicare Advantage Plans available in Macomb County, Michigan from 16 different health insurance providers. These plans offer additional benefits that aren't available through Original Medicare.

How much is a Medicare Plan in Macomb County, Michigan?

Michigan residents who are interested in a Medicare Advantage Plan may choose among many cost options depending on your necessary benefits. The lowest plan premium is $0 and the highest premium is $283. The deductibles in Macomb County range from $0-$505

Can I get help in the coverage gap in Macomb County, MI?

Yes. 39 Medicare Advantage Plans in Macomb County offer additional gap coverage. Once in the coverage gap, you’ll pay no more than 25% of the cost for brand-name and generic prescription drugs. If you choose a drug plan that includes coverage in the gap, you may get a discount applied to the drug's price.

What is the most popular plan in Macomb, MI?

The most popular plan by enrollment in Macomb is the HAP Senior Plus (HMO) with 23219 enrollment.



Source: CMS. Data as of Oct 1, 2022.
Plans are subject to change as contracts are finalized.
Includes 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2023, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.


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Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

Every year, Medicare evaluates plans based on a 5-star rating system.