The university added Michigan Care, a new managed care plan similar to U-M Premier Care, to the health plan options for 2021.
The university continues to offer BCBSM Community Blue PPO, Comprehensive Major Medical and U-M Premier Care, as well as GradCare for benefits-eligible graduate students.
Michigan Care Overview
Michigan Care offers a narrower network than U-M Premier Care and a lower monthly premium for non-Medicare participants. It also includes:
- Chiropractic coverage
- Expanded telehealth coverage through Amwell Online Care Group. Review coverage details.
- Access to Michigan Medicine health care providers as well as other high-quality network providers in Southeast Michigan, including providers from Integrated Health Associates (IHA) and Huron Valley Physicians Associates (HVPA), facilities that are part of the St. Joseph Mercy system (St. Joseph in Ann Arbor, Chelsea, Livingston and Oakland, and St. Mary Mercy in Livonia), and University Health Service. Check the Michigan Care provider directory.
Because of the narrow provider network, access to the plan is limited to faculty, staff and retirees who live in a specific geographic area within Southeast Michigan. Find out if your zip code is included in the coverage area.
View a brief video for Michigan Care highlights (2:25).
The plan is administered by Physicians Health Plan based in Lansing, MI. Michigan Medicine purchased a minority stake in PHP as part of an affiliation agreement with Sparrow Health System in 2019. Michigan Medicine leaders are engaged in and committed to the development and success of the plan. This engagement includes an emphasis on enhanced coordination between Michigan Medicine and the Michigan Care plan administrator (PHP) to improve service, quality and clinical outcomes for plan members.
Hearing Services Coverage
As a member of Michigan Care, you have access to a Hearing Services Value Network. Providers in this Value Network have agreed to offer standard hearing aid options that will not result in out-of-pocket costs. Michigan Care members must receive hearing services from a Hearing Services Value Network provider in order for these services to be covered.
You can “buy up” to advanced or premium hearing aid options, but will pay the difference in the cost between what the provider charges for these buy-up options and the amount the plan pays for a standard hearing aid.
Contact Michigan Medicine Audiology Services at (734) 936-8051 for more information or to locate a Michigan Medicine provider, or visit Hearing Loss and Hearing Testing on the Michigan Medicine website.
TruHearing has an extensive nationwide network of highly qualified hearing aid providers who offer affordable hearing aid options. Contact TruHearing at (844) 815-7195 to speak with a hearing consultant or to locate a TruHearing provider, or view information at TruHearing Choice.
Access to On-Demand Services through Amwell Online Care Group Physicians
You may continue to use telehealth services with your network providers based on availability, such as video visits and e-visits with Michigan Medicine providers through Michigan Medicine Virtual Care.
In addition to telehealth coverage with your network PCP or specialist, Michigan Care members will have on-demand video access to Amwell physicians for urgent medical needs and access to the Amwell behavioral health network by appointment, with the same copays as Michigan Care in-network coverage and no extra fees.
The US based, board certified and credentialed Amwell Online Care Group physicians can address urgent health concerns 24/7/365. In addition, the Amwell Online Care Group licensed and credentialed behavioral health providers (psychiatrists, psychologists and therapists) provide scheduled behavioral health services like medication evaluation and management, counseling and assessment, and therapy services. The availability of Amwell Online Care Group providers extends the Michigan Care network using telehealth for urgent health issues and behavioral health needs.
Summary of Benefits
- No annual deductible
- No out-of-pocket cost to you for preventive care
- $25 copay for office visit for injury or illness
- $30 copay for specialist visit
- $25 copay for urgent care*
- $25 copay for 24/7 on-demand physician telemedicine visits for acute or urgent health matters
- $25 copay per visit for up to 24 visits per year for chiropractic spinal manipulation
- $100 copay for emergency care (waived if admitted)*
- $25 copay for mental health, behavioral health or substance abuse services
- No out-of-pocket cost to you for inpatient services
- No out-of-pocket cost to you for outpatient surgery
- $3,000 individual/$6,000 family out-of-pocket maximum
* Members can access any urgent care provider or emergency room for urgent or emergency medical needs and receive in-network coverage.
Use the health plan comparison tool to compare Michigan Care covered services with services covered under other U-M health plans.
2021 Rates and Enrollment
Michigan Care monthly rates for 2021 are available to review.
Enrollment in the plan is available on or after January 1, 2021.
Using the Plan
Michigan Care is a managed care plan. Members must live in the plan's service area and choose a Primary Care Physician (PCP) from the Michigan Care network. In order to visit a specialist, you will need a referral from your PCP. Services received outside of the network are not covered except in the event of emergency. If members need urgent or emergent care when out of the network area, the plan will cover this care as if they were seeing an in-network provider. Plan documents will provide details.
The plan provides coverage for dependents who reside outside the network service area and meet eligibility guidelines. Pre-certification is required for certain services, and the member must register with Physicians Health Plan to obtain approval for out-of-area dependent coverage. For more information, call Michigan Care customer service at 833-484-8450.
If You Move Out of the Michigan Care Service Area
You must live in the Michigan Care service area to be eligible for the plan. If you are enrolled and move outside the Michigan Care service area, you must change your health plan.
To enroll in a different health plan, download the Moving out a Managed Care Service Area form and submit your signed and completed within 30 days of the date of your move. Your new coverage will become effective the first day of the month following the move or the receipt of this form, whichever is later. Please remember to update your home address with the university.
Find a Participating Provider
Search the provider directory to find out if your preferred providers are in the Michigan Care network. Use the "Find a Provider" link. No registration is required to search the provider directory.
2021 Michigan Care Benefits-at-a-Glance MNA (for members of the Michigan Nurses Association)
Plan Contact Information
Michigan Care Customer support: 833-484-8450
Physicians Health Plan
1400 E. Michigan Ave
Lansing MI 48912