- Why is the university offering this new plan?
- The university is offering Michigan Care as an additional choice of high-quality health plans available to faculty, staff and retirees. The plan originates from a partnership between Michigan Medicine, Physicians Health Plan (PHP) and the Benefits Administration Office. Michigan Medicine has invested financially in PHP, which is a subsidiary of Sparrow Health System in Lansing, MI, as part of a larger affiliation agreement with Sparrow. The university will continue to offer BCBSM Community Blue PPO, Comprehensive Major Medical and U-M Premier Care, as well as GradCare for benefits-eligible graduate students.
- How is Michigan Care different from other U-M health plans?
- Michigan Care is a managed care plan similar to U-M Premier Care. Members are required to have a primary care physician in the network and must have a referral to see a specialist or provider outside of the network. In addition to the services that are currently covered in U-M Premier Care, Michigan Care offers coverage for chiropractic spinal manipulation and expanded telehealth coverage for urgent care and behavioral health.
The provider network for Michigan Care is narrower than the other plans.
There is no annual deductible, similar to U-M Premier Care and Community Blue PPO. The monthly premium is higher than Comprehensive Major Medical and lower than Community Blue PPO and U-M Premier Care for non-Medicare members.
More information about plans can be found at hr.umich.edu/health-plans.
- Why is eligibility limited to a specific geographic area?
- Michigan Care eligibility is limited because it has a narrow provider network. If additional providers are added to the network, the coverage area may expand over time.
- What if I have an urgent or emergency medical need and I am not in the service area for Michigan Care?
- Members can access any urgent care provider or emergency room for urgent or emergency medical needs and receive in-network coverage for these situations.
- My current PCP (primary care physician) is in the Michigan Care network, but is listed as "not accepting new patients." Can I keep my PCP if I switch to Michigan Care?
- Yes. You will be allowed to stay in your PCP's practice even if they are not accepting new patients when you change your plan to Michigan Care.
- Why is this plan less expensive than U-M Premier Care for non-Medicare members?
- Michigan Care has a lower premium for most members because of the narrower network and partnership with Physicians Health Plan (PHP) and Michigan Medicine to enhance coordination for improved service, quality and clinical outcomes. View your rates.
- Will this plan eventually replace U-M Premier Care or other U-M health plans?
- There are no plans to end U-M Premier Care or other U-M health plans.
- Members can access any urgent care provider or emergency room for urgent or emergency medical needs and receive in-network coverage for these situations.
- The Benefits Office performs periodic reviews of all benefit plans (health, dental, life insurance, etc.) to evaluate their quality and cost effectiveness. This is to provide quality coverage to faculty, staff and retirees and manage costs for plan members and the university.
- What is Physicians Health Plan?
- Physicians Health Plan (PHP) is a health insurance company based in Lansing and affiliated with Sparrow Health System. Learn more at phpmichigan.com. Michigan Medicine has an ownership stake in PHP as part of a broader affiliation agreement with Sparrow Health System. PHP has 35 years of experience as a provider-sponsored health plan in the mid-Michigan market. It offers statewide PPO and regional HMO products that are highly rated by the National Committee on Quality Assurance (NCQA), a health care accrediting body. Learn more at phpmichigan.com.
- What is Michigan Medicine’s role in Michigan Care?
- 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.
- Michigan Medicine is part of the Michigan Care network which also includes other high-quality providers in southeast Michigan.
- What is the expanded telehealth coverage through Amwell Online Care Group and how is it different from my primary care physician’s telehealth service?
- Michigan Care offers on-demand video access to Amwell physicians for urgent medical needs and access to the behavioral health network by appointment.
- This coverage is in addition to telehealth coverage with your network physician or specialist.
- 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.