Michigan Care

Eligible faculty, staff and retirees will have an additional health plan choice during Open Enrollment for 2021 benefits, October 19-30 (ends at 5:00 p.m), 2020. The university will add Michigan Care to the available options, a new managed care plan similar to U-M Premier Care. 

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. 

Michigan Care Overview

Michigan Care will offer a narrower network than U-M Premier Care and a lower monthly premium for non-Medicare participants. It will also include:

  • 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

Because of the narrow provider network, access to the plan will be limited to faculty, staff and retirees who live in a specific geographic area within Southeast Michigan. Find out now 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.

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

In-network Providers

  • 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.

2021 Rates and Enrollment

Michigan Care monthly rates for 2021 are available to review.

Eligible faculty, staff and retirees may choose to enroll in Michigan Care during the annual benefits open enrollment period, October 19-30 (ends at 5:00 p.m.). Coverage will be effective January 1, 2021. Complete plan details will be included in Open Enrollment communications.

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. 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.

Find out now if you are eligible for Michigan Care.

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.

Plan Contact Information

A customer support telephone number will be available beginning on the plan effective date, January 1, 2021.

michigancare.com

Physicians Health Plan
1400 E. Michigan Ave
Lansing MI 48912