A $50,000 PIP medical limit is available when the applicant is enrolled in Medicaid and family members have QHC or PIP medical coverage. This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. The new Michigan no-fault auto insurance law means that residents are no longer required to buy unlimited personal injury protection, or PIP, with their auto insurance. hbbd```b``"Iu"g=`5`8z0yD2H/`st@_ `4f`4F0 %X Once logged in, navigate to the QHC letter in the Proof of Insurance section at the bottom of the page. (Michigan Government DIFS Bulletin 2020-03-INS) If you're like a lot of people, you never even thought about this. Although Michigans overall average rate change for 2023 individual/family coverage is an increase of 5.5%, overall average rate changes dont paint a full picture, for several reasons: Numerous factors have affected premiums over the years, including the risk corridor shortfalls, the end of the ACAs reinsurance program after 2016, the repeal of the individual mandate at the end of 2018 (and public perception that it wasnt being enforced before that), the expansion of short-term plans, whether or not a state has expanded Medicaid, and overall utilization of health care. Three of the available options require that drivers and/or any spouse and resident relatives have . State of Michigan Department of Insurance and Financial Services (DIFS), Information for auto insurance policies renewed or issues after July 1, 2020, the people covered under your HAP/Alliance health care coverage, your yearly deductible amount per covered person. 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. 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. Enrollments completed by December 15 will have coverage effective January 1, while enrollments completed between December 16 and January 15 will have coverage effective February 1. Since 1973, all Michigan auto . <> A QHP is a health insurance plan that meets the requirements established by the ACA. Your doctor will submit the form by following the instructions on the back. Qualified Health Coverage QHC cannot exclude or limit coverage for injuries related to motor vehicle accidents, and must have an annual deductible of $6,000 or less per individual (this $6,000 amount may be annually adjusted). However, U-M health plans do not cover certain services, such as attendant care, housing and vehicle modifications, as well as lost wages. The $50,000 coverage level for drivers enrolled in Medicaid requires that the drivers spouse or relative who lives in the same home have QHC, be enrolled in Medicaid or have his or her own No-Fault auto insurance policy. This Video is unable to play due to Privacy Settings. The total opt-out of No-Fault PIP medical benefits for a driver who has Medicare requires that his or her spouse or family member that lives with the driver either have qualified health coverage that is required under the new Michigan No-Fault insurance law (i.e., insurance for accident-related medical care through a private plan or through Medicare) or have his or her own No-Fault auto insurance policy. Member reference | Aetna Better Health of Michigan The Handbook and COC includes but are not limited to the following information: This can include private health insurance or a different Michigan No-Fault policy with PIP medical coverage. 2017: Average rate increas of 16.7%. (MCL 500.2111f(3)), When health insurance is coordinated with the $250,000 coverage level (assuming all of the required persons have the necessary qualified coverage), the premium for [No-Fault PIP medical] benefits payable under section 3107(1)(a) under the policy must be reduced by 100%. (MCL 500.3109a(2)(a)). But what the politicians who passed this new auto law neglected to tell people (aside from that these promised savings will be limited and for most of us very disappointing) was that these lower PIP medical coverage levels would be unavailable if the driver or certain family members did not have the right type of health insurance coverage. The law also allows a car owner to select a $250,000 PIP medical limit, with an exclusion from PIP medical coverage for the applicant and any family members with QHC. The enrollment growth was largely driven by Medicaid expansion and the COVID pandemic (including the Families First Coronavirus Response Act, which has paused Medicaid eligibility redeterminations throughout the COVID public health emergency). Michigan has a state-federal partnership exchange; the state oversees plan management, but HealthCare.gov is used for enrollment. References to UnitedHealthcare pertain to each individual company or other UnitedHealthcare affiliated companies. Michigan Auto Insurance Reform | State Farm Some of the information on this site may be deemed attorney advertising in some states. 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). Qualified health coverage is the insurance that the new Michigan No-Fault insurance law requires drivers to have to be able to select certain PIP medical benefit levels. They are required to prepare and provide this documentation. Medicaid - $50,000. It is important to know that actuarial value applies to a given policy's value for an overall population. Michigan did accept federal funding to expand Medicaid under the ACA. They explained that the decision was based on many uncertainties related to premium stabilization programs, enforcement of the individual mandate and not knowing whether the federal government will continue to fund cost-sharing reductions (CSRs).. This is for Blue Cross Blue Shield of Michigan members who want details about Michigans new no-fault auto insurance law that goes into effect on July 1, 2020. The guidance also indicates that a group health plan with an individual deductible offset in any manner (e.g., by funds contributed to health reimbursement arrangements) so as not to exceed $6,000 could qualify as QHC, provided the plan doesnt exclude or limit medical coverage for auto accident injuries. Site Map|Feedback|Download Adobe Acrobat Reader, Learn more about a Healthier Michigan.org, Important Information About Medicare Plans, Your subscriber ID card, formerly known as enrollee ID. Employees and retirees with U-M health plans - even with Medicare as primary coverage - are already covered for medical claims resulting from an automobile accident. Not Registered? That declined to ten for 2017 (although some of the decrease was due to PPO entities leaving the exchange, while their HMO sister companies remained in the exchange). % Provide your contact information to get in touch, https://www.mercer.com/content/dam/mercer/attachments/global/law-and-policy/gl-2020-michigan-clarifies-qualified-health-coverage-for-auto-insurance-law.pdf, Diversity, Equity and Inclusion in investments, Michigans new auto insurance law Choosing PIP medical coverage, Michigans automobile insurance reforms may cost group health plans. Past results are no guarantee of future results. What does PIP cover? Can I Opt Out of Personal Injury Protection (PIP) If I Have Medicare? Health Alliance also dropped their PPOs, continued to offer more than 45 Personal Alliance HMO plans, both on and off-exchange (the PPOs were offered via Alliance Health and Life Insurance Company, which is a subsidiary of Health Alliance; Alliance Health and Life Insurance Company plans are no longer offered on the Michigan exchange). 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 60 0 obj <> endobj Register Now. In most of Michigan, at least four insurers are offering plans in the exchange for 2023, although there are just two participating insurers in upper Michigan. No attorney-client relationship is formed nor should any such relationship be What is a qualified health plan (QHP)? - PeopleKeep They continued to offer one bronze plan off-exchange in 2017. %PDF-1.6 % Michigan clarifies qualified health coverage for auto - Mercer Across the 11 insurers, there was an overall average premium decrease of 2.5% for 2020. 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. 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. Michigan Health Insurance Consumer Assistance Program (HICAP), Ascension Personalized Care/US Health and Life Insurance Company. PDF How we coordinate health coverage with your car or motorcycle - BCBSM Self-insured plan sponsors may need to adjust expected costs for Michigan residents. Registration is easy! Accidental injuries and critical illness happen when you least expect them. However, the restated guidance clarifies that a group health plan with any annual deductible that doesnt exceed $6,000 per individual and doesnt exclude or limit medical coverage for injuries related to auto accidents will meet the QHC standard. 4 0 obj How much could you save on 2023 coverage? The Senate passed a bill to authorize a state-run exchange, but the bill was voted down by the Houses Health Policy committee and didnt get a floor vote. Individual & Family ACA Marketplace plans Medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization, Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc.; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in LA, TN and AL; Optimum Choice, Inc. in VA and MD; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of Texas, Inc.; and UnitedHealthcare of Oregon, Inc. in WA. For 2022, Total Health Care has merged with Priority Health, but two new insurers are offering plans in the exchange: US Health and Life is new for 2022, and UnitedHealthcare has returned after a five-year hiatus. What is a qualified health plan? | healthinsurance.org Physician Qualification Form (PDF) Healthy Blue Achieve Form Your doctor will submit the form by following the instructions on the back. Are you looking for the form that coordinates your auto and medical insurance after an accident? 500.3107d Election to not maintain personal protection insurance benefit coverage; proof of qualified health coverage; form; failure to make election; termination of qualified health coverage; definitions. There are several ways you can request a QHC letter. Youll have the option of choosing from different levels of personal injury protection coverage. How are Michigan exchange premiums changing for 2023? Dental and vision insurance plans, underwritten by Golden Rule Insurance Company, have no age limit restrictions.6 They offer coverage for the dental and vision services many medical insurance plans dont include. Because the only health insurance coverages that will meet the No-Fault laws requirements are plans that do not exclude or limit coverage for injuries related to motor vehicle accidents, health insurance will now have to provide the same coverage to auto accident victims that No-Fault has been providing for more than 40 years. endstream endobj startxref (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. ;-- UnitedHealthcare Individual & Family ACA Marketplace plans offer affordable, reliable coverage options from UnitedHealthcare Community Plan, Inc. As part of theAmerican Rescue Plan Act of 2021and Inflation Reduction Act of 2022, many individuals and families are now eligible for lower or in some cases $01,2,3 monthly premiums for ACA Marketplace health coverage. The open enrollment period for individual/family coverage runs from November 1, to January 15 in Michigan. 2 0 obj This could leave the employer-sponsored health plan as the sole source of medical coverage for injuries related to an auto accident in some situations. If a policyholder qualifies, this allows them to purchase only $50,000 of PIP coverage. You can find what youll need on oursubrogation page. Michigan health insurance marketplace guide 2023 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. What is Qualified Health Coverage (QHC) and how will I know if I have it? She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. This is a supplement to health insurance and is not a substitute for the minimum essential coverage defined by the Affordable Care Act (ACA). Would love your thoughts, please comment. Health ProtectorGuard fixed indemnity insurance,5underwritten by Golden Rule Insurance Company, can supplement your major medical plan by paying cash for eligible, covered medical services, like a doctor visit, a trip to urgent care or a surgical procedure. This was the highest enrollment had been since 2017. Ultimately, the Court ruled that subsidies would continue to be available in every state, and Michigan did not have to consider a back-up plan to create a state-run exchange. 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. For Medicare Members: No-fault auto law changes | bcbsm.com The benefits described may not be offered in all plans or in all states. So even if your insurer doesnt change its rates at all for the coming year, your price will still go up just because youre a year older (if you receive subsidies, the subsidies will grow to keep pace with the age-related premium increases; subsidies for older enrollees are larger than subsidies for younger enrollees). Across the full individual market, including the two off-exchange insurers, the average rate increase was 4.7% for 2022. Qualification Forms | Managing My Account | bcbsm.com