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Health Insurance In Michigan


A citizen of Michigan has certain rights under the federal and state law which protects him if he seeks to buy, keep, or switch over his health insurance. A federal law, known as the Health Insurance Portability and

Accountability Act sets national standards for all health insurance in Michigan. In addition to this the state has the right to reform various insurance plans which they regulate. If a person leaves Michigan his protections may vary. Most health insurance in Michigan is renewable. A resident of Michigan has the right to buy health insurance or health policy from any insurer. The insurer won't charge him more due to his health status, age or any other factor. Health status means disability, medical condition or history and genetic information. This protection is called nondiscrimination. A person can apply for a group health plan only if he is eligible for it. For example an employer may not give health benefits to part-time employees.

The person may be given a special opportunity to sign up for his group health plan, if certain changes happen to his family. In addition to any regular enrollment period his employer or group health plan may offer thirty days opportunity to enroll in his health plan after certain events. At this time the health group plan may offer family coverage, his dependants can elect coverage as well. Enrollment during a special enrollment period is not considered late enrollment. There are certain changes that can trigger a special enrolment opportunity for example marriage, birth, adoption of a child and involuntary loss of other coverage.

Under the Michigan law, newborns are covered under the parents fully insured health plan for the first 31 days, provided the plan covers dependents. The insurer suggests the parents to enroll the child and pay the premium within thirty-one days in order to continue coverage beyond the first thirty-one days. Under the Michigan law unmarried disabled child may remain covered under fully insured group plan till adulthood. This is applicable if your child was already disabled and covered under the plan before he or she reached the limiting age for dependent coverage. In this regard, the person has to submit proof of his child's continued disability.

If a person has to take a leave from his job due to illness, the birth or adoption of a child, or to take care of

a seriously sick family member, he may keep his group health coverage for a limited period. In these circumstances a federal law known as the Family and Medical Leave Act guarantees a twelve weeks of job protected leave. If the person qualifies for leave under this act his employer would continue his health benefits. The person in this case has to pay his share of the premium. This act is applicable to the person if he works in a company with fifty or more employees. But if the person decides not to return to work at the end of the leave period, his employer may ask him to pay back the employer's share of the health insurance premium. However, if he couldn't return to work because of some factors outside his control may be, he has to continue caring for the sick family member or his spouse is transferred to a job in a different city, in such circumstances he will not have to repay the premium.

If a person does not have an access to employer sponsored group insurance then he has to buy an individual health policy from a private insurer. In health insurance in michigan such individual health insurance sold by private insurers has fewer guarantees. When applying for an individual health insurance, the insurer generally asks questions about health conditions. Depending on the health status insurers at times refuses to sell you coverage or they may sell a policy which has lot of limitations on what it covers.

Generally in Michigan, there are no limits as to how the individual insurer can vary premiums due to age, gender, health status, family size, and other factors. The law does not prohibit Michigan private health insurers from charging a higher rate because of the health status.

In Michigan, help is given to certain low income residents who cannot afford to buy health insurance. There are state designed programs that offer free or subsidized health insurance coverage, direct medical services and other help at low cost or free of cost to them. In addition the federal Health Coverage Tax Credit Program provides tax credits to early retirees and some workers who lose their jobs or whose working hours and wages have been reduced as a result of increased imports.

MICHILD is one such state designed program that provides health coverage to low income children under the age of 19 who are not eligible for Medicaid and who have no health coverage.

The Michigan Breast and Cervical Cancer Control Program, which is part of the National Breast and Cervical Cancer Early Detection Program, provides a qualified woman with full healthcare benefits through Medicaid at no cost or for a nominal payment. Women diagnosed with breast or cervical cancer is eligible for free health coverage throughout the duration of treatment.

In order to be eligible for such programs, the person has to be a resident of Michigan. To be eligible for cervical cancer screening the person has to be between the ages 18 and 64 and have limited or no health coverage and have an income below 250 percent of the federal poverty level.