Updates About Health Insurance

In the recent Medicaid health plan rebid by Michigan’s Department of Health and Human Services, significant changes have reshaped coverage across the state’s ten regions. Blue Cross Blue Shield of Michigan emerged as the primary beneficiary, expanding its territory across various regions. The rebid, a key part of Governor Whitmer’s 2024-2025 fiscal year budget recommendation, will prioritize equitable, person-centered care for the nearly two million Medicaid beneficiaries. Additionally, revisions to the payment structure include withholding a greater percentage of funds to incentivize improved health outcomes and address social determinants of health.

The rebid resulted in a redistribution of territories among nine health plans, with Blue Cross Blue Shield of Michigan gaining ground in several regions. Notably, McLaren emerged as the sole plan in nine of the ten regions, while Blue Cross now has a presence in seven regions, marking significant shifts in coverage landscape.

At this time, the contracts are not yet secured in place. The new contracts are scheduled to come into effect on October 1 of this year.

In February, over 140,000 Michigan residents saw their Medicaid coverage renewed, bringing the total renewed coverage under Medicaid and the Healthy Michigan Plan to over 1.4 million individuals, according to the Michigan Department of Health and Human Services (MDHHS). However, an additional 14,688 individuals were removed from the rolls due to eligibility or procedural issues, resulting in a total of 701,589 residents who have lost their Medicaid health coverage since June 2023.

The post-pandemic purge has exceeded earlier predictions, with more than triple the predicted 200,000 cuts forecasted by the Michigan House Fiscal Agency last year. Despite these challenges, efforts are underway to maintain health care coverage for eligible residents, with the department extending renewals and providing additional support to ensure continued access to care.

With ongoing renewal efforts and extensions, Medicaid recipients are encouraged to submit their paperwork and utilize available resources to maintain their coverage.

Beginning January 1st, 2024, MDHHS will be implementing changes to the Healthy Michigan Plan (HMP) that affect cost-sharing and healthy behaviors for beneficiaries.

Enrolled individuals will not face care disruptions or benefit reductions due to these updates. Alterations to the plan include revised copayment obligations for beneficiaries aged 21 and older, where copayments may now be required at the point of service instead of through the MI Health Account. Exceptions for copayments related to chronic conditions and exemptions for medically frail individuals will be discontinued.

While encouraging healthy behaviors remains a focus, requirements for annual Health Risk Assessments and specific activities via the MI Health Account will no longer be mandatory or incentivized. MDHHS plans to collaborate with Medicaid Health Plans to introduce financial incentives for enrollees displaying improved health outcomes, adopting healthy behaviors, or completing screenings or procedures that contribute to better health.