You do not have to sort out Medicare in Michigan alone, and you do not have to pay a broker to help. MMAP, the state's free and neutral counseling program, will walk you through your options one-on-one at 1-800-803-7174. This guide covers what a Michigan reader actually needs for 2026: what Parts A and B cost, how Medicare Advantage and Medigap work here, the new integrated plan for people with both Medicare and Medicaid, and how to get help paying. The standard Part B premium for 2026 is $202.90 a month, and the Part D donut hole is gone for good.,,

In This Guide

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year. For the most current figures, check medicare.gov or call 1-800-MEDICARE, and MMAP will go over them with you at no cost at 1-800-803-7174.

What Do Parts A and B Cost in Michigan?

Original Medicare is run directly by the federal government, so the costs and mechanics are identical in Michigan and every other state.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care. Most people pay no premium because they or a spouse paid Medicare taxes for at least 10 years (40 quarters) of work.

Cost Amount
Monthly premium $0 for most people (40+ quarters of work history)
Hospital deductible $1,736 per benefit period
Hospital coinsurance, days 61-90 $434 per day
Lifetime reserve days $868 per day
SNF coinsurance, days 21-100 $217 per day

The hospital deductible rose $60 from 2025. A benefit period starts the day you are admitted and ends after 60 days in a row with no inpatient hospital or skilled nursing care. Get readmitted after that, and the deductible applies again.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. It does not cover routine dental, vision, or hearing.

  • Monthly premium: $202.90 (higher if your 2024 income was above $109,000 single or $218,000 married, under the income-related adjustment)
  • Annual deductible: $283
  • After the deductible: you pay 20% of the Medicare-approved amount for most services

Part B is technically optional, but nearly everyone signs up. Delay past your enrollment window without qualifying for a Special Enrollment Period or a Medicare Savings Program and you will owe a late penalty of 10% for every 12 months you could have had it, for as long as you keep Part B. Creditable drug coverage does not protect you here; that is the Part D test, not the Part B one.

Medicare Advantage Plans in Michigan (Part C)

Medicare Advantage plans are an alternative to Original Medicare, sold by private insurers. They cover everything Parts A and B do, except hospice, which Original Medicare keeps covering, and most bundle in Part D drug coverage along with extras like dental, vision, and hearing.

Michigan has a competitive Medicare Advantage market, with plans sold across the state by national carriers and Michigan-based insurers alike. Plan availability, provider networks, and benefits vary a lot by county, so a plan that is strong in metro Detroit may not even be sold in the Upper Peninsula. Use the Medicare Plan Finder at medicare.gov to compare the plans sold in your ZIP code, enter your doctors and prescriptions, and see which plans cover them and your estimated cost.

How These Plans Work

If your current plan leaves your area for 2026, you get a Special Enrollment Period to pick a new one. For a full side-by-side, see our guide to Original Medicare vs. Medicare Advantage.

How Do Medicare Part D Drug Plans Work in Michigan?

Part D covers outpatient prescription drugs. You can get it as a standalone plan paired with Original Medicare, or built into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the old coverage gap, the donut hole, so that higher-cost middle stage is gone. Part D now moves through three phases:

  1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).
  2. Initial coverage: you pay copays or coinsurance while your plan and drug makers cover the rest.
  3. Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs the rest of the year.

That $2,100 cap is the number that matters most in Part D. It was $2,000 in 2025 and rises with drug-spending growth. Insulin is also capped: a one-month supply of each covered insulin product costs no more than $35, with no deductible. The national base plan premium is $38.99 a month for 2026, though actual plan premiums vary. Every plan also has to offer the Medicare Prescription Payment Plan, which lets you spread your out-of-pocket drug costs into capped monthly payments across the year rather than paying in full at the pharmacy. People who qualify for Extra Help often pay much less, sometimes nothing.

Not sure which Part D plan fits your prescriptions? Chat with Brevy's care navigator at brevy.com, or call MMAP at 1-800-803-7174 for free one-on-one help.

Medigap in Michigan (and Why There's No Birthday Rule)

Medigap policies are sold by private insurers to fill the gaps in Original Medicare: the deductibles, coinsurance, and copays. They are built for Original Medicare: a Medigap policy can't be used to pay your Medicare Advantage copayments, coinsurance, deductibles, or premiums, and while you're in an Advantage plan CMS says it's illegal for anyone to sell you one unless you're switching back to Original Medicare. That isn't permanent. If you joined a Medicare Advantage plan for the first time, federal law gives you a trial right to buy a Medigap policy and a separate drug plan when you return to Original Medicare within 12 months of joining.,

Michigan offers the federally standardized plans, labeled A, B, C, D, F, G, K, L, M, and N. Plans C and F are closed to anyone who became Medicare-eligible on or after January 1, 2020. Plan G is the popular choice for people newly eligible: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible on you. Premiums for the same lettered plan vary by carrier, age, and other rating factors, so it pays to compare several quotes.,

Why Michigan Has No Birthday Rule

A handful of states, such as California, Illinois, and neighboring Indiana, give Medigap holders an annual window to switch plans without a health screening. Michigan is not one of them. As of 2026, Michigan has no Medigap birthday rule or any yearly guaranteed-issue window. That makes the timing of your first Medigap purchase matter here: your one strongly protected opening is the Medigap Open Enrollment Period, the six months that begin the first day of the month you are both 65 or older and enrolled in Part B. During that window, an insurer must sell you any plan it offers regardless of your health, and it cannot charge you more because you have health problems.

Once that six-month window closes, a Michigan insurer can medically underwrite your application, meaning it can charge you more or turn you down based on your health history, except in the specific federal guaranteed-issue situations (such as losing employer coverage or a Medicare Advantage plan leaving your area). Michigan Medigap policies are regulated by the Michigan Department of Insurance and Financial Services (DIFS), and MMAP counselors can help you compare plans without a sales pitch.

Help Paying for Medicare in Michigan

If you are on a fixed income, two programs can cut your Medicare costs sharply.

Medicare Savings Programs

Michigan's Medicare Savings Programs pay some or all of your Medicare premiums and cost-sharing based on income and assets. The Michigan Department of Health and Human Services (MDHHS) administers them through the state Medicaid program.

Program (Michigan's name) Individual Couple What it pays
QMB, full coverage Up to $1,350 Up to $1,824 Part A and B premiums, deductibles, coinsurance
SLM (Michigan's SLMB) $1,350.01 to $1,616 $1,824.01 to $2,184 Part B premium
ALMB (Michigan's QI) $1,616.01 to $1,816 $2,184.01 to $2,455 Part B premium

Those middle two are bands, not ceilings. If your income is $1,200 a month you are not an SLM case, you qualify for full-coverage QMB, which pays considerably more. Watch the names, too: Michigan's own policy uses both naming systems. Its income tables head the columns "LIMITED-COVERAGE QMB (SLM)" and "ALMB MONTHLY INCOME LIMITS", while the eligibility manual calls the same two categories "Specified Low-Income Medicare Beneficiaries (SLMB)" and "QI Additional Low-Income Medicare Beneficiaries (ALMB)", so a search for either "SLMB" or "QI" in Michigan policy does find them.

QMB is the most generous, covering your Part B premium plus your deductibles and coinsurance, and federal law bars providers from billing a QMB enrollee for that cost-sharing. Michigan does apply an asset test, though Social Security records that some states have used their federal disregard authority to effectively eliminate their resources tests. MDHHS caps countable assets at $9,950 for one person and $14,910 for two, effective January 1, 2026, and countable is the load-bearing word: not all assets are counted. For the SSI-related Medicaid category the Medicare Savings Programs sit in, MDHHS excludes the homestead you live in, one motorized vehicle, and household and personal goods. Owning your home and a car does not disqualify you, and $9,950 is not a cap on your total net worth. These income and asset figures are the federal standards, not absolute cutoffs: states can disregard certain income and resources, so apply rather than rule yourself out if you are somewhat over. ALMB, Michigan's version of QI, also has to be reapplied for every year. Watch the two calendars as well: Michigan's asset limits change every January 1, but its income limits change every April 1, so a figure you check in February may still be last year's. Michigan's published income limits already include the $20 monthly income disregard, so do not subtract it again. Enrolling in QMB, SLMB, or QI, which Michigan labels QMB, SLM, and ALMB, automatically qualifies you for Extra Help with Part D. QDWI, the fourth Medicare Savings Program, is the exception: it pays the Part A premium for certain working people with disabilities who lost premium-free Part A, and it does not confer Extra Help, so a QDWI enrollee who wants Extra Help has to apply through Social Security.,

How to Apply for Michigan's Medicare Savings Programs

You apply through MDHHS, and free help is one phone call away if you would rather not do it alone.

1
Step 1

Gather your paperwork

Have your Medicare card and recent proof of income and assets ready, such as a Social Security award letter, pension or wage statements, and current bank balances.

2
Step 2

Apply through MI Bridges

File your application with MDHHS online at the MI Bridges portal, by mail, or in person at your county MDHHS office.

3
Step 3

Or talk it through with a SHIP counselor first

Call Michigan's SHIP, the program known here as MMAP, at 1-800-803-7174 and a local certified counselor will walk you through your Medicare costs and what these programs would cover, at no charge.

4
Step 4

Confirm this year's limits first

Because the income thresholds rise every year with the federal poverty level, verify the current figures with MDHHS before you file so you know whether you qualify.

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, pays Part D premiums, deductibles, and copays for people with limited income and resources. Since 2024, the partial-subsidy tier is gone, so everyone who qualifies now gets the full subsidy.

  • Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple, in the 48 contiguous states and DC (Alaska and Hawaii limits run higher)
  • Resource limits: $16,590 for an individual, $33,100 for a married couple; those limits rise to $18,090 and $36,100 if you tell Social Security you expect to use some of your resources for burial expenses
  • If you qualify for QMB, SLMB, or QI, you are enrolled in Extra Help automatically

Apply through Social Security at ssa.gov or call 1-800-772-1213.

If You Have Both Medicare and Medicaid: MI Coordinated Health

Many people who have Medicare also qualify for Medicaid. Effective January 1, 2026, Michigan replaced its old MI Health Link demonstration with MI Coordinated Health (MICH), a Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP). MICH is for Michigan residents age 21 or older who are enrolled in both Medicare and Medicaid and not in hospice care. It covers all Medicare benefits and most Medicaid benefits, including long-term services and supports, and members have no co-pays or deductibles for in-network services, except in some cases for Part D drugs. You use one card and get a care coordinator.

For 2026, MICH is available in Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, Macomb, St. Joseph, Van Buren, and Wayne counties, plus most Upper Peninsula counties, with statewide expansion planned for 2027. Nine health plans hold MICH contracts, including Aetna Better Health, AmeriHealth, HAP CareSource, Humana, Molina, Priority Health Choice, UnitedHealthcare, Wellcare-Meridian, and Upper Peninsula Health Plan. Enrollment is voluntary, and full-benefit dual eligibles can switch integrated plans in any month under the federal Integrated Care Special Enrollment Period. MDHHS does not publish a phone line dedicated to MICH enrollment, so start with MICHIGAN ENROLLS at 1-888-367-6557, the state's Medicaid managed-care enrollment line: it answers general questions about Medicaid benefits, can tell you which doctors, pharmacies, and hospitals are part of each health plan, and can enroll you by phone in the health plan you choose. For the full picture, see our guides to MI Coordinated Health and Michigan Medicaid Programs for Seniors.

Medicare Enrollment Periods

Miss a deadline and you can face coverage gaps or permanent penalties. These dates are federal and the same in Michigan as everywhere else.

Period Dates What you can do
Initial Enrollment 7 months around your 65th birthday Sign up for Parts A, B, and D; pick MA or Medigap
Annual Open Enrollment Oct 15 - Dec 7 Switch MA plans, move between MA and Original Medicare, change Part D
MA Open Enrollment Jan 1 - Mar 31 Switch MA plans or drop MA for Original Medicare (if already in MA)
General Enrollment Jan 1 - Mar 31 Sign up for Part B if you missed your initial window (coverage starts the month after you enroll)
Medigap Open Enrollment 6 months from age 65 + Part B Buy any Medigap plan at the standard rate, no health screening

Changes you make during Annual Open Enrollment take effect the following January 1. If you are already receiving Social Security before 65, you are enrolled in Parts A and B automatically; if not, you sign up through Social Security. If you are still working past 65 with group health coverage based on that current employment, you can usually delay Part B without penalty and get an eight-month Special Enrollment Period when that job or coverage ends. COBRA and retiree coverage do not count as coverage based on current employment, and if you are self-employed or your plan is not available to everyone at the company, ask your insurer whether it qualifies before you delay; if it does not, sign up at 65. This Special Enrollment Period does not apply if you are eligible for Medicare based on End-Stage Renal Disease (ESRD).

Free Medicare Help: MMAP

You do not have to figure this out by yourself. Michigan's State Health Insurance Assistance Program (SHIP), long known here as MMAP, is the state's free, unbiased resource for navigating Medicare. MDHHS runs it through its Aging, Community Living and Supports Bureau, and its local certified counselors give personal assistance at no charge to you or your caregiver.

A SHIP (MMAP) counselor can help you:

  • Understand your Medicare options and what each part covers
  • Compare Medicare Advantage, Part D, and Medigap plans side by side
  • Understand the Medicare cost-help programs you may qualify for, such as Medicare Savings Programs and Extra Help
  • Sort out billing problems, denials, and appeals

Calling a counselor before you talk to an insurance broker helps you avoid being steered into a higher-commission plan that does not actually fit, because these counselors do not sell Medicare plans. Call 1-800-803-7174 to reach a local certified counselor. If you have both Medicare and Medicaid and your question is about your Medicaid health plan, MICHIGAN ENROLLS at 1-888-367-6557 is the line for that.

Key Michigan Medicare Contacts

Michigan SHIP (MMAP) Michigan's free, unbiased resource for navigating Medicare, run by MDHHS's Aging, Community Living and Supports Bureau. Local certified counselors give personal assistance at no charge and do not sell Medicare plans. 1-800-803-7174 michigan.gov SHIP
MICHIGAN ENROLLS Michigan's Medicaid managed-care enrollment line. It answers general questions about Medicaid benefits, can tell you which doctors, pharmacies, and hospitals are part of each health plan, and can enroll you by phone in the health plan you choose. 1-888-367-6557 michigan.gov beneficiary support
1-800-MEDICARE The federal Medicare help line can confirm your enrollment, explain the QMB billing protection, and point you to plans in your area. 1-800-633-4227 medicare.gov
Social Security Administration Handles Medicare enrollment and the Extra Help (Low-Income Subsidy) application for Part D drug costs. 1-800-772-1213 ssa.gov

Frequently Asked Questions

What does Medicare cost in Michigan in 2026?

Most people pay $0 for Part A. The standard Part B premium is $202.90 a month with a $283 annual deductible. Part D premiums vary by plan (deductible up to $615, out-of-pocket capped at $2,100 for the year), and many Medicare Advantage plans charge no extra premium., Your total depends on the plan you pick and the care you use.

Does Michigan have a Medigap birthday rule?

No. As of 2026, Michigan has no birthday rule or any annual window to switch Medigap plans without a health screening. Your protected window is the six months after you turn 65 and enroll in Part B, when insurers must sell you any plan regardless of health. After that, a Michigan insurer can medically underwrite your application, so the timing of your first Medigap purchase matters.

What is MMAP and how do I contact them?

MMAP is the name Michigan families have long used for the state's State Health Insurance Assistance Program (SHIP), which MDHHS runs through its Aging, Community Living and Supports Bureau. It is Michigan's free, unbiased resource for navigating Medicare, staffed by local certified counselors who give personal assistance at no charge and do not sell Medicare plans. Call 1-800-803-7174.

Can dual-eligible Michigan seniors get integrated Medicare and Medicaid coverage?

Yes. MI Coordinated Health (MICH) launched January 1, 2026 as a Highly Integrated Dual Eligible Special Needs Plan that covers all Medicare benefits and most Medicaid benefits, including long-term services and supports, for people enrolled in both programs. It is available in select counties in 2026, expanding statewide in 2027. For help with Michigan's Medicaid health plans, call MICHIGAN ENROLLS at 1-888-367-6557; for free help understanding the Medicare side, call Michigan's SHIP (MMAP) at 1-800-803-7174.

What changed in Part D for 2026?

The Inflation Reduction Act capped out-of-pocket drug spending at $2,100 for the year, after which you pay $0 for covered drugs, and the old donut hole is gone. Insulin is capped at $35 for a one-month supply of each covered product. These apply across all plans.

Your next step Not sure where to start? Call Michigan's SHIP (MMAP) at 1-800-803-7174 for free, unbiased one-on-one help comparing your Medicare Advantage, Part D, and Medigap options and understanding the cost-help you may qualify for. A local certified counselor will walk through it at no charge, and they do not sell Medicare plans.

Learn More

MedicareMedicare Plans by State: What Varies and What Doesn'tOriginal Medicare is the same in all 50 states. Medicare Advantage, Part D, and Medigap rules are not. See what changes by state, then open your state guide. MedicareOriginal Medicare vs. Medicare AdvantageCompare original Medicare vs Medicare Advantage on cost, networks, the $9,250 cap, and switching back. A neutral 2026 side-by-side to help you choose. MedicareHow Medigap WorksMedigap (Medicare Supplement) explained: how the standardized A-N plans work, Plan G vs Plan N, closed C and F plans, and the 6-month guaranteed-issue window. MedicareMedicare Part D Drug CoverageMedicare Part D in 2026: a $2,100 out-of-pocket cap, no donut hole, three benefit phases, the $615 deductible, premiums, the late penalty, and Extra Help. MedicareMedicare Enrollment PeriodsWhen to sign up for Medicare without a lifelong penalty: the 7-month Initial Enrollment Period, working past 65, the GEP, and what each late penalty costs. MedicaidMichigan Medicaid Programs for SeniorsEvery Michigan Medicaid program for seniors in 2026: Nursing Home Medicaid, the MI Choice Waiver, Home Help, MICH, and who qualifies for each. MedicaidMI Coordinated Health (MICH): Michigan's Plan for Medicare-Medicaid DualsMI Coordinated Health (MICH) is Michigan's 2026 integrated Medicare-Medicaid plan for full-benefit duals. Who qualifies, the 2026 counties, and how to enroll. FinancialHow to Pay for Senior Care in MichiganEvery way to pay for senior care in Michigan in 2026: Medicare, Medicaid, VA, LTC insurance, reverse mortgages, caregiver agreements, and cost benchmarks.

Find personalized help comparing your Medicare options in Michigan at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.