You do not have to sort out Medicare in Michigan alone, and you do not have to pay a broker to help. Michigan's State Health Insurance Assistance Program (SHIP), the state's free, unbiased resource for navigating Medicare, offers personal assistance from local certified counselors at no charge at 1-800-803-7174.State of Michigan. (n.d.). MDHHS — Hotlines (statewide MDHHS phone directory). michigan.gov. Retrieved Aug 1, 2026, from https://www.michigan.gov/mdhhs/inside-mdhhs/hotlines 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.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Sep 4, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles,Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Aug 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf
In This Guide
- Key Takeaways
- What Do Parts A and B Cost in Michigan?
- Medicare Advantage Plans in Michigan (Part C)
- How Do Medicare Part D Drug Plans Work in Michigan?
- Medigap in Michigan (and Why There's No Birthday Rule)
- Help Paying for Medicare in Michigan
- If You Have Both Medicare and Medicaid: MI Coordinated Health
- Medicare Enrollment Periods
- Free Medicare Help: Michigan SHIP
- Key Michigan Medicare Contacts
- Frequently Asked Questions
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.
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.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Inpatient hospital care. medicare.gov. Retrieved Oct 11, 2026, from https://www.medicare.gov/coverage/inpatient-hospital-care Most people pay no premium because they or a spouse paid Medicare taxes for at least 10 years (40 quarters) of work.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Sep 4, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
| 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.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Sep 4, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
Part B (Medical Insurance)
Part B covers doctors' services, outpatient care, many preventive services, durable medical equipment, and mental health services.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — What Part B covers. medicare.gov. Retrieved Oct 11, 2026, from https://www.medicare.gov/providers-services/original-medicare/part-b It does not cover routine dental, vision, or hearing.Centers for Medicare & Medicaid Services. (n.d.). Dental service coverage. medicare.gov. Retrieved Oct 3, 2026, from https://www.medicare.gov/coverage/dental-services
- Monthly premium: $202.90 (higher if your 2024 income was above $109,000 single or $218,000 married, under the income-related adjustment)Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Sep 4, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- 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.Centers for Medicare & Medicaid Services. (n.d.). Avoid late enrollment penalties. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties
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.Centers for Medicare & Medicaid Services. (n.d.). Compare Original Medicare & Medicare Advantage - Medicare.gov. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
The plans you can join depend on where you live: to join a Medicare Advantage plan you need Part A and Part B and must live in the plan's service area.Centers for Medicare & Medicaid Services. (n.d.). 12026 understanding medicare advantage plans. medicare.gov. Retrieved Sep 24, 2026, from https://www.medicare.gov/publications/12026-understanding-medicare-advantage-plans.pdf Use the Medicare Plan Finder at medicare.gov to compare the plans offered in your area side by side.Centers for Medicare & Medicaid Services. (n.d.). medicare.gov — Your Yearly Medicare Review (CMS Product No. 11220). medicare.gov. Retrieved Oct 2, 2026, from https://www.medicare.gov/publications/11220-your-yearly-medicare-review.pdf
How These Plans Work
- You keep paying your Part B premium ($202.90) on top of any plan premium. CMS estimates the average Medicare Advantage premium at about $14 a month in 2026, and many MA plans charge no premium at all. Some plans go further and help pay all or part of your Part B premium.Centers for Medicare & Medicaid Services. (n.d.). Compare Original Medicare & Medicare Advantage - Medicare.gov. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Sep 4, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- Most plans, especially HMOs, generally require you to use in-network providers, except for emergency care, out-of-area urgent care, and temporary out-of-area dialysis; PPOs let you go out of network at a higher cost. Confirm your doctors and hospitals are in-network before you enroll.Centers for Medicare & Medicaid Services. (n.d.). Compare Original Medicare & Medicare Advantage - Medicare.gov. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
- Plans may require prior authorization (plan approval) for certain services or items, which Original Medicare generally does not.Centers for Medicare & Medicaid Services. (n.d.). Compare Original Medicare & Medicare Advantage - Medicare.gov. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
- Every plan caps your annual in-network out-of-pocket spending (federally limited to $9,250 in 2026; many plans set it lower). Original Medicare has no such cap: CMS says there's no yearly limit on what you pay out of pocket unless you have supplemental coverage, like Medigap, Medicaid, or employer, retiree, or union coverage.Centers for Medicare & Medicaid Services. (n.d.). Compare Original Medicare & Medicare Advantage - Medicare.gov. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
Outside the regular enrollment periods, events like moving or losing other coverage may open a Special Enrollment Period to change your health and drug coverage.Centers for Medicare & Medicaid Services. (n.d.). Open Enrollment. medicare.gov. Retrieved Sep 2, 2026, from https://www.medicare.gov/health-drug-plans/open-enrollment 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.Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Aug 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf Part D now moves through three phases:
- Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).Centers for Medicare & Medicaid Services. (n.d.). How much does Medicare drug coverage cost?. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/health-drug-plans/part-d/basics/costs
- Initial coverage: under the standard benefit, you pay 25% coinsurance until your out-of-pocket spending reaches the yearly cap.Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Aug 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf
- Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs the rest of the year.Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Aug 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf
That $2,100 cap is the number that matters most in Part D. It was $2,000 in 2025.Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Aug 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf Insulin is also capped: a one-month supply of each covered insulin product costs no more than $35, with no deductible.Centers for Medicare & Medicaid Services. (n.d.). Continuous glucose monitors. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/coverage/continuous-glucose-monitors The national base plan premium is $38.99 a month for 2026, though actual plan premiums vary.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Sep 4, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles 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.Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Aug 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf 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 Michigan's SHIP at 1-800-803-7174 for free personal assistance from a local certified counselor.State of Michigan. (n.d.). MDHHS — Hotlines (statewide MDHHS phone directory). michigan.gov. Retrieved Aug 1, 2026, from https://www.michigan.gov/mdhhs/inside-mdhhs/hotlines
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.Centers for Medicare & Medicaid Services. (n.d.). Compare Original Medicare & Medicare Advantage - Medicare.gov. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage,Centers for Medicare & Medicaid Services. (2025). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2025) - Medicare.gov. medicare.gov. Retrieved Aug 22, 2026, from https://www.medicare.gov/publications/02110-choosing-a-medigap-policy.pdf
Michigan uses the federally standardized lettered plans (A through D, F, G, and K through N), and every policy with the same letter offers the same basic benefits from any insurer.Centers for Medicare & Medicaid Services. (n.d.). Compare Medigap Plan Benefits. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits Plans C and F can't be sold to people new to Medicare: those who turned 65 on or after January 1, 2020 and had no Part A before then. If you had Medicare before 2020 due to disability or ESRD, or were eligible before 2020 but haven't enrolled, you may still be able to buy C or F.Centers for Medicare & Medicaid Services. (n.d.). Compare Medigap Plan Benefits. medicare.gov. Retrieved Sep 28, 2026, from https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits,Centers for Medicare & Medicaid Services. (2026). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2026) - Medicare.gov. medicare.gov. Retrieved Aug 22, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf Plan G stays open to newcomers: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving you only the $283 Part B deductible. Premiums vary by policy, location, and other factors and change yearly, so compare quotes.Centers for Medicare & Medicaid Services. (2025). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2025) - Medicare.gov. medicare.gov. Retrieved Aug 22, 2026, from https://www.medicare.gov/publications/02110-choosing-a-medigap-policy.pdf,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Sep 4, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
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.Centers for Medicare & Medicaid Services. (n.d.). Get Medigap Basics - Medicare.gov. medicare.gov. Retrieved Oct 15, 2026, from https://www.medicare.gov/health-drug-plans/medigap/basics That makes the timing of your first Medigap purchase matter here: your main 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.Centers for Medicare & Medicaid Services. (2025). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2025) - Medicare.gov. medicare.gov. Retrieved Aug 22, 2026, from https://www.medicare.gov/publications/02110-choosing-a-medigap-policy.pdf
Afterward, DIFS says insurers may deny or rate you on healthlegislature.mi.gov. (1956). Michigan Compiled Laws § 500.3829 (Insurance Code of 1956, Act 218 of 1956) — Michigan Legislature. Retrieved Sep 27, 2026, from https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-500-3829 unless you have a guaranteed-issue right under MCL 500.3830, such as when employer coverage supplementing Medicare ends or your Advantage plan leaves your area. Apply within 63 days after coverage ends, with proof of that date.legislature.mi.gov. (1956). Michigan Compiled Laws § 500.3830 — Eligible person; requirements (Insurance Code of 1956) — Michigan Legislature. Retrieved Sep 27, 2026, from https://www.legislature.mi.gov/Laws/MCL?objectName=MCL-500-3830
Michigan Medigap policies are regulated by the Michigan Department of Insurance and Financial Services (DIFS). Michigan SHIP counselors can help you review your Medigap needs and compare policies, and Michigan's SHIP doesn't sell Medicare plans.State of Michigan. (n.d.). MDHHS — State Health Insurance Assistance Program (SHIP). michigan.gov. Retrieved Sep 27, 2026, from https://www.michigan.gov/mdhhs/adult-child-serv/adults-and-seniors/acls/state-health-insurance-assistance-program
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.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Aug 7, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023
| Program (Michigan's name) | Individual | Couple | What it pays |
|---|---|---|---|
| QMB, full coverage | Up to $1,350 | Up to $1,824 | Part A premium (if owed), Part B premium, 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 net income is $1,350 a month or less you are not an SLM case, you qualify for full-coverage QMB, which pays considerably more. 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.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Aug 7, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023
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.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Aug 7, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023 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 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.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Aug 7, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023 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.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Aug 7, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023 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 disregard for RSDI income.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Aug 7, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023 Enrolling in QMB, SLMB, or QI, which Michigan labels QMB, SLM, and ALMB, automatically qualifies you for Extra Help with Part D.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Aug 7, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023 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.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Aug 7, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023,U.S. Social Security Administration. (n.d.). SSA POMS HI 03030.025 - Resource Limits for Subsidy Eligibility. secure.ssa.gov. Retrieved Jun 22, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0603030025
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.
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.
Apply through MDHHS
MDHHS directs Medicare Savings Program applicants to the MDHHS office in their county, and MI Bridges is its online route for applying for health coverage.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Aug 7, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023
Or talk it through with a SHIP counselor first
Call Michigan's SHIP at 1-800-803-7174; its local certified counselors give personal assistance at no charge and can help you enroll in a Medicare Savings Program.State of Michigan. (n.d.). MDHHS — Hotlines (statewide MDHHS phone directory). michigan.gov. Retrieved Aug 1, 2026, from https://www.michigan.gov/mdhhs/inside-mdhhs/hotlines
Confirm this year's limits first
Michigan's income limits are set as percentages of the federal poverty level and change every April 1, so check the current figures with MDHHS before you file.U.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Aug 7, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023
Extra Help for Part D
Extra Help, also called the Low-Income Subsidy, pays Part D premiums (up to a regional benchmark amount, so a pricier plan can leave you paying the difference), deductibles, and copays for people with limited income and resources.U.S. Social Security Administration. (n.d.). SSA POMS HI 03030.025 - Resource Limits for Subsidy Eligibility. secure.ssa.gov. Retrieved Jun 22, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0603030025 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)U.S. Social Security Administration. (n.d.). SSA POMS HI 03030.025 - Resource Limits for Subsidy Eligibility. secure.ssa.gov. Retrieved Jun 22, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0603030025
- Resource limits: $18,090 for an individual, $36,100 for a married couple living together. The lower $16,590 and $33,100 apply only if you tell Social Security none of your resources will be used for funeral or burial expenses. Your home, personal possessions, and vehicles don't count.U.S. Social Security Administration. (n.d.). SSA POMS HI 03030.025 - Resource Limits for Subsidy Eligibility. secure.ssa.gov. Retrieved Jun 22, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0603030025
- If you qualify for QMB, SLMB, or QI, you automatically qualify for Extra Help and don't need to applyU.S. Social Security Administration. (2026). SSA - POMS: HI 00815.023 - Medicare Savings Programs Income and Resource Limits - 02/26/2026. secure.ssa.gov. Retrieved Aug 7, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0600815023,U.S. Social Security Administration. (n.d.). SSA POMS HI 03030.025 - Resource Limits for Subsidy Eligibility. secure.ssa.gov. Retrieved Jun 22, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0603030025
Apply through Social Security at ssa.gov or call 1-800-772-1213.U.S. Social Security Administration. (n.d.). SSA POMS HI 03030.025 - Resource Limits for Subsidy Eligibility. secure.ssa.gov. Retrieved Jun 22, 2026, from https://secure.ssa.gov/poms.nsf/lnx/0603030025
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).Centers for Medicare & Medicaid Services. (n.d.). CMS — D-SNPs: Integration & Unified Appeals & Grievance Requirements. cms.gov. Retrieved Oct 13, 2026, from https://www.cms.gov/medicare/medicaid-coordination/about/dsnps MICH is for Michigan residents age 21 or older who are enrolled in both Medicare and Medicaid, do not live in a state-operated veteran's home, and are 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.Centers for Medicare & Medicaid Services. (n.d.). CMS — D-SNPs: Integration & Unified Appeals & Grievance Requirements. cms.gov. Retrieved Oct 13, 2026, from https://www.cms.gov/medicare/medicaid-coordination/about/dsnps
For 2026, MICH is available in Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, Macomb, St. Joseph, Van Buren, and Wayne counties, plus every Upper Peninsula county except Chippewa, Gogebic, and Menominee, with statewide expansion planned for 2027.Centers for Medicare & Medicaid Services. (n.d.). CMS — D-SNPs: Integration & Unified Appeals & Grievance Requirements. cms.gov. Retrieved Oct 13, 2026, from https://www.cms.gov/medicare/medicaid-coordination/about/dsnps 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. Under the federal Integrated Care Special Enrollment Period, full-benefit dual eligibles can switch integrated plans in any month, but only to align their coverage with an affiliated Medicaid managed care organization.Centers for Medicare & Medicaid Services. (n.d.). CMS — D-SNPs: Integration & Unified Appeals & Grievance Requirements. cms.gov. Retrieved Oct 13, 2026, from https://www.cms.gov/medicare/medicaid-coordination/about/dsnps For questions about Medicaid health plans, start with MICHIGAN ENROLLS at 1-800-975-7630, 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.State of Michigan. (n.d.). MDHHS — Hotlines (statewide MDHHS phone directory). michigan.gov. Retrieved Aug 1, 2026, from https://www.michigan.gov/mdhhs/inside-mdhhs/hotlines 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.Centers for Medicare & Medicaid Services. (n.d.). Open Enrollment. medicare.gov. Retrieved Sep 2, 2026, from https://www.medicare.gov/health-drug-plans/open-enrollment
| 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 start getting Social Security or Railroad Retirement Board benefits at least 4 months before you turn 65, you are enrolled in Parts A and B automatically; if not, you sign up through Social Security.Centers for Medicare & Medicaid Services. (n.d.). Open Enrollment. medicare.gov. Retrieved Sep 2, 2026, from https://www.medicare.gov/health-drug-plans/open-enrollment 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).Centers for Medicare & Medicaid Services. (n.d.). When does Medicare coverage start?. medicare.gov. Retrieved Aug 9, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-does-medicare-coverage-start
Free Medicare Help: Michigan SHIP
Michigan's State Health Insurance Assistance Program (SHIP) is the state's free, unbiased resource for navigating Medicare, and its local certified counselors give personal assistance at no charge.State of Michigan. (n.d.). MDHHS — Hotlines (statewide MDHHS phone directory). michigan.gov. Retrieved Aug 1, 2026, from https://www.michigan.gov/mdhhs/inside-mdhhs/hotlines Barry County's Commission on Aging, for example, calls it the Medicare/Medicaid Assistance Program (MMAP).State of Michigan. (n.d.). MDHHS — State Health Insurance Assistance Program (SHIP). michigan.gov. Retrieved Sep 27, 2026, from https://www.michigan.gov/mdhhs/adult-child-serv/adults-and-seniors/acls/state-health-insurance-assistance-program
A Michigan SHIP counselor can help you:
- Understand your Medicare health plan optionsAdministration for Community Living. (n.d.). Local Help Navigating Medicare (SHIP overview flyer) — Administration for Community Living. acl.gov. Retrieved Sep 27, 2026, from https://acl.gov/sites/default/files/programs/2022-06/SHIP_OverviewFlyer_Final.pdf
- Review your Medigap needs and compare policiesAdministration for Community Living. (n.d.). Local Help Navigating Medicare (SHIP overview flyer) — Administration for Community Living. acl.gov. Retrieved Sep 27, 2026, from https://acl.gov/sites/default/files/programs/2022-06/SHIP_OverviewFlyer_Final.pdf
- Connect with programs that lower Medicare costs, such as Medicare Savings Programs and the Part D Low-Income SubsidyAdministration for Community Living. (n.d.). Local Help Navigating Medicare (SHIP overview flyer) — Administration for Community Living. acl.gov. Retrieved Sep 27, 2026, from https://acl.gov/sites/default/files/programs/2022-06/SHIP_OverviewFlyer_Final.pdf
- Understand doctor bills, hospital bills, Medicare Summary Notices, claims, and appealsAdministration for Community Living. (n.d.). Local Help Navigating Medicare (SHIP overview flyer) — Administration for Community Living. acl.gov. Retrieved Sep 27, 2026, from https://acl.gov/sites/default/files/programs/2022-06/SHIP_OverviewFlyer_Final.pdf
Michigan's SHIP doesn't sell Medicare plans; its counselors just help you understand them.State of Michigan. (n.d.). MDHHS — Hotlines (statewide MDHHS phone directory). michigan.gov. Retrieved Aug 1, 2026, from https://www.michigan.gov/mdhhs/inside-mdhhs/hotlines Call 1-800-803-7174 to reach a local certified counselor.State of Michigan. (n.d.). MDHHS — Hotlines (statewide MDHHS phone directory). michigan.gov. Retrieved Aug 1, 2026, from https://www.michigan.gov/mdhhs/inside-mdhhs/hotlines If you have both Medicare and Medicaid and your question is about your Medicaid health plan, MICHIGAN ENROLLS at 1-800-975-7630 is the line for that.State of Michigan. (n.d.). MDHHS — Hotlines (statewide MDHHS phone directory). michigan.gov. Retrieved Aug 1, 2026, from https://www.michigan.gov/mdhhs/inside-mdhhs/hotlines
Key Michigan Medicare Contacts
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.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Sep 4, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles 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.Centers for Medicare & Medicaid Services. (n.d.). How much does Medicare drug coverage cost?. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/health-drug-plans/part-d/basics/costs,Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Aug 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf Your total depends on the plan you pick and the care you use.
Does Michigan have a Medigap birthday rule?
No. Michigan isn't among the states that have added a birthday rule or other annual window to switch Medigap plans without a health screening.Centers for Medicare & Medicaid Services. (n.d.). Get Medigap Basics - Medicare.gov. medicare.gov. Retrieved Oct 15, 2026, from https://www.medicare.gov/health-drug-plans/medigap/basics 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.Centers for Medicare & Medicaid Services. (2025). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2025) - Medicare.gov. medicare.gov. Retrieved Aug 22, 2026, from https://www.medicare.gov/publications/02110-choosing-a-medigap-policy.pdf After that, insurers may deny or rate you on healthlegislature.mi.gov. (1956). Michigan Compiled Laws § 500.3829 (Insurance Code of 1956, Act 218 of 1956) — Michigan Legislature. Retrieved Sep 27, 2026, from https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-500-3829 unless you have a Michigan guaranteed-issue right (63 days to apply).legislature.mi.gov. (1956). Michigan Compiled Laws § 500.3830 — Eligible person; requirements (Insurance Code of 1956) — Michigan Legislature. Retrieved Sep 27, 2026, from https://www.legislature.mi.gov/Laws/MCL?objectName=MCL-500-3830
How do I reach Michigan's free Medicare counseling program?
Call Michigan's State Health Insurance Assistance Program (SHIP) at 1-800-803-7174. 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.State of Michigan. (n.d.). MDHHS — Hotlines (statewide MDHHS phone directory). michigan.gov. Retrieved Aug 1, 2026, from https://www.michigan.gov/mdhhs/inside-mdhhs/hotlines Barry County's Commission on Aging, for example, calls the program MMAP, short for Medicare/Medicaid Assistance Program.State of Michigan. (n.d.). MDHHS — State Health Insurance Assistance Program (SHIP). michigan.gov. Retrieved Sep 27, 2026, from https://www.michigan.gov/mdhhs/adult-child-serv/adults-and-seniors/acls/state-health-insurance-assistance-program
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.Centers for Medicare & Medicaid Services. (n.d.). CMS — D-SNPs: Integration & Unified Appeals & Grievance Requirements. cms.gov. Retrieved Oct 13, 2026, from https://www.cms.gov/medicare/medicaid-coordination/about/dsnps It is available in select counties in 2026, with statewide expansion planned for 2027.Centers for Medicare & Medicaid Services. (n.d.). CMS — D-SNPs: Integration & Unified Appeals & Grievance Requirements. cms.gov. Retrieved Oct 13, 2026, from https://www.cms.gov/medicare/medicaid-coordination/about/dsnps For help with Michigan's Medicaid health plans, call MICHIGAN ENROLLS at 1-800-975-7630; for free help understanding the Medicare side, call Michigan's SHIP at 1-800-803-7174.State of Michigan. (n.d.). MDHHS — Hotlines (statewide MDHHS phone directory). michigan.gov. Retrieved Aug 1, 2026, from https://www.michigan.gov/mdhhs/inside-mdhhs/hotlines
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.Centers for Medicare & Medicaid Services. (2026). Final CY 2026 Part D Redesign Program Instructions - CMS. cms.gov. Retrieved Aug 22, 2026, from https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf Insulin is capped at $35 for a one-month supply of each covered product.Centers for Medicare & Medicaid Services. (n.d.). Continuous glucose monitors. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/coverage/continuous-glucose-monitors These apply across all plans.
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