How Michigan Families Can Save on Group Health Insurance Plans

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With rising medical costs making employer-sponsored coverage more and more important, households need to get extra creative when looking for affordable, yet comprehensive health insurance plans. While Michigan employers subsidize a substantial portion of premiums, families are still forced to deal with sizable expenses through payroll deductions, deductibles, copays, coinsurance, and uncovered services. 

Still, there are ways for households to lower their total cost of care without compromising access or quality. Let’s go over 10 quick steps Michigan families can take to lessen the burden on their budgets at least a bit.

1. Compare total cost and not just the premiums

First, the unfortunate reality is that going for “extra affordable” plans often ends up being more expensive in the end. A lower paycheck deduction does not always mean a cheaper plan. 

Instead, the trick is to find the best value, not the cheapest price. Evaluate the total cost of care, including the annual employee premium share and the expected out-of-pocket costs. 

2. Choose the right network type for your household

You can find all sorts of group healthcare plans in Michigan. There are HMOs, PPOs, as well as high-deductible health plans (HDHPs) paired with Health Savings Accounts (HSAs). 

• HMO plans typically require an in-network primary care coordinator and offer lower premiums.
• PPOs provide broader access and out-of-network options at a cost. 
• HDHPs trade lower premiums for higher deductibles but unlock HSA tax advantages.

Michigan Group Health Insurance and other reputable healthcare providers in the state offer various types of plans and switching to the right plan can from single-person plans can save you hundreds, if not thousands of dollars. However, remember to confirm that your primary care physician and preferred hospitals will still be in-network. 

3. Look for spousal coverage and coordinate it carefully

Employers in Michigan often apply working-spouse surcharges or spousal carve-outs if a spouse has access to their own employer coverage. However, it’s important to compare each employer’s contribution, deductible, and out-of-pocket maximum (OOPM) before placing the entire family on one plan by default. Otherwise, you risk running into inefficiencies. 

4. Take advantage of wellness and preventative care programs

Group healthcare plans today tend to reward preventive care. Stuff, such as biometric screenings, tobacco-cessation attestations, or activity programs, often generate premium credits, deductible reductions, or HSA deposits.

Going through such preventative and wellness programs not only gets the most out of a group plan, but obviously works to reduce medical issues and emergencies in the future. 

5. Optimize prescription spending

A major part of family out-of-pocket expenses lies in pharmacy costs. Being careful with exactly how you purchase medications, from where, at what prices, and in what batches is a crucial cost-saving tip. 

For example, with maintenance medications, a 90-day mail-order fill usually reduces copays and minimizes refill gaps. If your drug is non-preferred or specialty tier, a good idea to explore manufacturer copay assistance and patient support programs.

Finally, remember to check if a lower-cost therapeutic equivalent is covered before accepting a brand-name prescription.

6. Use lower-cost sites of care

It’s a bit counterintuitive, but services can cost vastly different sums at different healthcare sites. For example, freestanding imaging centers tend to be much more affordable than emergency departments.

Most carriers provide price estimators and care navigation support, so it is a good idea to use them before scheduling elective services.

7. Be careful with prior authorization and referrals

People often encounter denials due to avoidable process issues, not out of medical necessity. It’s advisable to always get a confirmation for any service that requires prior authorization. 

For example, for HMOs that require referrals, you should double-check that they are on file before seeing a specialist. Also, always keep copies of authorizations and referral numbers in case there are issues or questions.

8. Coordinate your group healthcare plan with Michigan’s auto insurance choices

Since Michigan’s recent auto insurance reforms, families can choose different levels of Personal Injury Protection (PIP) medical coverage. And your PIP can have multiple interactions with your family’s group health plan. 

If you aren’t sure how exactly these two different plans relate to each other in your case, you can talk with your employer’s HR or with a licensed insurance professional to figure out how to proceed. In short, you want to avoid duplicative premiums while also avoiding any gaps in the coverage. As above, efficiency and value-for-money is the rule of thumb here.

9. Frequently audit your current plan 

Just signing up for a new plan isn’t the end of it all, as things change quickly both in life and in healthcare plans. So, you’d want to frequently audit your plan and check if all dependents on the plan are still eligible, if anything needs updating, if the qualifications for life events (birth, adoption, marriage, divorce, or loss of other coverage) still apply, and so on.

Denials often happen because of ineligibilities that have occurred during the life of the plan but weren’t there when it was signed.

10. Appeal and resolve all billing issues

You should always take the time to read the Explanations of Benefits (EOBs) you receive and then compare them to the provider invoices. Yes, this takes a bit of time we often don’t feel we have; however, services often get billed as “out-of-network” erroneously. 

But, if you spot them in time, you can request corrections and get full refunds rather quickly after the internal appeal process. If not, there are also external review rights that many people fail to consider.

*This article is based on personal suggestions and/or experiences and is for informational purposes only. This should not be used as professional advice. Please consult a professional where applicable.