Happy senior residents

At the Michigan Health Endowment Fund, helping Michigan’s most vulnerable residents is part of our mandate and our mission. That’s why we’re committing $120 million to help low-income residents pay for Medigap policies over the next four years. Read on to learn about the subsidy, and visit MichiganMedigapSubsidy.com for even more information.

Who is eligible for the subsidy?

The subsidy will be available to Michigan residents who have a Medigap policy and an annual income at or below 150 percent of the federal poverty level ($17,820 or less for an individual and $24,030 or less for a couple). To be eligible, your Medigap policy must be with a participating insurer. As of July, 2016, that list includes the following:

  • Blue Cross Blue Shield of Michigan
  • Blue Care Network
  • Priority Health
  • United/AARP

How much is the subsidy?

The subsidy amount depends on your age and whether you have a disability:

  • $40/month for people 65-75 years of age
  • $65/month for people older than 76
  • $125/month for people under the age of 65 who have a disability

How can people get the subsidy?

If you think you’re eligible based on the requirements above, you can apply for the subsidy starting on October 1, 2016. The earliest you can get the subsidy is January 1, 2017, and you’ll need to apply by December 15, 2016 to start receiving it on the first of the year.

You’ll be able to apply online at MichiganMedigapSubsidy.com or by phone at 1-866-824-9772 (TTY: 1-866-824-7002). You’ll also be able to download or request a paper application that you can mail in.

It will take us a few weeks to review your application and confirm your eligibility. Once you’re approved, you’ll receive a letter letting you know. After that, you don’t need to do anything—we’ll pay the subsidy directly to your insurer, and you’ll see a lower amount due on your Medigap policy bill. This way, you don’t have to pay the full bill up front and wait for reimbursement. Also, we don’t want the subsidy to show up as income and potentially put other income-based benefits at risk.

How did you set the amounts and eligibility requirements?

The overall budget of $120 million was set by the Michigan Legislature when they created the Health Fund as part of Blue Cross Blue Shield’s conversion from a nonprofit to a mutual insurer back in 2013. In deciding how best to spend those dollars, we needed to balance two main considerations: helping the people who need it the most, and providing a large enough subsidy to make a meaningful difference in those individuals’ bills.

But we didn’t just do the math; we sought input from the experts. We met with officials from the State of Michigan, insurance companies, and—most importantly—nonprofits who support, advocate, and serve Michigan seniors and residents with disabilities. Based on conversations with all these groups, we structured the subsidy to ensure the greatest benefit to the greatest number of people with the greatest need.

Why is the subsidy only lasting for four years?

The subsidy is intended to help Medigap policyholders adjust to market rates, now that BCBSM is no longer required to freeze or subsidize Medigap policies. This means that each year, the subsidy amount and eligibility requirements are subject to change.

Where can I get more information?

The best place to start is MichiganMedigapSubsidy.com which will serve as an up-to-date clearinghouse of information throughout the subsidy program. You can also call 1-866-824-9772 (TTY: 1-866-824-7002) and speak to a representative if you’re more comfortable with phone calls than websites.

While we’re striving to provide all the subsidy-related information you could ever want or need, we can’t provide guidance on your overall insurance options or needs. For a bigger discussion about your options, we recommend contacting your insurance company directly. You can also contact the Michigan Medicare/Medicaid Assistance Program (MMAP) at 1-800-803-7174. MMAP is a service that exists to help counsel Michigan seniors and residents with disabilities through the maze of health benefits and options.


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