Michigan’s Marketplace is highly geographically fragmented. DIFS reports 116 Marketplace plans from seven issuers (with 191 total individual-market plans on and off Marketplace), and approved a 20.2% average Marketplace rate increase for 2026.
Carrier-level increases range from 9.3% (Oscar) to 25.8% (UnitedHealthcare).
A Priority Health narrow-network HMO in Wayne County has nothing in common with an Oscar EPO in Kent County, even if both are labeled “Silver.”
A common mistake is comparing carrier logos instead of comparing ZIP codes, exact provider networks, and actual utilization against specific plan designs.
In this guide, we’ll be exploring:
- 10 individual Marketplace plans across Michigan’s major carriers
- County-level premium examples, deductibles, and OOP limits
- What patients and providers need to know about every plan
- Matching geography, hospital systems, & health needs
Let’s get into it.
Quick skim — Michigan plans compared
A side-by-side view of all 10 plans. Premium examples come from DIFS-published rate tables or CMS-filed Marketplace data — note that a rating area (such as Wayne/Monroe) does not mean a plan is sold in every county within that area.
| Plan | Type | Example premium | Deductible / OOP max | Best for |
| BCBSM Blue Cross Premier PPO Silver | PPO Silver | $864.39 (age 45, Wayne/Monroe area) | $3,200 / $10,100 | Provider flexibility |
| BCN Blue Cross Preferred HMO Silver | HMO Silver | $773.94 (age 45, Wayne/Monroe area) | $4,500 / $10,600 | Lower Peninsula |
| Priority Balanced Silver SE Michigan | HMO Silver | $652.86 (age 45, Wayne/Monroe area) | $3,200 / $9,000 | Wayne/Oakland/Macomb |
| Priority Balanced Silver Corewell West | HMO Silver | $611.64 (age 40, Newaygo) | $3,200 / $9,000 | West Michigan |
| Priority Enhanced Gold SE Michigan | HMO Gold | $886.95 (age 45, Wayne/Monroe area) | $0 / $9,200 | Frequent-care users, SE MI |
| UHC Silver Value | Silver | $573.75 (age 45, Wayne/Monroe area) | $4,000 / $9,500 | Lower-premium Silver |
| UHC Gold Standard | Gold | $614.03 (age 45, Wayne/Monroe area) | $2,000 / $8,200 | Lower-cost Gold |
| McLaren Silver Exchange Rewards | HMO Silver | $952.66 (age 45, Wayne/Monroe area) | $2,000 Rewards / $9,000 | McLaren-aligned care |
| Ambetter Clear Silver | HMO Silver | $446.37 (age 40, Kalamazoo) | $7,000 / $7,000 | Premium-conscious buyers |
| Oscar Silver Simple PCP Saver | EPO Silver | ~$471 (age 40, lowest MI area) | $5,500 / $9,800 | Grand Rapids digital-first users |
1. Blue Cross Blue Shield of Michigan — Blue Cross Premier PPO Silver
The only PPO on this list with meaningful out-of-network benefits. BCBSM ranked #1 in Michigan in J.D. Power’s 2026 Commercial Member Health Plan Study with 614 points — its third consecutive win.
The $3,200 in-network deductible and no specialist referral requirement make it the broadest-access option in this comparison.
If you’re a patient
For Michiganders with established relationships across several health systems, Premier PPO provides specialist access without PCP referrals and meaningful out-of-network coverage.
Out-of-network care has a separate $6,400 deductible and $20,200 OOP cap (with balance-billing risk beyond that).
At $864.39 for a 45-year-old in the Wayne/Monroe rating area, it runs roughly $291/month above UHC Silver Value.
If you’re a provider
No PCP referral requirement for specialists, which simplifies scheduling. Prior authorization still applies for advanced imaging and hospital procedures.
The PPO provides a path for some out-of-network treatment, which can matter for rare-specialty referrals. Providers should clarify in-network versus out-of-network status before expensive services.
Key features
Premier PPO provides the broadest access among these 10 plans.
- 20% hospital coinsurance after deductible
- $15 generic Rx (30-day retail); no specialist referral required
- $3,200 / $6,400 in-network deductible; $10,100 / $20,200 OOP max
- $30 PCP / $50 specialist / $75 urgent care
Pricing
$864.39/month (age 45, non-tobacco, Wayne/Monroe rating area). Actual premiums vary by plan, age, rating area, and tobacco status. A rating area does not guarantee a plan is available in every county within it.
Pros and cons
The PPO structure carries a clear premium cost.
| Pros | Cons |
| Only plan with meaningful out-of-network benefits | ~$291/month more than UHC Silver Value in Wayne area |
| #1 J.D. Power Michigan 2026 (614 points, 3rd consecutive win) | Specialty Rx at 40–45% coinsurance |
| No specialist referral requirement | Out-of-network balance billing remains a risk |
BCBSM reviews
BCBSM’s 614-point J.D. Power score and third consecutive Michigan win represent the strongest carrier-level independent satisfaction evidence in the state.
The rating reflects the overall BCBSM commercial member experience, not a specific review of Premier PPO Silver.
2. Blue Care Network — Blue Cross Preferred HMO Silver
BCN’s managed-care alternative for consumers who want Blue Cross coverage without PPO pricing. The $4,500 deductible is higher than Premier PPO’s $3,200, but the premium drops to $773.94 in the Wayne/Monroe area — saving ~$90/month.
If you’re a patient
Some everyday services receive coverage before the deductible (PCP visits, lab services, urgent care).
The trade-off is HMO rules — specialist referrals are required and out-of-network routine services are generally not covered, apart from emergency and limited exceptions.
A patient whose PCP, hospital, and specialists are already in Blue Care Network gets strong infrastructure at a lower price.
If you’re a provider
PCPs play a larger gatekeeping role. Practices must confirm specialist referral completion before treatment.
Providers should verify the exact Preferred HMO network — multiple distinct BCBS networks exist in Michigan, and accepting one does not automatically mean participating in another.
Key features
BCN provides Blue Cross infrastructure with managed-care controls.
- Specialist referrals required
- Selected services covered before deductible
- Out-of-network routine services generally not covered
- $4,500 / $9,000 deductible; $10,600 / $21,200 OOP max
Pricing
$773.94/month (age 45, non-tobacco, Wayne/Monroe rating area).
Pros and cons
BCN trades flexibility for a lower premium.
| Pros | Cons |
| ~$90/month less than Premier PPO in Wayne area | $4,500 deductible — relatively high for Silver |
| Blue Cross infrastructure | Specialist referrals required |
| Select pre-deductible services | Out-of-network routine care generally not covered |
BCN reviews
BCBSM ranked first in Michigan in J.D. Power’s 2026 study.
However, that carrier-level win should not be directly attributed to this separate BCN Marketplace HMO product. The two operate under the same parent organization but serve different member populations.
3. Priority Health — MyPriority Balanced Silver Southeast Michigan Network
One of the most locally compelling plans for Wayne, Oakland, and Macomb counties.
At $652.86/month (age 45, Wayne/Monroe rating area — note the plan is sold in Wayne, Oakland, and Macomb, not necessarily Monroe), it undercuts both Blue Cross Silver products significantly while offering a $3,200 deductible and pre-deductible office copays.
If you’re a patient
The $30 PCP, $70 specialist, and $5 Tier 1a prescription copays are available before meeting the deductible. $0 virtual urgent care through Corewell Health adds daily-use value.
No specialist referral is required. The narrow network is the defining trade-off — routine care outside it can leave you responsible for the full cost.
If you’re a provider
The network centers on participating Corewell Health East and Trinity Health East providers. Priority specifically directs practices to verify using the Southeast Michigan network filter.
Participating in other Priority Health products does not automatically mean participating in this narrow-network product — a frequent source of billing confusion.
Key features
Priority SE Michigan combines strong pricing with pre-deductible access.
- $5 Tier 1a / $25 Tier 1b prescriptions
- $30 PCP / $70 specialist copays before deductible
- $0 virtual urgent care; no specialist referral required
- $3,200 / $6,400 deductible; $9,000 / $18,000 OOP max
Pricing
$652.86/month (age 45, non-tobacco, Wayne/Monroe rating area). Plan availability is Wayne, Oakland, and Macomb counties.
Pros and cons
Strong local value with a deliberate network trade-off.
| Pros | Cons |
| Competitive SE Michigan pricing with pre-deductible copays | Narrow network — Corewell East/Trinity East focused |
| 4/5 CMS Marketplace quality rating | Routine out-of-network care = full patient responsibility |
| No specialist referral required | Not available statewide |
Priority SE Michigan reviews
Priority Health’s 2026 individual/family plans carry a 4-out-of-5-star CMS Marketplace Quality Rating based on member experience, medical care, and plan administration.
The MyPriority Marketplace HMO also reports NCQA accreditation.
4. Priority Health — MyPriority Balanced Silver Corewell Health West Michigan Network
The West Michigan counterpart, available in Kent, Barry, Mecosta, Newaygo, Ottawa, and specified Allegan County ZIP codes.
Same $3,200 deductible and $9,000 OOP structure, built around Corewell’s West Michigan hospitals and physicians.
If you’re a patient
For Grand Rapids-area residents whose pediatric, specialty, and hospital care centers on Helen DeVos/Butterworth/Corewell, the network-cost trade-off can work well.
$0 virtual urgent care and $5 Tier 1a prescriptions match the SE Michigan version. No specialist referral is required. Routine care outside the network means full patient responsibility.
If you’re a provider
The network includes Corewell Health Butterworth, Blodgett, Helen DeVos Children’s, Zeeland, Big Rapids, Gerber, Greenville, and several other hospitals, along with Corewell Health Medical Group West.
Practices deeply integrated with Corewell West find the plan straightforward. Providers outside that system should not assume participation.
Key features
Corewell West is designed around West Michigan’s hospital system.
- $3,200 deductible; $9,000 OOP max
- $30 PCP / $70 specialist / $75 urgent care
- $0 virtual urgent care; no specialist referral required
- Corewell West-centered network in 5+ West MI counties
Pricing
$611.64/month (age 40, non-tobacco, Newaygo County). Exact premiums vary by age and location.
Pros and cons
Geography is the main qualification criterion.
| Pros | Cons |
| Designed around Corewell West hospital system | Geographically limited to West Michigan |
| 4/5 CMS Marketplace Quality Rating | Out-of-network = full patient cost |
| Pre-deductible office copays | Fewer hospital options than a broad network |
Priority West Michigan reviews
Same 4/5 CMS Marketplace Quality Rating as the SE Michigan product. CMS incorporates member experience, medical care, and plan administration.
5. Priority Health — MyPriority Enhanced Gold Southeast Michigan Network
A $0 deductible Gold HMO in the Detroit metro.
At $886.95/month (age 45, Wayne/Monroe area), the premium buys predictable cost-sharing from day one — $20 PCP, $45 specialist, $20 mental-health visits, $5 Tier 1a prescriptions.
The individual OOP maximum is $9,200/$18,400 family.
If you’re a patient
The $0 deductible eliminates the front-loaded spending problem that makes many Silver plans painful early in the year.
For someone managing chronic conditions, pregnancy, or recurring specialist care, paying ~$234/month more than Balanced Silver may produce lower total annual spending — though that depends on your specific utilization pattern, specialty drug needs, and whether your providers fit the narrow network.
If you’re a provider
Same Corewell Health East/Trinity Health East narrow-network structure as Balanced Silver.
Providers outside the network should expect limited routine coverage. The localized design can simplify care coordination within participating systems.
Key features
Enhanced Gold eliminates the deductible entirely.
- $5 Tier 1a prescriptions
- Narrow SE Michigan network (Corewell East/Trinity East)
- $20 PCP / $45 specialist / $20 mental health / $75 urgent care
- $0 annual deductible; $9,200 individual / $18,400 family OOP max
Pricing
$886.95/month (age 45, non-tobacco, Wayne/Monroe rating area).
Pros and cons
The $0 deductible is the selling point; the narrow network is the trade-off.
| Pros | Cons |
| $0 deductible — benefits from day one | ~$234/month more than Balanced Silver SE Michigan |
| Predictable copay structure | Same narrow SE Michigan network |
| 4/5 CMS Marketplace Quality Rating | Not available outside SE Michigan |
Priority Enhanced Gold reviews
Covered under Priority’s 4-star 2026 CMS Quality Rating, based on third-party-validated quality measures and enrollee survey data.
6. UnitedHealthcare — UHC Silver Value (no referrals)
A competitive Silver premium with no specialist referral requirement. At $573.75/month (age 45, Wayne/Monroe area), it runs ~$200 below BCN Preferred HMO Silver. The $4,000 deductible and $9,500 OOP max sit in the mid-range.
If you’re a patient
The no-referral design and $8 Tier 2 generic prescriptions are real daily-use benefits.
Do not confuse UHC’s national brand size with universal in-network access — the Marketplace network is more limited than employer UHC plans.
UHC received the largest approved 2026 rate increase among major Michigan Marketplace carriers at 25.8%.
If you’re a provider
No referral requirement simplifies specialist workflow, but authorization and exact exchange-product network verification remain necessary.
Provider offices should verify patient insurance by confirming the specific individual-exchange product rather than treating it as interchangeable with UHC employer PPO coverage.
Key features
UHC Silver Value combines lower premiums with no-referral access.
- No specialist referral required
- $8 Tier 2 generic prescriptions
- UHC administrative infrastructure
- $4,000 deductible; $9,500 OOP max
Pricing
$573.75/month (age 45, non-tobacco, Wayne/Monroe area). $566.57 in Kalamazoo (age 40).
Pros and cons
Competitive pricing with a quality trade-off.
| Pros | Cons |
| Competitive Silver premium | 25.8% approved 2026 rate increase — highest among major carriers |
| No specialist referral | ~3/5 CMS Marketplace Quality Rating |
| Low generic Rx cost | Exchange network ≠ employer UHC network |
UHC Silver Value reviews
CMS-filed 2026 Marketplace data show approximately 3/5 Quality Rating stars. J.D. Power evaluates UHC among Michigan commercial plans but only publishes the regional winner (BCBSM) in its public release.
7. UnitedHealthcare — UHC Gold Standard (no referrals)
Remarkably close in premium to Silver Value — $614.03/month versus $573.75 in the Wayne/Monroe area. The extra ~$40/month buys a $2,000 deductible (versus $4,000) and $8,200 OOP max (versus $9,500).
If you’re a patient
That ~$480 annual premium increase buys roughly $2,000 in deductible reduction and $1,300 in lower OOP ceiling.
For anyone expecting moderate healthcare use, Gold Standard can produce lower total spending than Silver Value over a full year. $30 PCP, $60 specialist, and $15 generic prescription costs are predictable. The network limitation remains the central concern.
If you’re a provider
Same no-referral design as Silver Value. Exchange-specific eligibility, network participation, and prior authorization must be confirmed before expensive services.
The Gold patient population tends to use more care, which increases the importance of accurate eligibility verification for practices.
Key features
Gold Standard offers a notable deductible improvement for a modest premium jump.
- $30 PCP / $60 specialist
- No specialist referral required
- $2,000 deductible; $8,200 OOP max
- $15 generic / $30 preferred brand / $60 non-preferred Rx
Pricing
$614.03/month (age 45, non-tobacco, Wayne/Monroe area).
Pros and cons
The Silver-to-Gold premium difference is unusually small in SE Michigan.
| Pros | Cons |
| Only ~$40/month more than Silver Value in Wayne area | Same ~3/5 CMS Quality Rating |
| $2,000 deductible reduction vs. Silver | 25.8% rate increase across UHC Marketplace products |
| No specialist referral | Marketplace network is more limited than employer plans |
UHC Gold Standard reviews
Same ~3/5 CMS Marketplace rating as Silver Value — adequate but below Priority’s 4-star Marketplace Quality Rating in Michigan.
8. McLaren Health Plan Community — MHP Silver Exchange Rewards
Michigan’s most unusual Silver design. McLaren creates two tiers within its network. Using a designated Rewards Provider gives a $2,000 deductible and 0% coinsurance after.
Using an ordinary in-network (non-Rewards) provider triggers an $8,000 deductible and 50% coinsurance. Same plan, drastically different financial outcomes.
If you’re a patient
The upside is exceptional — $2,000 deductible with $0 coinsurance through Rewards Providers. The downside is severe.
Choosing the wrong provider within the same “in-network” plan transforms a $2,000 experience into an $8,000 one.
You must verify every major physician and facility against the Rewards directory, not merely McLaren’s general network.
If you’re a provider
A practice can be “in network” with McLaren without being a Rewards Provider — and the patient’s cost-sharing will be drastically different.
McLaren explicitly states that Rewards Providers are a subset of participating providers. Provider designation in this plan affects billing outcomes more directly than in any other product on this list.
Key features
The Rewards tier distinction defines this plan.
- 0% Rewards coinsurance / 50% non-Rewards coinsurance
- $2,000 Rewards / $8,000 non-Rewards deductible
- $9,000 / $18,000 overall OOP max
- $10 generic prescriptions
Pricing
$952.66/month (age 45, non-tobacco, Wayne/Monroe area) — relatively expensive for the area.
Pros and cons
Rewards vs. non-Rewards is the single most important variable.
| Pros | Cons |
| $2,000 deductible + 0% coinsurance with Rewards Providers | Wrong provider = $8,000 deductible + 50% coinsurance |
| 4/5 CMS Marketplace Quality Rating | Rewards vs. non-Rewards is confusing |
| $10 generic Rx | Higher premium than many SE Michigan alternatives |
McLaren reviews
CMS gives McLaren’s Michigan QHPs 4/5 Quality Rating stars. Consumers should distinguish this Marketplace rating from McLaren’s separate Medicaid or other commercial product ratings.
9. Ambetter from Meridian — Clear Silver
A high-deductible Silver plan with a structural advantage — the $7,000 deductible is also the $7,000 OOP maximum. Once you hit $7,000, covered in-network care is fully covered.
No specialist referral required. In Kalamazoo County, the age-40 premium is $446.37/month — among the lowest Silver premiums in Michigan.
If you’re a patient
For consumers primarily concerned with premium affordability, Ambetter delivers. But $7,000 is substantial upfront exposure.
The real value appears for lower-income consumers eligible for Silver cost-sharing reductions — the 94% actuarial-value CSR variation drops to an $850 deductible and $850 OOP maximum.
That transformed plan looks nothing like the standard design, and it’s only available to qualifying Marketplace enrollees.
If you’re a provider
No formal referral barrier, but Ambetter maintains a tightly managed network and authorization structure. The SBC notes penalties can apply when authorization rules are missed.
Practices should verify exact Meridian/Ambetter Marketplace participation and confirm prior authorization requirements rather than assume other Meridian products use the same rules or network.
Key features
Clear Silver combines low premiums with a clean deductible = OOP structure.
- No specialist referral required
- $7,000 deductible = $7,000 OOP max
- HMO with managed network and authorization structure
- CSR variants can reduce to $850/$850 for qualifying enrollees
Pricing
$446.37/month (age 40, non-tobacco, Kalamazoo County).
Pros and cons
Premium affordability comes with real deductible exposure.
| Pros | Cons |
| Among the lowest Silver premiums in Michigan | $7,000 standard deductible |
| Simple deductible = OOP structure | Tightly managed network with authorization penalties |
| CSR versions dramatically improve cost-sharing | ~3/5 CMS Marketplace Quality Rating |
Ambetter reviews
CMS Marketplace data show Ambetter/Meridian at approximately 3/5 Quality Rating stars.
Meridian is the largest individual-market carrier in Michigan by enrollment (156,012 members), though enrollment reflects market presence rather than satisfaction.
10. Oscar — Silver Simple PCP Saver
Oscar’s digitally-oriented EPO in a limited West Michigan footprint — Kent, Muskegon, Oceana, and Ottawa counties. $20 PCP visits, $3 preferred generic prescriptions, $0 virtual urgent care, and a dedicated digital Care Team through the app.
If you’re a patient
The digital-first experience and $20 PCP visits are genuinely attractive for younger, tech-comfortable consumers.
The $5,500 deductible and EPO design (no routine out-of-network coverage) are the trade-offs.
Patients with complex care needs outside Grand Rapids/West Michigan should evaluate the limited out-of-area protection carefully.
If you’re a provider
Oscar requires careful network checking because of its limited geography.
West Michigan practices should verify their specific Oscar individual-market contract rather than assuming participation based on another insurer relationship.
The EPO structure means out-of-area coverage focuses on emergencies and urgent services.
Key features
Oscar pairs low everyday costs with a digital-first member experience.
- $20 PCP / $70 specialist / $20 mental health
- $3 preferred generic Rx; $0 virtual urgent care
- Digital Care Team; EPO with limited West MI geography
- $5,500 / $11,000 deductible; $9,800 / $19,600 OOP max
Pricing
~$471/month (age 40, lowest-cost Michigan rating area) before subsidies.
Pros and cons
Oscar’s strengths and limitations are both geographic.
| Pros | Cons |
| $20 PCP, $3 generics, $0 virtual urgent care | Limited to ~4 West Michigan counties |
| Strong digital/app experience | No routine out-of-network coverage |
| Low-cost generic prescriptions | Currently unrated for CMS QRS scoring |
Oscar reviews
Oscar’s 2026 Michigan plan is currently unrated for CMS Quality Rating scoring.
Oscar reports a companywide NPS of 69, but that is self-reported, not Michigan-specific, and not equivalent to CMS or J.D. Power evidence.
Why Michigan’s payer fragmentation makes structured billing management necessary
Michigan’s 116 Marketplace plans across seven carriers, county-specific networks, and 20.2% average rate increase create a billing environment where every detail determines whether claims get paid.
A McLaren Rewards Provider and a McLaren in-network (non-Rewards) provider produce dramatically different patient bills under the same plan.
A Priority SE Michigan network provider and a Priority West Michigan provider are not interchangeable. When payer-specific differences still produce rejected or unpaid claims, structured denial management becomes the downstream recovery workflow.
For practices collecting $500K–$3M+ monthly, MedHeave’s Michigan medical billing services turn this complexity into consistent collections through payer-specific workflows by state, carrier, and plan design.
For practices evaluating medical billing outsourcing, that model provides dedicated ownership rather than a rotating claims queue.
Claim scrubbing provides a front-end check for plan-specific errors before a claim reaches the payer. According to MedHeave’s published performance data, the company reports the following.
- 80%+ denial overturn within 72 hours
- 97%+ net collection rate; under 40 AR days
- Dedicated account managers (not a rotating queue)
- 30-day exit, 4–7% of collections, performance-based
- 90%+ first-pass claim rate; 98% in-network clearinghouse pass rate
Consistently producing clean claims is another core measure of submission quality.
MedHeave targets practices collecting $100K/month or more, with a focus on the $1M–$3M range. Practices comparing medical billing companies primarily on fee percentages against 2% vendors should look elsewhere.
How to choose the best health insurance plan in Michigan
Michigan is a ZIP-code-first market. The strongest plan for Wayne County may not be available in Kent County.
Enter your exact ZIP on HealthCare.gov
Many Michigan networks are county-specific. Priority’s SE Michigan and West Michigan products serve entirely different geographies. A rating area (like Wayne/Monroe) does not guarantee availability in every county within it.
Verify every provider against the exact network name
“Do you take Blue Cross?” is the wrong question. Michigan has multiple distinct BCBS networks, Priority has separate SE and West Michigan networks, and McLaren has a Rewards subset within its in-network directory. Always check the specific plan network, not just the carrier.
Check all prescriptions against the 2026 formulary
Formulary coverage varies by plan, and some medications that were covered in 2025 may not be covered in 2026. Verify before enrolling.
Compare subsidized premiums, not sticker prices
For Silver plans, check whether cost-sharing reductions apply — Ambetter’s standard $7,000 deductible drops to $850 at the 94% CSR level. Compare deductible + OOP max against realistic expected utilization, not premium alone.
Model the total-year cost, not just the monthly bill
For heavy users in SE Michigan, Priority Enhanced Gold’s $0 deductible may produce lower total spending than a cheaper Silver plan with a $3,200+ deductible. Run the math against your expected utilization.
Frequently asked questions
Common questions about Michigan health insurance for 2026:
DIFS approved an average 20.2% Marketplace increase. Carrier-level increases range from 9.3% (Oscar) to 25.8% (UnitedHealthcare). DIFS notes the approved rates saved about $250 million versus insurers’ original requests.
Under McLaren Exchange Rewards, Rewards Providers give you a $2,000 deductible with 0% coinsurance. Non-Rewards in-network providers trigger an $8,000 deductible with 50% coinsurance. Same plan, very different financial outcomes. Always verify against the Rewards directory.
Yes. Priority’s SE Michigan network serves Wayne, Oakland, and Macomb counties, centered on Corewell Health East and Trinity Health East. The West Michigan network serves Kent, Barry, Mecosta, Newaygo, Ottawa, and parts of Allegan County, centered on Corewell Health West. Availability and network composition differ by county.
Several do. BCBSM Premier PPO, Priority Balanced Silver (both SE and West Michigan), UHC Silver Value, UHC Gold Standard, Ambetter Clear Silver, and Oscar Simple PCP Saver all operate without specialist referrals. BCN Preferred HMO Silver requires referral verification.
Yes. The standard Clear Silver has a $7,000 deductible and $7,000 OOP max. The 94% actuarial-value CSR variation drops both to $850. That only applies to qualifying Marketplace consumers — check eligibility on HealthCare.gov.
