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What to Look for in a Health Insurance Policy in Michigan (2027 Checklist)
Most people compare health plans by premium and deductible. Those matter, but they're not where people get hurt. Here are the features that actually decide whether a plan works for you, in the order I check them.
1. The network
A cheap plan your doctors don't take is expensive. Check your primary care doctor, specialists, the hospital you'd want, and the nearest urgent care. Then check the network type (HMO, EPO, PPO), because it decides whether out-of-network care is covered at all. More in HMO vs. PPO.
2. The out-of-pocket maximum
This is the most you'll pay for covered, in-network care in a year. For 2027, ACA-compliant plans can set it as high as $12,000 for one person and $24,000 for a family, a big jump from $10,600 and $21,200 in 2026. Two plans with the same deductible can have very different maximums.
3. Your prescriptions
Search each drug in the plan's formulary. Note its tier, whether the deductible applies first, and any prior authorization or step therapy. See how prescription drug coverage works.
4. Deductible vs. copays
Some plans give you copays for office visits and generic drugs before the deductible; others make you pay full price until it's met. If you go to the doctor a lot, pre-deductible copays are worth real money. If you rarely go, a higher deductible with a lower premium may win. The mechanics: how deductibles, copays and coinsurance work.
5. What's actually covered
ACA plans have to cover 10 essential health benefits, including maternity, mental health and prescriptions. Private underwritten plans don't always, and may exclude pre-existing conditions. Read the exclusions page. Details: what health insurance covers.
6. HSA eligibility
If you can save, an HSA-eligible plan lets you put away up to $4,500 (single) or $9,000 (family) tax-free in 2027. Every bronze and catastrophic marketplace plan is HSA-eligible as of 2026.
Red flags
- Benefits listed as daily or per-visit cash amounts. That's a fixed-indemnity plan, not major medical.
- Annual or lifetime dollar caps on covered care.
- A "PPO" pitched over the phone that turns out to be a discount card.
- Pressure to sign today, or a salesperson who won't email you the plan documents.
Michigan specifics
In Michigan, open enrollment for 2027 coverage runs on HealthCare.gov from November 1, 2026 to January 15, 2027. Pick a plan by December 15, 2026 if you want coverage to start January 1, 2027; plans picked after that start later. Michigan has no state individual mandate, so there's no state tax penalty for going without coverage.
Check your options and we'll walk through this checklist with you for the plans in your ZIP code.
Frequently asked questions
What is the most important thing to look for in health insurance?
Whether your doctors, hospital and prescriptions are covered, followed by the out-of-pocket maximum, which caps your worst-case year.
What is the 2027 out-of-pocket maximum?
For ACA-compliant plans, $12,000 for an individual and $24,000 for a family for 2027.
Is a low deductible always better?
No. Low-deductible plans cost more each month. If you rarely use care, a higher deductible with a lower premium can cost less over the year.