Michigan Care

PHP Rebrands to University of Michigan Health Plan

Physicians Health Plan (PHP) is now University of Michigan Health Plan (UM Health Plan). 

PHP is the vendor that administers Michigan Care and Michigan Care Advantage health plans. This is a name change only; your coverage remains the same. Michigan Care and Michigan Care Advantage members will receive new cards in late December.

You’ll see University of Michigan Health Plan (formerly PHP) on U-M websites, in U-M booklets and in other resources throughout Open Enrollment. 

Michigan Care Basics

Michigan Care provides enhanced coordination to improve service, quality and clinical outcomes for plan members. Members have access to Michigan Medicine health care providers as well as other high-quality network providers in southeast Michigan. Access to the plan is limited to faculty, staff and retirees who live in a specific geographic area of southeast Michigan.

Plan highlights include:

  • A narrower network than U-M Premier Care with a lower monthly premium for non-Medicare participants
  • Access to Michigan Medicine health care providers, Integrated Health Associates (IHA), Huron Valley Physicians Associates (HVPA) and Jackson Health Network facilities that are part of the St. Joseph Mercy system (St. Joseph in Ann Arbor, Chelsea, Livingston and Oakland, and St. Mary Mercy in Livonia), Henry Ford Jackson Hospital and University Health Service 
  • Chiropractic coverage

Because of the select provider network, access to the plan is limited to faculty, staff and retirees who live in a specific geographic area within southeast Michigan. Find out if your zip code is included in the coverage area.

The plan is administered by Physicians Health Plan/University of Michigan Health Plan based in Lansing. Michigan Medicine has a majority ownership as part of an affiliation agreement with Sparrow Health System reached in 2023. Michigan Medicine leaders are engaged in and committed to the development and success of the plan. This engagement includes an emphasis on enhanced coordination between Michigan Medicine and the Michigan Care plan administrator (PHP/UM Health Plan) to improve service, quality and clinical outcomes for plan members.

Search here to locate a participating Michigan Care provider to find out if your doctor accepts this plan. 

In the "I'm A Member/I'm A Guest" section of the Michigan Care provider directory: 

  1. If you're a current Michigan Care member, enter your Member ID number, OR
  2. Select "Michigan Care employees only" in the Network/Plan Type drop-down menu in the "I'm A Guest" section.

Hearing Services Coverage

As a member of Michigan Care, you have access to a Hearing Services Value Network. Providers in this Value Network have agreed to offer standard hearing aid options that will not result in out-of-pocket costs. Michigan Care members must receive hearing services from a Hearing Services Value Network provider in order for these services to be covered.

You can “buy up” to advanced or premium hearing aid options, but will pay the difference in the cost between what the provider charges for these buy-up options and the amount the plan pays for a standard hearing aid.

Hearing Services Value Network providers include Michigan Medicine Audiology Services and TruHearing providers.

Contact Michigan Medicine Audiology Services at (734) 936-8051 for more information or to locate a Michigan Medicine provider, or visit Hearing Loss and Hearing Testing on the Michigan Medicine website.

TruHearing has an extensive nationwide network of highly qualified hearing aid providers who offer affordable hearing aid options. Contact TruHearing at (844) 815-7195 to speak with a hearing consultant or to locate a TruHearing provider, or view information at TruHearing Choice.

Summary of Benefits

In-network Providers

  • No annual deductible
  • No out-of-pocket cost to you for preventive care
  • $25 copay for office visit for injury or illness
  • $30 copay for specialist visit
  • $25 copay for urgent care*
  • $25 copay for 24/7 on-demand physician telemedicine visits for acute or urgent health matters
  • $25 copay per visit for up to 24 visits per year for chiropractic spinal manipulation
  • $100 copay for emergency care (waived if admitted)*
  • $25 copay for mental health, behavioral health or substance abuse services
  • No out-of-pocket cost to you for inpatient services
  • No out-of-pocket cost to you for outpatient surgery
  • $3,000 individual/$6,000 family out-of-pocket maximum 

* Members can access any urgent care provider or emergency room for urgent or emergency medical needs and receive in-network coverage.

Use the health plan comparison tool to compare Michigan Care covered services with services covered under other U-M health plans.

Using the Plan

Michigan Care is a managed care plan. Members must live in the plan's service area and choose a Primary Care Physician (PCP) from the Michigan Care network. In order to visit a specialist, you will need a referral from your PCP. Services received outside of the network are not covered except in the event of emergency. If members need urgent or emergent care when out of the network area, the plan will cover this care as if they were seeing an in-network provider. Plan documents will provide details.

The plan provides coverage for dependents who reside outside the network service area and meet eligibility guidelines. Pre-certification is required for certain services, and the member must register with Physicians Health Plan/University of Michigan Health Plan to obtain approval for out-of-area dependent coverage. For more information, call Michigan Care customer service at 833-484-8450.

Find out if you are eligible for Michigan Care.

If You Move Out of the Michigan Care Service Area

You must live in the Michigan Care service area to be eligible for the plan. If you are enrolled and move outside the Michigan Care service area, you must change your health plan.

To enroll in a different health plan, download the Moving out a Managed Care Service Area form and submit your signed and completed within 30 days of the date of your move. Your new coverage will become effective the first day of the month following the move or the receipt of this form, whichever is later. Please remember to update your home address with the university.

Find a Participating Provider

Search the provider directory to find out if your preferred providers are in the Michigan Care network. Use the "Find a Provider" link. No registration is required to search the provider directory.

Plan Documents

Plan Contact Information

Michigan Care Customer support: 1-800-832-9186

michigancare.com

Physicians Health Plan/University of Michigan Health Plan
1301 N. Hagadorn, Ste 1E
East Lansing, MI 48823 

Group Number: L0002184

Consider a Health Care Flexible Spending Account

If you are eligible, you may want to consider enrolling in a pre-tax health care Flexible Spending Account (FSA) to complement your health plan.