Michigan health plan · 2025

MHP Silver Exchange Rewards · 74917MI0020017

McLaren Health Plan Community offers this marketplace health insurance plan (Plan ID 74917MI0020017) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Silver Plan type: HMO CSR: Limited Cost Sharing Plan Variation Issuer: McLaren Health Plan Community
Telehealth Data pending HSA eligible No Dental Not listed Vision Adult/Child

CMS AV Calculator output: 70.38% (29.62% member share on average). Learn about AV methodology.

2025 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$312 – $1666

Before subsidies

Estimate after subsidies

Deductible

N/A

N/A

See deductible details

Max out-of-pocket

$8,250

$16500 per group

Review MOOP rules

Office visits

Primary care 0.00% Coinsurance after deductible
Specialist 0.00% Coinsurance after deductible
HSA Not eligible

Drug tiers

Generic $10.00
Preferred brand $85.00

View formulary tiers

$539 / mo before subsidies

≈ $6470 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$1489 / mo before subsidies

≈ $17864 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • This Silver tier qualifies for CSR if household income is ≤250% FPL.

$1958 / mo before subsidies

≈ $23497 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • This Silver tier qualifies for CSR if household income is ≤250% FPL.

$1151 / mo before subsidies

≈ $13808 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

0.00% Coinsurance after deductible

Durable Medical Equipment

0.00% Coinsurance after deductible

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Enrollment guidance

Stay on top of 2025 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Michigan). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Limited Cost Sharing Plan Variation plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

0.00% Coinsurance after deductible

Durable Medical Equipment

0.00% Coinsurance after deductible

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 74917MI0020017
Coverage year 2025
State Michigan
Issuer McLaren Health Plan Community
Formulary document Download formulary
Variant ID 74917MI0020017-03
Available variants

Standard Off Exchange Plan · 74917MI0020017-00

Standard On Exchange Plan · 74917MI0020017-01

Open to Indians below 300% FPL · 74917MI0020017-02

Open to Indians above 300% FPL · 74917MI0020017-03

73% AV Silver Plan · 74917MI0020017-04

87% AV Silver Plan · 74917MI0020017-05

94% AV Silver Plan · 74917MI0020017-06
Last plan update Sat, 12 Oct 2024 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Michigan N/A
PCPs in Michigan N/A
Telehealth support Data pending
Nationwide providers N/A

Provider network(s)

Providers Michigan All US states
All N/A N/A
PCP N/A N/A
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A

Drug coverage overview

7,479 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
PREFERRED-GENERIC 2,954
NON-PREFERRED 2,606
SPECIALTY 1,444
PREFERRED-BRAND 475
Prior authorization Drugs
Required 1,566
Not Required 5,913
Step therapy Drugs
Required 870
Not Required 6,609
Quantity limits Drugs
Has Limit 2,312
No Limit 5,167

Customer highlights

What stands out for members

  • Issuer: McLaren Health Plan Community · Plan ID 74917MI0020017 · 2025 filing.
  • Download the latest formulary directly from the issuer here.
  • Variant 74917MI0020017-03 (Open to Indians above 300% FPL) currently displayed.
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Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 30.0 Visit(s) per Year

Limit combined with OT and PT.

Exclusions: nan

Diabetes Education

No Charge
Tier 1 in-network No Charge
Tier 2 in-network No Charge
Out-of-network 100.00%

nan

Exclusions: nan

Home Health Care Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Laboratory Outpatient and Professional Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Other Practitioner Office Visit (Nurse, Physician Assistant)

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Preventive Care/Screening/Immunization

No Charge
Tier 1 in-network No Charge
Tier 2 in-network No Charge
Out-of-network 100.00%

nan

Exclusions: nan

Primary Care Visit to Treat an Injury or Illness

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Rehabilitative Occupational and Rehabilitative Physical Therapy

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 30.0 Visit(s) per Year

Combined with chiro.

Exclusions: nan

Rehabilitative Speech Therapy

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 30.0 Visit(s) per Year

nan

Exclusions: nan

Specialist Visit

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Urgent Care Centers or Facilities

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

nan

Exclusions: nan

X-rays and Diagnostic Imaging

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Delivery and All Inpatient Services for Maternity Care

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Dialysis

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Durable Medical Equipment

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Emergency Room Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

nan

Exclusions: nan

Emergency Transportation/Ambulance

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

nan

Exclusions: nan

Hospice Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Coverage includes inpatient and outpatient hospice care.

Exclusions: nan

Inpatient Hospital Services (e.g., Hospital Stay)

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Inpatient Physician and Surgical Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Mental/Behavioral Health Inpatient Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Mental/Behavioral Health Outpatient Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Outpatient Rehabilitation Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 30.0 Visit(s) per Year

PT/OT/Chiro - combined visits per contract year; 30 ST per contract year; 30 cardiac/pulmonary visits per contract year.

Exclusions: nan

Outpatient Surgery Physician/Surgical Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Radiation

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Skilled Nursing Facility

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 45.0 Days per Year

nan

Exclusions: nan

Substance Abuse Disorder Inpatient Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Substance Abuse Disorder Outpatient Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Transplant

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Mental health & substance use

Behavioral health visits and substance use treatment.

Autism Spectrum Disorders

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Only covered in relation to Autism Spectrum Disorder.

Exclusions: nan

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

Coverage details pending

nan

Exclusions: nan

Hearing Aids

Coverage details pending

nan

Exclusions: nan

Major Dental Care - Child

Coverage details pending

nan

Exclusions: nan

Prenatal and Postnatal Care

No Charge
Tier 1 in-network No Charge
Tier 2 in-network No Charge
Out-of-network 100.00%

nan

Exclusions: nan

Routine Eye Exam for Children

No Charge
Tier 1 in-network No Charge
Tier 2 in-network No Charge
Out-of-network 100.00%

Limit: 1.0 Exam(s) per Year

nan

Exclusions: nan

Well Baby Visits and Care

No Charge
Tier 1 in-network No Charge
Tier 2 in-network No Charge
Out-of-network 100.00%

nan

Exclusions: nan

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$10.00
Tier 1 in-network $10.00
Tier 2 in-network $10.00
Out-of-network 100.00%

nan

Exclusions: nan

Non-Preferred Brand Drugs

50.00%
Tier 1 in-network 50.00%
Tier 2 in-network 50.00%
Out-of-network 100.00%

nan

Exclusions: nan

Preferred Brand Drugs

$85.00
Tier 1 in-network $85.00
Tier 2 in-network $85.00
Out-of-network 100.00%

nan

Exclusions: nan

Specialty Drugs

50.00%
Tier 1 in-network 50.00%
Tier 2 in-network 50.00%
Out-of-network 100.00%

nan

Exclusions: nan

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

Coverage details pending

nan

Exclusions: nan

Basic Dental Care - Adult

Coverage details pending

nan

Exclusions: nan

Dental Check-Up for Children

Coverage details pending

nan

Exclusions: nan

Infusion Therapy

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Major Dental Care - Adult

Coverage details pending

nan

Exclusions: nan

Nutritional Counseling

No Charge
Tier 1 in-network No Charge
Tier 2 in-network No Charge
Out-of-network 100.00%

Limit: 6.0 Visit(s) per Year

Dietician Services.

Exclusions: nan

Orthodontia - Adult

Coverage details pending

nan

Exclusions: nan

Orthodontia - Child

Coverage details pending

nan

Exclusions: nan

Prosthetic Devices

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Routine Dental Services (Adult)

Coverage details pending

nan

Exclusions: nan

Weight Loss Programs

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

nan

Exclusions: nan

Acupuncture

Coverage details pending

nan

Exclusions: nan

Allergy Testing

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Applied Behavior Analysis Based Therapies

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Bariatric Surgery

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 1.0 Procedure(s) per Lifetime

nan

Exclusions: nan

Cosmetic Surgery

Coverage details pending

nan

Exclusions: nan

Eye Glasses for Children

No Charge
Tier 1 in-network No Charge
Tier 2 in-network No Charge
Out-of-network 100.00%

Limit: 1.0 Item(s) per Year

nan

Exclusions: nan

Gender Affirming Care

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Habilitation Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 30.0 Visit(s) per Year

Yearly limits: PT and OT: 30 visits, Speech: 30 visits.

Exclusions: nan

Imaging (CT/PET Scans, MRIs)

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Infertility Treatment

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Underlying causes only.

Exclusions: nan

Long-Term/Custodial Nursing Home Care

Coverage details pending

nan

Exclusions: nan

Private-Duty Nursing

Coverage details pending

nan

Exclusions: nan

Reconstructive Surgery

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Routine Eye Exam (Adult)

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 1.0 Exam(s) per Year

nan

Exclusions: nan

Routine Foot Care

Coverage details pending

nan

Exclusions: nan

Treatment for Temporomandibular Joint Disorders

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Tier 2 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Coverage includes medical care or services to treat dysfunction or TMJS resulting from a medical cause or injury, Office visits for medical evaluation and treatment, X-rays of the temporomandibular joint including contrast studies, but not dental X-rays, Myofunctional therapy and Surgery to the temporomandibular joint, such as condylectomy, meniscectomy, arthrotomy, and arthrocentesis.

Exclusions: nan

Variant attributes

MHP Silver Exchange Rewards · Variant 74917MI0020017-03

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2025

CSR Variation Type

Limited Cost Sharing Plan Variation

HIOS Product ID

74917MI002

Metal Level

Silver

Plan ID (Standard Component ID with Variant)

74917MI0020017-03

Plan Marketing Name

MHP Silver Exchange Rewards

Plan Variant Marketing Name

MHP Silver Exchange Rewards

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

74917

Issuer Marketplace Marketing Name

McLaren Health Plan Community

Market Coverage

Individual

Multiple In Network Tiers

Yes

National Network

No

Network ID

MIN001

Out of Country Coverage

Yes

Out of Country Coverage Description

Emergency only

Out of Service Area Coverage

Yes

Out of Service Area Coverage Description

Emergency only

Service Area ID

MIS001

State Code

MI

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

0.703797942105115

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

0.00%

Drug EHB Deductible, In Network (Tier 2), Default Coinsurance

0.00%

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

No

Medical Drug Maximum Out of Pocket Integrated

Yes

Medical EHB Deductible, In Network (Tier 1), Default Coinsurance

0.00%

Medical EHB Deductible, In Network (Tier 2), Default Coinsurance

50.00%

SBC Scenario, Having a Baby, Coinsurance

$300

SBC Scenario, Having a Baby, Copayment

$0

SBC Scenario, Having a Baby, Deductible

$8,000

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$1,200

SBC Scenario, Having Diabetes, Deductible

$1,900

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$10

SBC Scenario, Treatment of a Simple Fracture, Deductible

$2,800

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

Not Applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$16500 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$8250 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$8,250

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Group

$16500 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Person

$8250 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Individual

$8,250

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

Not Applicable

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

MIF007

Formulary URL

Open link

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$20

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

0

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Drug EHB Deductible, Combined In/Out of Network, Family Per Group

per group not applicable

Drug EHB Deductible, Combined In/Out of Network, Family Per Person

per person not applicable

Drug EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Drug EHB Deductible, In Network (Tier 1), Family Per Group

$0 per group

Drug EHB Deductible, In Network (Tier 1), Family Per Person

$0 per person

Drug EHB Deductible, In Network (Tier 1), Individual

$0

Drug EHB Deductible, In Network (Tier 2), Family Per Group

$0 per group

Drug EHB Deductible, In Network (Tier 2), Family Per Person

$0 per person

Drug EHB Deductible, In Network (Tier 2), Individual

$0

Drug EHB Deductible, Out of Network, Family Per Group

per group not applicable

Drug EHB Deductible, Out of Network, Family Per Person

per person not applicable

Drug EHB Deductible, Out of Network, Individual

Not Applicable

Dental Only Plan

No

Design Type

Not Applicable

EHB Percent of Total Premium

0.9994

First Tier Utilization

36%

Import Date

2024-10-12 20:01:46

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

No

New/Existing Plan

Existing

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

No

Medical EHB Deductible, Combined In/Out of Network, Family Per Group

per group not applicable

Medical EHB Deductible, Combined In/Out of Network, Family Per Person

per person not applicable

Medical EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Medical EHB Deductible, In Network (Tier 1), Family Per Group

$4000 per group

Medical EHB Deductible, In Network (Tier 1), Family Per Person

$2000 per person

Medical EHB Deductible, In Network (Tier 1), Individual

$2,000

Medical EHB Deductible, In Network (Tier 2), Family Per Group

$16000 per group

Medical EHB Deductible, In Network (Tier 2), Family Per Person

$8000 per person

Medical EHB Deductible, In Network (Tier 2), Individual

$8,000

Medical EHB Deductible, Out of Network, Family Per Group

per group not applicable

Medical EHB Deductible, Out of Network, Family Per Person

per person not applicable

Medical EHB Deductible, Out of Network, Individual

Not Applicable

Plan Effective Date

2025-01-01

Plan Level Exclusions

No

Plan Type

HMO

QHP/Non QHP

Both

Second Tier Utilization

64%

Source Name

SERFF

Plan ID

74917MI0020017

Unique Plan Design

No

Wellness Program Offered

No

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Michigan?

MHP Silver Exchange Rewards (74917MI0020017) is a Silver HMO from McLaren Health Plan Community in Michigan for the 2025 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does MHP Silver Exchange Rewards support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is MHP Silver Exchange Rewards HSA-eligible and does it include dental or vision coverage?

It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.

Dental coverage is not listed for this plan.

Vision add-ons: Adult, Child.

Does MHP Silver Exchange Rewards support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Is there out-of-country coverage for MHP Silver Exchange Rewards?

Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Emergency only

Does MHP Silver Exchange Rewards cover care outside the service area?

Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Emergency only

How do I enroll in or manage payments for MHP Silver Exchange Rewards?

Use HealthPorta to shortlist plans, then finish enrollment through Healthcare.gov or your state-based marketplace.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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