Affordable individual and family coverage
Plans that meet you or your family's needs.
HAP individual and family plans
HAP offers a variety of HMO and PPO plans to fit your budget. Both types of plans focus on preventive care and reducing your health care costs.
HAP 2021 plans - costs at a glance
| HAP Individual Silver Plans |
HMO 3200 HMO HFC* 3200 HMO GC** 3200 PPO 3200 |
HMO VCP 3500*** | ||
|---|---|---|---|---|
| Deductible (individual/family) | $3,200/$6,400 |
$3,500/$7,000 | ||
| Coinsurance | 30% | 30% | ||
| Out-of-pocket limit | $8,550/$17,100 | $8,500/$17,100 | ||
| Telehealth/ PCP/ specialty visit | $0/$30/$45 | Telehealth: Virtual visit covered (through HFHS) PCP: Virtual visit covered, Office visit $70 copay Spec: Virtual visit covered, Office visit $85 copay |
||
| Emergency room/ urgent care | ER: 30% coinsurance UC: $65 |
ER: 30% coinsurance UC: Virtual visit covered, Office visit $65 copay |
||
| Prescription copay (generic drug purchased at a preferred pharmacy) |
$5 | $5 | ||
| HAP Individual Bronze plans |
HMO 7000 HMO HFC* 7000 HMO GC** 7000 PPO 7000 |
HMO 6900 (HSA) HMO HFC* 6900 (HSA) HMO GC** 6900 (HSA) PPO 6900 (HSA) |
HMO 8550 HMO HFC* 8550 HMO GC** 8550 PPO 8550 |
HMO VCP 7500*** | ||
|---|---|---|---|---|---|---|
| Deductible (individual/ family) | $7,000/$14,000 |
$6,900/$13,800 | $8,550/$17,100 | $7,500/$15,000 | ||
| Coinsurance | 40% | 0% | 0% | 40% | ||
| Out-of-pocket limit | $8,550/$17,100 | $6,900/$13,800 | $8,550/$17,100 | $8,550/$17,100 | ||
| Telehealth/ PCP/ specialty visit | $0/$55/$85 | Covered after deductible | $0/$50/ covered after deductible | Telehealth: Virtual visit covered (through HFHS) PCP: Virtual visit covered, Office visit $80 copay Spec: Virtual visit covered, Office visit $100 copay |
||
| Emergency room/ urgent care | 40% coinsurance after deductible | Covered after deductible | Covered after deductible | ER: 40% coinsurance UC: Virtual visit covered, Office visit 40% coinsurance |
||
| Prescription copay (generic drug purchased at a preferred pharmacy) |
$10 | Covered after deductible | $10 | $10 | ||
| HAP Catastrophic plans *Plans are available only to individuals under the age of 30, unless they qualify for a hardship exemption. |
HMO Catastrophic 8550 HMO Catastrophic HFC 8550 HMO Catastrophic GC 8550 PPO Catastrophic 8550 |
||
|---|---|---|---|
| Deductible (individual/ family) | $8,550/$17,100 |
||
| Coinsurance | 0% | ||
| Out-of-pocket limit | $8,550/$17,100 | ||
| Telehealth/ PCP/ specialty visit | Telehealth: covered after deductible PCP: Fully covered for first three visits, all other visits covered after deductible Specialist: covered after deductible |
||
| Emergency room/ urgent care | Covered after deductible | ||
| Prescription copay (generic drug purchased at a preferred pharmacy) |
Covered after deductible | ||
*HFC = Henry Ford Choice
**GC = Genesys Choice
***HFHS Virtual Care with a $0 Cost Share
- Video visit on demand: a video chat with a Henry Ford doctor 24/7 through your mobile device or computer.
- Scheduled video visit: a video appointment scheduled with your Henry Ford doctor for routine or follow-up care.
- Clinic to clinic scheduled video visit: a scheduled appointment at a local clinic where a Henry Ford team member helps to connect you by secure video to a specialist at another location.
- E-Visit: send your non-urgent symptoms through a secure patient portal online form to your Henry Ford doctor.
Learn more about Henry Ford Health System Virtual Care.
HAP 2021 Virtual Care Plans Individual Group flyer
Important information for you to know about Virtual Care:
- Henry Ford Health System affiliated providers: $0 copay for virtual care
- Not all Henry Ford affiliated providers offer virtual care services. And not all services can be performed virtually.
- While traveling outside the state of Michigan, members can take advantage of HAP's contracted rate with Amwell (American Well to provide urgent telehealth services.
*Exact copay may vary. Review plan details for specific cost share.
Download the full 2021 HAP Qualified Health Plan Summary
HAP Individual plan overview
HMO health insurance plans
HMO plans tend to be more affordable than PPO plans. You need to select a primary care physician from HAP’s network of providers. Your PCP will manage your health care services. When you need to see a specialist, your PCP will coordinate your care.
HAP HMO Choice network plans
HAP also offers choice networks which give you access to quality care from a select group of doctors. This type of plan allows you to enjoy lower monthly premiums because it’s easier for your PCP to coordinate your care.
Henry Ford Choice plan highlights
- Access to more than 1,400 doctors in Henry Ford network
- Save as much as 12 percent on monthly premiums with Henry Ford Choice network plan
- Available for residents of Macomb, Oakland and Wayne county
- You will need to select a PCP from the Henry Ford network and see a Henry Ford doctor if you need specialty care
Genesys Choice plan highlights
- Access to leading mid-Michigan doctors and specialists within Genesys Regional Medical Center
- More affordable premiums
- Available for residents of Genesee county
- You will need to select a PCP from the Genesys Choice network and see a Genesys network doctor if you need specialty care
PPO health insurance plans
PPO plans offer more choice and flexibility. You don’t need to have a PCP, and you can seek care from providers within or outside of the network without referrals. Out-of-network care will cost more, however.
Health plans with a health savings account
Our HSA plans are coupled with a health savings account to help you pay for out-of-pocket costs. These plans have higher deductibles but lower premiums. You’ll pay less each month on your monthly premium. You will pay more out-of-pocket each time you get care.
The health savings account allows you to set aside pretax money to pay for your health care costs. You can use this money through a plan-provided debit care and any unused money rolls over into the next benefit period as long as you are enrolled in an HAS plan.
Plan highlights:
- Great option if you are generally healthy, and only plan to see a doctor one or twice a year
- Preventive services are covered at no cost to you
- Pay for health care expenses with pre-tax dollars, saving you money
Catastrophic health insurance plans
If you are under the age of 30, we offer something called a catastrophic plan. This type of plan has a low premium, but a high deductible. It’s designed for people under 30 who are generally healthy and only seek care a handful of times a year. If that sounds like you, a catastrophic plan may be a great option.
HAP individual and family plan service area
HMO network – you must reside and seek care in the 20 county service area
PPO network – you must reside and seek care in the 23 county service area
Henry Ford Choice network – you must reside and seek care in Macomb, Oakland and Wayne counties
Genesys Choice network – you must reside and seek care in Genesee county