Choosing a plan · Networks
HMO or PPO on Michigan’s Marketplace: what you get and what it costs
The network type decides which doctors you can see and what happens if you go outside it. In Michigan, the choice is narrower than most people expect.
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- 99 HMO plans
- 9 PPO plans
- Check your doctors
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Michigan’s 2026 mix
- HMO: 99 plans. PPO: 9 plans, all from Blue Cross Blue Shield of Michigan Mutual Insurance Company, available in 83 of 83 counties. EPO: 8 plans, in 4 counties (Kent, Muskegon, Oceana, Ottawa).[2]
- An EPO covers services only from in-network doctors, specialists and hospitals, except in an emergency.[1]
- An HMO may require you to live or work in its service area.[1]
What the flexibility cost in 2026
Lowest full-price Silver HMO vs. lowest Silver PPO, age 40, non-smoker, before tax credits:[2]
| County | Lowest Silver HMO | Lowest Silver PPO | PPO costs more by |
|---|---|---|---|
| Kent | $511.03 | $965.85 | $454.82 |
| Wayne | $507.63 | $764.92 | $257.29 |
| Oakland | $502.68 | $764.84 | $262.16 |
| Ingham | $444.69 | $776.60 | $331.91 |
| Calhoun | $446.37 | $787.73 | $341.36 |
| Marquette | $769.09 | $914.31 | $145.22 |
CMS plan year 2026 file.[2] 2027 prices come out November 1.[3]
How to decide
- List the doctors and hospitals you want to keep, and check them in each plan; HealthCare.gov shows whether each plan covers them in network.[4]
- If they’re in an HMO’s network, price the HMO first: in all 6 counties above, the lowest Silver HMO cost less than the lowest Silver PPO in 2026.[2]
- If you split time between places or see out-of-network specialists, price the PPO.
Your premium tax credit is figured from the benchmark Silver plan in your area, not from the plan you pick.[5] See insurers by county and picking a plan with a chronic condition.
Sources
- HealthCare.gov, Health insurance plan & network types: HMOs, PPOs, and more. https://www.healthcare.gov/choose-a-plan/plan-types/
- CMS, QHP Landscape Individual Market Medical file, plan year 2026 (HealthCare.gov states), Michigan rows. https://data.healthcare.gov/datafile/py2026/individual_market_medical.zip
- HealthCare.gov, Dates and deadlines. https://www.healthcare.gov/quick-guide/dates-and-deadlines/
- HealthCare.gov, 3 things to know before you pick a health insurance plan. https://www.healthcare.gov/choose-a-plan/comparing-plans/
- IRS, Questions and answers on the premium tax credit. https://www.irs.gov/affordable-care-act/individuals-and-families/questions-and-answers-on-the-premium-tax-credit
Checked October 16, 2026. 2027 Marketplace plans and final 2027 rates aren’t published yet; we’ll update this page when they are.
Frequently asked questions
Are most Michigan Marketplace plans HMOs?
Yes. In 2026, 99 of 116 Marketplace plans in Michigan were HMOs, 9 were PPOs and 8 were EPOs.
Who sells PPO plans on Michigan's Marketplace?
In 2026, all 9 Marketplace PPO plans were from Blue Cross Blue Shield of Michigan Mutual Insurance Company, available in all 83 counties.
Does a PPO cover out-of-network doctors?
Yes, for an additional cost and without a referral. You pay less if you use providers in the plan's network.
Will you sell my information?
No. Your information goes to Nexus Benefit Solutions only and is never sold.