DIFS Recommends Priority Health HMO Plan Continue as Michigan’s EHB Benchmark Health Insurance Plan For 2022
The Affordable Care Act (ACA) requires each state to select an Essential Health Benefits (EHB) benchmark plan to serve as a reference for all other individual and small business health plans to follow.
The EHB plan is intended to reflect both the scope of services and quantitative limits on those services by a “typical employer plan” in the State. This is the third time
“Remaining the designated benchmark plan in the state is a reflection of how we take care of our members,” said
In selecting the new benchmark plan for 2022, the
- Coverage of at least one intranasal spray opioid reversal agent when prescriptions of opioids are dosages of 50MME or higher.
- Removal of barriers to prescribing buprenorphine or generic equivalent products for medication-assisted treatment of opioid use disorder.
The selected EHB benchmark plan must provide benefits in 10 categories defined by DIFS. The categories are: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services (including behavioral health treatment), prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventative and wellness services and chronic disease management, and pediatric services (including oral and vision care). Small business and individual market plans – offered both on and off HealthCare.gov – must meet the benefit standard set by the EHB benchmark plan.
Additional information regarding Michigan’s current EHB benchmark plan and the updates for the 2022 plan year are available online at the DIFS EHB Information webpage.
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