Application for Individual Coverage

Who is this for?

Michigan Health Insurance – Customer Service – Documents and Forms

If you live in Michigan and you're ready to apply for one of our individual and family plans, this page can help you apply online or by mail. 

Online Application

Ready to sign up for one of our individual and family plans? Applying online is usually the best way to sign up.

You can apply during open enrollment, Nov. 1, 2016, to Jan. 31, 2017. If you missed open enrollment, you can see if you're eligible for special enrollment. If you'd like to lower your costs, you can see if you're eligible for a subsidy

Mail application

For 2017 plans, you have the option to print the application, fill it out and mail it in.  

Please note: If you're applying for a plan using a subsidy or applying for a multi-state plan, you can apply online or by calling a health plan advisor at 1-855-237-3501.

For 2016 plans: If you're applying for the remainder of 2016, please use the 2016 application

To apply, you'll need:

  • A social security number or tax ID number and date of birth for everyone who'll be covered by the plan
  • A credit card if you want to make your first payment

If you're printing the application, you'll need: 

  • A printer
  • An envelope and postage to mail the form