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HMO Accreditation Information

HMO Accreditation Information

Below is a list of HMOs in Michigan that are accredited by an accreditation organization. The accreditation information is current as of 12/16/21.

For additional information about the accrediting organization, its accreditation processes, and current accreditation status of an HMO, visit the organization's website. Michigan HMOs not listed are not accredited.

NCQA has changed its rating system. HMOs are either Accredited or not, and a star rating has been added. For more detailed information go to: https://reportcards.ncqa.org

Lines of Business
Some HMOs may be listed more than once as they have different lines of business.

  • Commercial: private health care plans not paid for by the government.
  • Marketplace: as part of the Affordable Care Act, the federal government set up Health Insurance Marketplaces (also called Exchanges) where individuals and small groups can shop for health care coverage and compare plans offered by private health care companies.
  • Medicaid: a joint federal and state program that helps eligible low-income individuals or families pay for health care costs.
  • Medicare: a federal program that provides health insurance for individuals aged 65 or higher and those with certain disabilities.
National Committee for Quality Assurance (NCQA)
HMO Line of Business NCQA
Accredited		 Star Rating
(Out Of 5)		 Expiration Date
Aetna Better Health of Michigan Medicaid Yes 3 06/04/24
Blue Care Network of Michigan Commercial Yes 4.5 06/14/22
Blue Care Network of Michigan Marketplace Yes N/A 06/14/22
Blue Care Network of Michigan Medicare Yes 4 06/14/22
Blue Cross Complete of Michigan Medicaid Yes 3.5 05/20/23
HAP Midwest Health Plan Medicaid Yes 3.5

04/19/22
Health Alliance Plan of Michigan Commercial Yes 4 04/19/22
Health Alliance Plan of Michigan Medicare Yes 4 04/19/22
McLaren Health Plan Medicaid Yes 3.5 04/23/24
McLaren Health Plan Community Commercial Yes 3.5 04/23/24
McLaren Health Plan Community Marketplace Yes N/A 04/23/24
Meridian Health Plan of Michigan, Inc. Marketplace Yes N/A 09/27/22
Meridian Health Plan of Michigan, Inc. Medicaid Yes 4 09/27/22
Molina Healthcare of Michigan Marketplace Yes N/A 06/27/23
Molina Healthcare of Michigan Medicaid Yes 3.5 06/27/23
Paramount Care Medicare Provisional-
Under
Corrective
Action		 4 06/21/22
Priority Health Commercial Yes 4.5 09/26/23
Priority Health Marketplace Yes N/A 09/26/23
Priority Health Medicare Yes 4.5 09/26/23
Total Health Care, Inc. Medicaid Yes 3.5 05/31/22
Total Health Care USA, Inc. HMO Marketplace Yes N/A 05/31/22
Total Health Care USA, Inc. HMO/POS Commercial Yes 3 05/31/22
United Healthcare Community Plan Medicaid Yes 3.5 10/11/22
Upper Peninsula Health Plan Medicaid Yes 4.5 11/07/23

Utilization Review Accreditation Commission (URAC)
HMO Line of Business URAC Accreditation Level Expiration Date
Physicians Health Plan Commercial Full Accreditation 07/01/24
Physicians Health Plan Marketplace Full Accreditation 07/01/24