Age or disability combined with low-income status is not an arbitrary predictor of an individual’s ability to make decisions about their health insurance.

But that was the perspective given by one former health insurance executive at a national conference in Chicago last week.

Speaking about people who are dually eligible for both Medicare and Medicaid – people often referred to as ‘duals’ -- a former CEO of a major U.S. health plan stated, “All duals should be mandatorily enrolled [in managed care] almost for their own protection.”

While I don’t want to take the comment out of context, nor attribute this perspective to all health insurance companies, the statement raised my ire.

Older adults and younger persons with disabilities who happen to have a low-income status do not need to be “protected” by auto-enrolling them into an insurance product that may or may not meet their individual needs or desires.

Medicare provides insurance coverage for older adults and younger persons with disabilities. Medicaid provides coverage for people who meet low income criteria. Within both programs there are a variety insurance products and companies that provide that coverage from which to choose.

In many states, managed care is one of those options. It’s been around since the late 1980s.

Throughout the history of managed care, many seniors and younger people with disabilities have found managed care to be a health insurance product that has well met their needs. In other cases, individuals have not found it to be the best option for them.

Like many other things, one-size does not fit all when it comes to health insurance products.

Currently Michigan has a managed care demonstration for people who are dully eligible for both Medicare and Medicaid in four areas of the state. The demonstration area covers the counties of Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, Macomb, St. Joseph, Van Buren, Wayne and every county in the Upper Peninsula. It’s called MI Health Link.

Region IV Area Agency on Aging participates as a partner in that initiative with the two participating insurance companies offering MI Health Link services in Berrien, Cass and Van Buren counties. 

People who live in the demonstration region have a choice to participate in MI Health Link; to choose which of the two different participating insurance companies within MI Health Link in which to enroll; or opt to not participate in MI Health Link and continue with their traditional Medicare and Medicaid health plans.

The choice is theirs. And it should be.

Whether you’re eligible to receive your health insurance through Medicare, Medicaid or both, health insurance choices can indeed be daunting. But there’s help available to sort through options.

The Michigan Medicare/Medicaid Assistance Program (MMAP) is a free health-benefit counseling service provided to Michigan residents who have questions about Medicare, Medicaid, Medicare Supplemental Insurance, Medicare Part D enrollment, Long-Term Care Insurance and related issues.

The goal is to help Michigan’s Medicare beneficiaries find their way through the health benefits maze.

MMAP works through the Area Agencies on Aging across Michigan to provide high quality and accessible health benefit information and counseling, supported by a statewide network of highly trained paid and un-paid counselors.

Counseling services can be provided over the phone or at specific sites in the community. You can find a MMAP counselor near you by calling 800-803-7174 or by visiting

Armed with information, you can take control of your own health insurance decisions.