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McLaren Medicare Inspire Select (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for McLaren Medicare Inspire Select (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on McLaren Medicare Inspire Select (HMO) in 2026, please refer to our full plan details page.
McLaren Medicare Inspire Select (HMO) is a HMO plan offered by McLaren Health Care Corporation available for enrollment in 2026 to people living in Lower Peninsula of Michigan. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that McLaren Medicare Inspire Select (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about McLaren Medicare Inspire Select (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For McLaren Medicare Inspire Select (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $75.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6750.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The McLaren Medicare Inspire Select (HMO) plan features an annual drug deductible of $615. Under this plan, there is no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs at standard pharmacies or through standard mail order. For Tier 2 generic medications, standard pharmacy copays range from $12 for a one-month supply to $36 for a three-month supply, with a three-month standard mail order costing a $27 copay. For higher-tier medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs and Tier 5 specialty drugs require a 25% coinsurance at standard pharmacies and standard mail order. Tier 4 non-preferred brand drugs carry a 30% coinsurance for both standard pharmacy and standard mail order fills.
Additional Benefits
The McLaren Medicare Inspire Select (HMO) plan offers comprehensive coverage for essential medical services with an emphasis on predictable out-of-pocket costs. Members enjoy no copay and no coinsurance for primary care doctor visits, annual physicals, preventive dental care, and home health services. For hospital care, inpatient stays require a daily copay for the first five days with no copay thereafter, while emergency and outpatient services are covered with flat copayments and no coinsurance. Specialized needs such as routine vision and hearing exams are covered with a standard copay, and select eyewear and over-the-counter items are provided with no copay. Other services, including durable medical equipment, dialysis, and therapeutic radiology, are covered with a 20% coinsurance. Skilled nursing facility care is also accessible with no copay for the first 20 days, followed by a daily copay for longer stays.
Inpatient Hospital See details
McLaren Medicare Inspire Select (HMO) covers inpatient acute hospital stays with no coinsurance and a $550 daily copay for days 1 through 5, followed by no copay for unlimited additional days. Inpatient psychiatric hospital stays are also covered with no coinsurance and a $465 daily copay for days 1 through 5, then no copay for days 6 through 90, though additional psychiatric days and non-Medicare-covered stays are not covered.
Outpatient Services See details
McLaren Medicare Inspire Select (HMO) covers outpatient services with no coinsurance, including a $350 copay for outpatient hospital, observation, and ambulatory surgical center services. Outpatient substance abuse sessions require a $50 copay with no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by McLaren Medicare Inspire Select (HMO) with an $80.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
McLaren Medicare Inspire Select (HMO) covers ground and air ambulance services with a $350 copay and no coinsurance, though prior authorization is required. Routine transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
McLaren Medicare Inspire Select (HMO) covers emergency services with a $115 copay and no coinsurance (waived if admitted) and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent services are partially covered up to a $50,000 lifetime limit with no coinsurance and copays of $115 and $40 respectively, but worldwide emergency transportation is not covered.
Primary Care See details
McLaren Medicare Inspire Select (HMO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $50 copay and no coinsurance. Other services including physical, occupational, and psychiatric therapies are covered with copays ranging from $25 to $50 and no coinsurance, while podiatry and routine chiropractic care are not covered.
Preventive Services See details
McLaren Medicare Inspire Select (HMO) provides partially covered preventive services with no copay and no coinsurance for annual physical exams, kidney disease education, and other routine screenings. However, several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, wigs, weight management, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation, telemonitoring, remote access technologies, home modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by McLaren Medicare Inspire Select (HMO), offering routine hearing exams with a $50 copay, no coinsurance, and no deductible. Prescription hearing aids are also partially covered with a copay ranging from $699 to $999 and no coinsurance for up to two aids every two years, while OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
McLaren Medicare Inspire Select (HMO) offers partially covered vision services, including routine eye exams for a $50 copay and no coinsurance with no deductible, while other eye exam services are not covered. Eyewear is also partially covered with no copay, no coinsurance, and no deductible for contact lenses and complete eyeglasses, but individual frames, lenses, and upgrades are excluded.
Dental Services See details
Dental Services are partially covered by McLaren Medicare Inspire Select (HMO), featuring a $50 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for preventive services up to a $1,500 annual maximum. Covered comprehensive services require no copay with 0% to 50% coinsurance, though other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
McLaren Medicare Inspire Select (HMO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs are covered with no copay and 0% to 20% coinsurance.
Dialysis Services See details
McLaren Medicare Inspire Select (HMO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
McLaren Medicare Inspire Select (HMO) covers durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes and inserts with no copay and a 20% coinsurance. This benefit is partially covered, as diabetic supplies are not covered, and prior authorization is required for covered equipment.
Diagnostic and Radiological Services See details
McLaren Medicare Inspire Select (HMO) partially covers diagnostic and radiological services, requiring prior authorization for all services while lab services are not covered. Diagnostic procedures feature no coinsurance and a copay ranging from $20.00 to $350.00, while radiological services carry a $25.00 copay for X-rays, a minimum $150.00 copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under McLaren Medicare Inspire Select (HMO) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
McLaren Medicare Inspire Select (HMO) covers Cardiac Rehabilitation Services with no coinsurance. Members will pay a $25 copay for cardiac and intensive cardiac rehabilitation services, and a $20 copay for pulmonary rehabilitation and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
McLaren Medicare Inspire Select (HMO) covers skilled nursing facility (SNF) care with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
Other Services under the McLaren Medicare Inspire Select (HMO) are partially covered, offering over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and naloxone are not covered under this benefit.
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