Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Zing Open Choice MI (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Zing Open Choice MI (PPO) in 2026, please refer to our full plan details page.
Zing Open Choice MI (PPO) is a PPO plan offered by Zing Health Consolidator, Inc available for enrollment in 2025 to people living in Southeast Michigan. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Zing Open Choice MI (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Below are a few key facts and commonly-asked questions about Zing Open Choice MI (PPO).
The cost of a Medicare Advantage Plan is made up of four main parts.
For Zing Open Choice MI (PPO), 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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $8950.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $8950.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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.
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The Zing Open Choice MI (PPO) Medicare plan features a $0 drug deductible, meaning your prescription coverage begins immediately. For Tier 1 preferred generic drugs, you will pay no copay at standard pharmacies and through standard mail order. Tier 2 generic drugs also have no copay when ordered through standard mail order, while filling them at a standard pharmacy costs an $8 copay for a one-month supply. Tier 3 preferred brand drugs require a $47 copay for a one-month supply at standard pharmacies or standard mail order, with cost-saving options available on three-month mail orders. Higher-tier medications are subject to coinsurance, with Tier 4 non-preferred drugs requiring 25% coinsurance and Tier 5 specialty drugs requiring 33% coinsurance for a one-month supply. This plan offers a clear and structured approach to managing your prescription medication expenses.
The Zing Open Choice MI (PPO) plan offers robust medical coverage with predictable out-of-pocket costs, featuring no copays or coinsurance for primary care visits and preventive services. Specialist visits require a low $20 copay, while inpatient hospital stays carry a $310 daily copay for the first six days and no copay for days seven through 90. Outpatient hospital services require a $250 copay, and emergency care is covered with a $125 copay that is waived upon admission. Supplemental care is also highly accessible, offering preventive and comprehensive dental services with no copay up to a $2,000 annual limit, alongside routine vision coverage with no copay and a $200 eyewear allowance. Routine hearing exams have no copay, and the plan covers prescription hearing aids up to $750 per ear every three years. Additionally, members receive no-copay skilled nursing facility care for the first 20 days and a $120 quarterly allowance for over-the-counter items.
Zing Open Choice MI (PPO) covers inpatient acute and psychiatric hospital services with no coinsurance, requiring a $310 daily copay for days 1 through 6 and no copay for days 7 through 90. Acute care includes unlimited additional days at no copay, but the benefit is only partially covered as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Zing Open Choice MI (PPO) covers outpatient services with no coinsurance, featuring a $250 copay for outpatient hospital services, a $75 copay per stay for observation services, and a $225 copay for ambulatory surgical center services. Outpatient substance abuse and blood services are covered with no copay and no coinsurance.
Zing Open Choice MI (PPO) covers partial hospitalization services with a $70 copay and no coinsurance, although prior authorization is required.
Zing Open Choice MI (PPO) covers ground ambulance services with a $225 copay and coinsurance, and air ambulance services with a 20% coinsurance and copay, with prior authorization required for both. Routine transportation services to health-related locations are not covered under this plan.
Zing Open Choice MI (PPO) covers emergency services with a $125 copay and no coinsurance (waived if admitted to the hospital within 24 hours), and urgently needed services with a $0 to $20 copay and no coinsurance. Worldwide emergency and urgent services are partially covered up to a $50,000 maximum with no copays or coinsurance, though worldwide emergency transportation is not covered.
Zing Open Choice MI (PPO) covers primary care, mental health, and psychiatric services with no copay and no coinsurance, while specialist visits require a $20 copay and no coinsurance. Physical, occupational, and speech therapies have a $40 copay and no coinsurance, and podiatry services carry a $30 copay and no coinsurance. Some chiropractic services are covered with a $15 copay and no coinsurance, although routine and other chiropractic care are not covered.
Preventive services are partially covered under the Zing Open Choice MI (PPO) plan, featuring no copay and no coinsurance for covered services like annual physicals, kidney disease education, and select fitness, nutritional, and remote access benefits. However, several services are not covered, including health education, personal emergency response systems (PERS), weight management programs, and in-home support services.
Zing Open Choice MI (PPO) covers hearing services, featuring a $35 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine hearing exams and fitting evaluations. Prescription hearing aids are partially covered with no copay or coinsurance up to a $750 maximum per ear every three years, though OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Zing Open Choice MI (PPO) covers routine eye exams and eyewear with no copay, no coinsurance, and no deductible, including a $200 annual maximum for eyewear. Other eye exams require a $35 copay with no coinsurance, while eyewear upgrades and other eye exam services are not covered.
Dental services are partially covered by Zing Open Choice MI (PPO), offering covered preventive and comprehensive care with no copay and no coinsurance up to a $2,000 annual limit. This benefit does not cover other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, implant services, or orthodontics.
Zing Open Choice MI (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, covered Medicare Part B chemotherapy, radiation, and other drugs require a coinsurance ranging from no coinsurance up to 20%, while Part B insulin drugs require a $35 copay and up to 20% coinsurance.
Dialysis services are covered by the Zing Open Choice MI (PPO) plan with no copay and a 20% coinsurance.
Zing Open Choice MI (PPO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and a standard 20% coinsurance. Diabetic supplies range from no coinsurance to 20% coinsurance, and prior authorization is required for all covered equipment.
Diagnostic and radiological services are covered by Zing Open Choice MI (PPO) with prior authorization required. Diagnostic services feature no coinsurance, offering lab tests with no copay and diagnostic procedures with a copay ranging from $0 to $85, while radiological services require a $15 copay for X-rays, a minimum $50 copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services are covered under the Zing Open Choice MI (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Zing Open Choice MI (PPO) covers Cardiac Rehabilitation Services with no copay and no coinsurance, requiring prior authorization. While some services are covered, cardiac rehabilitation, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered in practice.
Zing Open Choice MI (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $214 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Zing Open Choice MI (PPO) partially covers other services, providing eligible members with over-the-counter (OTC) items up to $120 every three months and chronic illness meal benefits with no copay and no coinsurance, though acupuncture is not covered.
SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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