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Medicare Plus Blue PPO Part B Credit (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Medicare Plus Blue PPO Part B Credit (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Medicare Plus Blue PPO Part B Credit (PPO) in 2025, please refer to our full plan details page.
Medicare Plus Blue PPO Part B Credit (PPO) is a PPO plan offered by Blue Cross Blue Shield of Michigan Mutual Ins. Co. available for enrollment in 2025 to people living in State of Michigan. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Medicare Plus Blue PPO Part B Credit (PPO) 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 Medicare Plus Blue PPO Part B Credit (PPO).
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 Medicare Plus Blue PPO Part B Credit (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. Additionally, this plan comes with a Part B Premium reduction of $102.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $600.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 $9000.00 (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 $9000.00 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.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Medicare Plus Blue PPO Part B Credit (PPO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for each prescription, which varies based on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $10 copay at preferred pharmacies, while standard generic drugs have a $45 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs. If you qualify for the low-income subsidy (LIS), your Part D costs are $0.
Additional Benefits
The Medicare Plus Blue PPO Part B Credit (PPO) plan offers a range of benefits, including inpatient hospital stays with a copay, outpatient services with varying copays, and coverage for ambulance and emergency services. The plan also covers primary care with no copay, preventive services, and offers coverage for hearing, vision, and dental services with specific copays and annual maximums. This plan includes coverage for home infusion, dialysis, and medical equipment with copays or coinsurance, and also covers home health services with no copay. Additionally, there are no copays for skilled nursing facility stays for the first 20 days and covers other services like a meal benefit, mobile mental health, and ambulance services.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, there is a $375 copay for days 1-7, and no copay for days 8-90; additional days are covered with no copay. For Inpatient Hospital Psychiatric, there is a $290 copay for days 1-7, and no copay for days 8-90; additional days and non-Medicare covered stays are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services, and Outpatient Blood Services are covered. Outpatient Hospital Services have a $350 copay, Ambulatory Surgical Center (ASC) Services have a $300 copay, and Individual and Group Sessions for Outpatient Substance Abuse have a copay between $55 and $55.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for both ground and air ambulance services with a $360 copay, and also covers transportation services to any health-related location, with one round trip per year via medical transport. Transportation services to plan-approved health-related locations are not covered.
Emergency Services See details
Emergency Services are covered by the Medicare Plus Blue PPO Part B Credit (PPO) plan, with a $110 copay for Emergency Services and Worldwide Emergency Coverage, a $45 copay for Urgently Needed Services and Worldwide Urgent Coverage, and a $360 copay for Worldwide Emergency Transportation. There is no coinsurance for these services.
Primary Care See details
The Medicare Plus Blue PPO Part B Credit (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy with a $35 copay, physician specialist services with a $55 copay, mental health specialty services with a $40 copay for individual and group sessions, physical therapy and speech-language pathology services with a $40 copay, additional telehealth benefits, opioid treatment program services with a $40 copay, and other healthcare professional services with a copay between $0 and $55. This plan does not cover podiatry services.
Preventive Services See details
The Medicare Plus Blue PPO Part B Credit (PPO) plan covers preventive services, including Medicare-covered preventive services, annual physical exams, kidney disease education services, and other preventive services. Some additional preventive services, such as health education, in-home safety assessments, and home and bathroom safety devices, are not covered.
Hearing Services See details
Hearing Services includes routine hearing exams with a copay ranging from $0 to $55, and fitting/evaluation for hearing aids, with a limit of one visit every three years. Prescription hearing aids are covered, with a maximum benefit of $600 per ear every three years, while inner ear, outer ear, and over-the-ear prescription hearing aids, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams, eyewear, and other services. Routine eye exams have no copay, while other eye exam services have a $55 copay. Contact lenses and eyeglass lenses and frames are covered, with a combined maximum benefit of $100 per year for frames or elective contact lenses. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a maximum benefit of $1,000 per year. Oral exams have a copay of $0-$55 and are limited to 2 per year, while dental x-rays, prophylaxis (cleaning), and fluoride treatment are also covered with limitations. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%. Other Medicare Part B Drugs and Medicare Part B Chemotherapy/Radiation Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Medicare Plus Blue PPO Part B Credit (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance of 0% to 20%, Prosthetic Devices with a 20% coinsurance, and Medical Supplies with a 20% coinsurance, but Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. There is no copay for any of these services.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a minimum copay of $0 and a maximum copay of $150, while Lab Services have no copay. Diagnostic Radiological Services have a minimum copay of $150 and a maximum copay of $325, Therapeutic Radiological Services have a copay of $45, and Outpatient X-Ray Services have a copay of $35.
Home Health Services See details
Home Health Services are covered by the Medicare Plus Blue PPO Part B Credit (PPO) plan with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Medicare Plus Blue PPO Part B Credit (PPO) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Medicare Plus Blue PPO Part B Credit (PPO). For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Other Services include a meal benefit with no maximum coverage amount, and services such as mobile mental health with a $40 copay, and ambulance (no transport) with a $90 copay. Acupuncture, over-the-counter items, and several other services are not covered.
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