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Medicare Plus Blue + Meijer (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Medicare Plus Blue + Meijer (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 + Meijer (PPO) in 2026, please refer to our full plan details page.
Medicare Plus Blue + Meijer (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 2026.
It's important to know that Medicare Plus Blue + Meijer (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 + Meijer (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 + Meijer (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $35.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $11.90. 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 $150.00 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 combined Maximum Out-Of-Pocket cost of $6750.00 (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 $6750.00 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 + Meijer (PPO) plan has a drug deductible of $150. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at preferred pharmacies and preferred mail order, whereas standard pharmacies charge a $5 copay for 1 month and a $15 copay for 3 months. Tier 2 generic drugs cost a $7 copay for a 1-month supply at preferred locations, with no copay for a 3-month supply, compared to standard pharmacy copays of $12 for 1 month and $36 for 3 months. Higher-tier medications under this plan require coinsurance rather than flat copays during the initial coverage phase. Tier 3 preferred brands carry a 20% coinsurance and Tier 4 non-preferred drugs carry a 30% coinsurance across all pharmacy and mail order options. For Tier 5 specialty drugs, you will pay a 31% coinsurance for a 1-month supply at both preferred and standard pharmacies.
Additional Benefits
The Medicare Plus Blue + Meijer (PPO) plan offers robust medical coverage with predictable out-of-pocket costs, featuring no coinsurance for inpatient hospital stays, outpatient services, and primary care visits. While primary care and home health services require no copay, inpatient hospital stays carry a $325 daily copay for the first seven days, and specialist visits require a $50 copay. Emergency care is accessible with a $130 copay that is waived upon admission, and urgent care ranges from no copay to a $50 copay. For supplemental care, this plan provides no-copay preventive services, routine hearing exams, and dental care up to a $1,000 annual maximum, along with a $100 allowance for eyewear. Prescription hearing aids require copays ranging from $495 to $1,695, while medical equipment and dialysis services have no copays but require up to a 20 percent coinsurance. Additionally, members benefit from a $60 quarterly over-the-counter allowance and no-copay skilled nursing care for the first 20 days.
Inpatient Hospital See details
Medicare Plus Blue + Meijer (PPO) covers inpatient hospital stays with no coinsurance, requiring a $325 daily copay for days 1 through 7 and no copay for days 8 through 90. While unlimited additional days are covered for acute care, psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Medicare Plus Blue + Meijer (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services at no copay. Outpatient hospital services require a $150 to $375 copay, observation services have a $130 copay per stay, and outpatient substance abuse sessions carry a $50 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Medicare Plus Blue + Meijer (PPO) with a $55.00 copay and no coinsurance. Prior authorization is required for some of these covered services.
Ambulance and Transportation Services See details
Medicare Plus Blue + Meijer (PPO) partially covers ambulance and transportation services, offering Medicare-covered ground and air ambulance services for a $350 copay and no coinsurance. However, routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Medicare Plus Blue + Meijer (PPO) covers emergency services with a $130 copay and no coinsurance, and this copay is waived if you are admitted to the hospital within three days. Urgently needed services have no coinsurance and range from no copay to a $50 copay, while worldwide emergency services are covered up to a $50,000 maximum with copays between $50 and $290 and no coinsurance.
Primary Care See details
Medicare Plus Blue + Meijer (PPO) covers primary care physician services, telehealth, and opioid treatment with no copay and no coinsurance. Specialist visits, physical therapy, and occupational therapy require a $50 copay with no coinsurance, while mental health and psychiatric sessions carry a $20 copay with no coinsurance. Some chiropractic services are covered with a $15 copay and no coinsurance, but routine and other chiropractic services are not covered, and podiatry services are also not covered.
Preventive Services See details
Preventive services are partially covered under Medicare Plus Blue + Meijer (PPO) with no copay and no coinsurance for covered options like annual physicals, kidney disease education, diabetes self-management, and fitness benefits. However, several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, bathroom safety devices, and counseling.
Hearing Services See details
Hearing services offered by Medicare Plus Blue + Meijer (PPO) include one routine hearing exam and fitting evaluation per year with no deductible, no copay, and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $495.00 to $1,695.00 for up to two devices per year, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Medicare Plus Blue + Meijer (PPO), featuring eye exams with a $0 to $50 copay, no coinsurance, and no deductible, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible up to a $100 annual allowance for contacts, standard lenses, and frames, though upgrades and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Medicare Plus Blue + Meijer (PPO) partially covers dental services up to a $1,000 annual maximum benefit for both in-network and out-of-network care. Most covered preventive and comprehensive services, including cleanings, fillings, and root canals, feature no copay and no coinsurance, while Medicare-covered dental services require a $0 to $50 copay and no coinsurance. Orthodontics, maxillofacial prosthetics, and other diagnostic or preventive dental services are not covered.
Home Infusion bundled Services See details
Medicare Plus Blue + Meijer (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs carry a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Medicare Plus Blue + Meijer (PPO) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical Equipment is partially covered by Medicare Plus Blue + Meijer (PPO) with no copays, though prior authorization is required. Covered durable medical equipment and diabetic supplies range from no coinsurance to 20% coinsurance, and prosthetic devices and medical supplies carry a 20% coinsurance, but diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Medicare Plus Blue + Meijer (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. There is no copay for lab services, diagnostic tests range from no copay to a $150 copay, outpatient X-rays and therapeutic radiology have a copay starting at $35, and diagnostic radiology has a minimum copay of $150.
Home Health Services See details
Home health services are covered by Medicare Plus Blue + Meijer (PPO) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Medicare Plus Blue + Meijer (PPO) cardiac rehabilitation services feature no coinsurance, but some services are covered while cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered. These services require copayments ranging from $10 to $15.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered under Medicare Plus Blue + Meijer (PPO) with no coinsurance and no prior three-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, but additional days beyond the standard 100-day limit are not covered.
Other Services See details
Medicare Plus Blue + Meijer (PPO) partially covers other services, including over-the-counter items with no copay and no coinsurance up to $60 every three months. Mobile mental health is covered with a $20 copay and no coinsurance, and ambulance no-transport has a $90 copay and no coinsurance, while acupuncture and meal benefits are not covered.
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