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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 2025, 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 2025.
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 $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $3.00. 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 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 $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 an "Enhanced Alternative" drug benefit type and a $0 deductible. During the initial coverage phase, you will pay a copay for your prescriptions. For preferred generic drugs, the copay is $11 at preferred pharmacies and $20 at standard pharmacies. For standard generic drugs, the copay is $42 at preferred pharmacies and $47 at standard pharmacies. For preferred brand drugs, you will pay 50% coinsurance. For non-preferred drugs, you will pay 33% coinsurance. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase where you will pay nothing for your drugs.
Additional Benefits
The Medicare Plus Blue + Meijer (PPO) plan offers a range of benefits, including inpatient hospital stays with varying copays, outpatient services with a $375 copay, and no copay for ambulatory surgical center services. The plan also covers emergency services with a $125 copay and primary care services with copays ranging from $15 to $50. Additionally, the plan includes coverage for preventive services, hearing exams with no copay, and vision services with copays between $0 and $50 for eye exams. This plan provides dental services with no copay for oral exams, and a $1,500 annual maximum benefit. It also includes coverage for home infusion bundled services, dialysis services, medical equipment, and diagnostic services with varying copays. Home health services and skilled nursing facility services are covered with no copay for the first 20 days. There is also an allowance for over-the-counter items and a meal benefit for chronic illnesses.
Inpatient Hospital See details
Inpatient Hospital-Acute has a copay of $425 for days 1-7, and no copay for days 8-90. Inpatient Hospital Psychiatric has a copay of $300 for days 1-7, and no copay for days 8-90. Additional Days for Inpatient Hospital-Acute is covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a $375 copay, observation services, and ambulatory surgical center (ASC) services with no copay. Outpatient substance abuse services are covered with a copay of $50 for both individual and group sessions, and outpatient blood services are covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Medicare Plus Blue + Meijer (PPO) plan, with a $50 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Medicare Plus Blue + Meijer (PPO) plan. Ground and air ambulance services have a $350 copay, with no coinsurance. Transportation Services to any health-related location are covered for 1 round trip per year. Transportation services to plan-approved health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Medicare Plus Blue + Meijer (PPO) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a $55 copay, and Worldwide Emergency Transportation has a $290 copay, with a maximum plan benefit of $50,000.
Primary Care See details
The Medicare Plus Blue + Meijer (PPO) plan covers primary care physician services, chiropractic services with a $15 copay, occupational therapy services with a $40 copay, physician specialist services with a $50 copay, and mental health specialty services with a $20 copay for individual and group sessions. The plan also covers other health care professionals with a copay between $0 and $50, psychiatric services with a $20 copay for individual and group sessions, physical therapy and speech-language pathology services with a $40 copay, additional telehealth benefits, and opioid treatment program services. Podiatry services are not covered.
Preventive Services See details
Preventive Services are covered, including Medicare-covered services, annual physical exams, and additional preventive services. Some additional services like Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
Hearing Services include hearing exams, with no copay for routine hearing exams and fitting/evaluation for hearing aids. Prescription hearing aids are covered up to $750 per ear every three years, while inner ear, outer ear, and over the ear prescription hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a copay between $0 and $50, with routine eye exams having no copay. Eyewear has a $150 combined maximum benefit for frames and elective contact lenses, with eyeglass frames and lenses covered.
Dental Services See details
Dental Services with Medicare Plus Blue + Meijer (PPO) includes coverage for oral exams with no copay, up to 2 per year, and dental x-rays, once every 2 years, with a copay between $0 and $50. Other covered services include cleaning, fluoride treatment, restorative services, endodontics, periodontics, and oral and maxillofacial surgery with varying limitations; however, maxillofacial prosthetics and orthodontics are not covered. The plan has a maximum benefit of $1,500 per year for both in-network and out-of-network services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B insulin drugs, you will pay a $35 copay, and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by Medicare Plus Blue + Meijer (PPO) with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 0-20% coinsurance and no copay, and Prosthetics/Medical Supplies with a 20% coinsurance and no copay. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a copay required for all diagnostic and radiological services, but the maximum copay applies if multiple services are received at the same location on the same day. Diagnostic Procedures/Tests have a copay between $0 and $150, Lab Services have no copay, Diagnostic Radiological Services have a copay between $150 and $250, Therapeutic Radiological Services have a $35 copay, and Outpatient X-Ray Services have a $35 copay.
Home Health Services See details
Home Health Services are covered by the Medicare Plus Blue + Meijer (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 + Meijer (PPO) plan. Specifically, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Medicare Plus Blue + Meijer (PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Medicare Plus Blue + Meijer (PPO) plan covers a $160 allowance every three months for over-the-counter items, and also covers a meal benefit for chronic illnesses. Other services are partially covered, with a $20 copay for mobile mental health and a $90 copay for ambulance services (no transport). Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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