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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 $22.70. 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 features a $150 annual drug deductible. Under this plan, you will pay no copay for Tier 1 preferred generic drugs when using a preferred pharmacy or preferred mail order service for either a 1-month or 3-month supply. For Tier 2 generic drugs, you can also enjoy no copay on a 3-month supply at preferred locations, or pay a low $7 copay for a 1-month supply. For brand-name and specialty medications, costs transition to coinsurance percentages across all standard and preferred pharmacies. Tier 3 preferred brand drugs require a 20% coinsurance, while Tier 4 non-preferred drugs carry a 30% coinsurance for both 1-month and 3-month supplies. Specialty medications in Tier 5 require a 31% coinsurance for a 1-month supply, regardless of the pharmacy type you choose.
Additional Benefits
The Medicare Plus Blue + Meijer (PPO) plan offers comprehensive coverage with predictable out-of-pocket costs, featuring no copays and no coinsurance for primary care visits, preventive care, and home health services. For inpatient hospital stays, members pay a daily copay of $325 for the first seven days and no copay for days eight through 90, with no coinsurance. Outpatient hospital visits require a copay of $150 to $375, while emergency room care carries a $130 copay, both with no coinsurance. Ancillary benefits include routine hearing exams and preventive dental care with no copays and no coinsurance, alongside a $1,000 annual dental maximum. Vision benefits include routine exams for no copay to a $50 copay and an annual $100 eyewear allowance with no copay. Additionally, the plan provides a $60 quarterly over-the-counter allowance with no copay, while dialysis services and durable medical equipment carry up to a 20% coinsurance.
Inpatient Hospital See details
Medicare Plus Blue + Meijer (PPO) provides coverage for inpatient acute and psychiatric hospital stays with no coinsurance, featuring a $325 daily copay for days 1 through 7 and no copay for days 8 through 90. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Medicare Plus Blue + Meijer (PPO) covers outpatient services with no coinsurance, including outpatient hospital visits for a $150 to $375 copay and observation services for a $130 copay per stay. Ambulatory surgical center and outpatient blood services are available with no copay and no coinsurance, while outpatient substance abuse sessions require a $50 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under Medicare Plus Blue + Meijer (PPO) with a $55.00 copay and no coinsurance, although prior authorization may be required for some services.
Ambulance and Transportation Services See details
Medicare Plus Blue + Meijer (PPO) covers ground and air ambulance services with a $350 copay and no coinsurance per service. 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 (waived if admitted within 3 days) and no coinsurance, and urgently needed services with no copay to a $50 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum with no coinsurance and copays of $130, $50, and $290 respectively.
Primary Care See details
Medicare Plus Blue + Meijer (PPO) covers primary care, telehealth, and opioid treatment with no copay and no coinsurance, while podiatry services are not covered. Other services feature no coinsurance, costing a $50 copay for specialists and therapy services, a $20 copay for mental health and psychiatric sessions, and chiropractic services are partially covered with a $15 copay, excluding routine and other chiropractic services.
Preventive Services See details
Preventive services are partially covered under the Medicare Plus Blue + Meijer (PPO) plan with no copay and no coinsurance for covered care, including annual physical exams, glaucoma screenings, and fitness benefits. While many standard screenings are included, several supplemental services such as health education, weight management programs, and personal emergency response systems are not covered.
Hearing Services See details
Medicare Plus Blue + Meijer (PPO) partially covers hearing services, featuring routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered with no coinsurance and copays ranging from $495 to $1,695, but OTC devices and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Medicare Plus Blue + Meijer (PPO) offers partially covered vision services with no deductibles, featuring one routine eye exam per year for a $0 to $50 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay or coinsurance up to a $100 annual limit for contacts, lenses, and frames, but upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Medicare Plus Blue + Meijer (PPO) offers partially covered dental services with a $1,000 annual maximum benefit for in-network and out-of-network care, featuring no copay and no coinsurance for covered preventive and comprehensive services like cleanings, fillings, and root canals. Medicare-covered dental services require a $0 to $50 copay and no coinsurance, while other diagnostic, other preventive, maxillofacial prosthetics, and orthodontic 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. Associated Medicare Part B drugs, including chemotherapy and insulin, carry no coinsurance to 20% coinsurance, with a copay of up to $35 for insulin.
Dialysis Services See details
Medicare Plus Blue + Meijer (PPO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Medicare Plus Blue + Meijer (PPO) partially covers medical equipment with no copay for all covered items, though prior authorization is required. Durable medical equipment and diabetic supplies feature no coinsurance to 20% coinsurance, and prosthetics and medical supplies carry a 20% coinsurance, while diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Medicare Plus Blue + Meijer (PPO) with no coinsurance, though prior authorization is required. There is no copay for lab services, a $0 to $150 copay for diagnostic procedures, a $35 copay for X-rays and therapeutic radiology, and a $150 copay for diagnostic radiology.
Home Health Services See details
Medicare Plus Blue + Meijer (PPO) covers Home Health Services with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Medicare Plus Blue + Meijer (PPO) plan, with no coverage or cost-sharing benefits provided for standard cardiac, intensive cardiac, pulmonary, or SET for PAD services.
Skilled Nursing Facility (SNF) See details
Medicare Plus Blue + Meijer (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a three-day prior hospital stay is not necessary, and additional days beyond the standard 100 days are not covered.
Other Services See details
Medicare Plus Blue + Meijer (PPO) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance up to $60 every three months, mobile mental health with a $20 copay and no coinsurance, and non-transport ambulance services with a $90 copay and no coinsurance. Acupuncture, meal benefits, and dual-eligible SNP services are not covered.
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