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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. This plan has a $0 deductible. In the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy type. For example, preferred generic drugs have an $11 copay at a preferred pharmacy, and preferred brand drugs have 50% coinsurance. After your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Medicare Plus Blue + Meijer (PPO) plan offers a range of benefits, including coverage for inpatient hospital stays with varying copays depending on the length of stay, and outpatient services with copays for specific services. You'll find coverage for emergency and urgent care services, with copays for both in-network and worldwide services. Additional benefits include coverage for primary care, preventive services, and hearing and vision services. Dental services are also covered, with a maximum annual benefit, along with home infusion and dialysis services. The plan also covers medical equipment, diagnostic and radiological services, and home health services.
Inpatient Hospital See details
Inpatient Hospital-Acute has a copay of $425 for days 1-7, and no copay for days 8-90; additional days are covered with no copay. Inpatient Hospital Psychiatric has a copay of $300 for days 1-7, and no copay for days 8-90; additional days and non-Medicare stays are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, and outpatient substance abuse services, are covered. Outpatient hospital services have a $375 copay, while Ambulatory Surgical Center (ASC) Services have no copay. Individual and group sessions for outpatient substance abuse have a copay between $50 and $50.
Partial Hospitalization See details
Partial Hospitalization is covered under the Medicare Plus Blue + Meijer (PPO) plan, with a $50 copay. Prior authorization is required.
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 each have a $350 copay, and there is no coinsurance. Transportation Services to any health-related location are covered for one round trip per year. Transportation Services to plan-approved health-related locations are not covered.
Emergency Services See details
Emergency Services are covered by Medicare Plus Blue + Meijer (PPO), with a $125 copay and no coinsurance. Urgently Needed Services have a copay between $0 and $55, and no coinsurance. Worldwide Emergency Services are covered, with a copay of $125 for Worldwide Emergency Coverage, $55 for Worldwide Urgent Coverage, and $290 for Worldwide Emergency Transportation, and no coinsurance.
Primary Care See details
The Medicare Plus Blue + Meijer (PPO) plan covers primary care physician services, chiropractic services with a $15 copay, occupational therapy with a $40 copay, physician specialist services with a $50 copay, mental health specialty 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. Other health care professional services have a copay that ranges from $0 to $50. Psychiatric services are covered with a $20 copay for individual and group sessions.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams, additional preventive services, kidney disease education, and other preventive services such as glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and several other services are not covered.
Hearing Services See details
The Medicare Plus Blue + Meijer (PPO) plan covers hearing exams with no copay, as well as routine hearing exams (1 per year) and fitting/evaluation for hearing aids (1 every three years) with no copay. Prescription hearing aids are covered up to $750 every three years. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered, 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, and other eye exam services have a $50 copay. Eyewear has a combined maximum benefit of $150 per year, which applies to both in-network and out-of-network services and includes contact lenses, eyeglass lenses, and eyeglass frames. Eyeglasses are not covered, and upgrades are not covered.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a copay of $0-$50, and other dental services with a maximum benefit of $1500 per year. Oral exams are covered for 2 visits per year, dental x-rays are covered once every 2 years, prophylaxis (cleaning) is covered for 2 visits per year, and fluoride treatment is covered once per year. Restorative services, endodontics, periodontics, and oral and maxillofacial surgery are also covered with visit limits, while maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Medicare Plus Blue + Meijer (PPO) plan, with a $35 copay for Medicare Part B Insulin Drugs and coinsurance between 0% and 20% for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs. Prior authorization is required for coverage.
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 are covered by Medicare Plus Blue + Meijer (PPO), including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, though Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. DME has no copay and 0-20% coinsurance, while Prosthetic Devices and Medical Supplies have no copay and 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $150, while Lab Services have no copay. Diagnostic Radiological Services have a copay between $150 and $250, Therapeutic Radiological Services have a copay of $35, and Outpatient X-Ray Services have a $35 copay.
Home Health Services See details
Home Health Services are covered by Medicare Plus Blue + Meijer (PPO) with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by this plan. Some services are covered, including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services, but all of these services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Medicare Plus Blue + Meijer (PPO), but require prior authorization. For days 1-20, there is no copay, but for days 21-100, there is a $214 copay.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) items, with a maximum benefit of $160.00 every three months, and a meal benefit for a chronic illness. 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. Other Services also includes a $20 copay for Mobile Mental Health and a $90 copay for Ambulance No transport.
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