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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. The plan has no deductible. In the initial coverage phase, you will pay a copay for your prescriptions, which varies depending on the drug tier and pharmacy. For example, you will pay $11.00 for a 30-day supply of a preferred generic drug at a preferred pharmacy. After your total drug costs reach $2000.00, you will enter the catastrophic coverage phase and pay nothing for Part D covered drugs.
Additional Benefits
The Medicare Plus Blue + Meijer (PPO) plan offers a range of benefits, including coverage for inpatient and outpatient hospital services, with varying copays. Emergency services, including worldwide coverage, are available with a copay. The plan also includes coverage for primary care, preventive services, hearing, vision, and dental services, with specific copays and coverage limits. Additional benefits include ambulance and transportation services, home infusion, dialysis, and medical equipment coverage with copays and coinsurance. The plan also covers skilled nursing facility stays and offers an over-the-counter allowance, along with a meal benefit for chronic illnesses. Some services, such as cardiac rehabilitation, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with prior authorization required. For Inpatient Hospital-Acute, you pay a $425 copay for days 1-7, and no copay for days 8-90; for Inpatient Hospital Psychiatric, you pay a $300 copay for days 1-7, and no copay for days 8-90. Additional Days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as 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 outpatient substance abuse services. Ambulatory Surgical Center (ASC) Services have no copay, and outpatient blood services are also covered. Individual and group sessions for outpatient substance abuse have a copay between $50.00 and $50.00.
Partial Hospitalization See details
Partial Hospitalization is covered by the Medicare Plus Blue + Meijer (PPO) plan, with a $50 copay. Prior authorization is required for coverage.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under 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 via medical transport.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered by the Medicare Plus Blue + Meijer (PPO) plan. Emergency Services have a $125 copay, while Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a $55 copay, and Worldwide Emergency Transportation has a $290 copay; all services have no coinsurance.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered under the Medicare Plus Blue + Meijer (PPO) plan. Chiropractic Services have a $15 copay, Routine Chiropractic Care has a $50 copay, and Other Chiropractic Services have a $35 copay. Occupational Therapy Services have a $40 copay, Physician Specialist Services have a $50 copay, and Individual and Group Sessions for Mental Health Specialty Services and Psychiatric Services have a $20 copay. Other Health Care Professional services have a copay ranging from $0 to $50, and Physical Therapy and Speech-Language Pathology Services have a $40 copay.
Preventive Services See details
Preventive Services are covered, including Medicare-covered services, Annual Physical Exams, and other services not usually covered by Medicare. Additional services covered include Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit (Memory Fitness), Remote Access Technologies, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing Services includes hearing exams, with no copay for routine hearing exams and fitting/evaluation for hearing aids. Prescription hearing aids are covered up to $750 every three years, and all types of prescription hearing aids are covered for two visits every three years. OTC hearing aids are not covered.
Vision Services See details
The Medicare Plus Blue + Meijer (PPO) plan covers vision services, including routine eye exams with no copay, and other eye exam services with a $50 copay. Eyewear has a combined maximum benefit of $150 every year, and contact lenses, eyeglass lenses, and eyeglass frames are covered with limitations. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services with Medicare Plus Blue + Meijer (PPO) include a yearly maximum of $1500 for both in-network and out-of-network services, with copays ranging from $0 to $50 for Medicare Dental Services. Other covered dental services include oral exams (2 per year), dental x-rays, prophylaxis (cleaning) (2 per year), fluoride treatment (1 per year), restorative services, endodontics (root canals - once per tooth per lifetime), periodontics (deep cleaning - once per quadrant per 24 months), and oral and maxillofacial surgery, with specific limitations. 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. Medicare Part B Insulin Drugs have a $35 copay, with coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Medicare Plus Blue + Meijer (PPO) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance of 0-20%, and Prosthetics/Medical Supplies - Non-Medicare benefit with coinsurance. Diabetic Equipment benefits are covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Medicare Plus Blue + Meijer (PPO) plan. 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 the Medicare Plus Blue + Meijer (PPO) plan with no copay and no coinsurance. However, 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. While Cardiac Rehabilitation Services are generally covered, the plan does not cover 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 the Medicare Plus Blue + Meijer (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays are not covered.
Other Services See details
The Medicare Plus Blue + Meijer (PPO) plan covers Over-the-Counter (OTC) items with a maximum benefit of $160.00 every three months, and it offers a meal benefit for chronic illnesses. Acupuncture, 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, 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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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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