A non-government entity
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 $16.70. 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:
Sign up for Medicare Plus Blue + Meijer (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Medicare Plus Blue + Meijer (PPO) plan features a $150 annual drug deductible. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at preferred pharmacies and mail-order services, while standard pharmacies charge a $5 copay for a 1-month supply. Tier 2 generic drugs cost a $7 copay for a 1-month supply and no copay for a 3-month supply at preferred locations, compared to a $12 copay for a 1-month supply at standard locations. For higher-tier medications, the plan uses coinsurance across both preferred and standard pharmacy options. Tier 3 preferred brand drugs require a 20% coinsurance, and Tier 4 non-preferred drugs carry a 30% coinsurance for both 1-month and 3-month supplies. Tier 5 specialty drugs require a 31% coinsurance for a 1-month supply through all pharmacy and mail-order channels.
Additional Benefits
The Medicare Plus Blue + Meijer (PPO) plan offers robust medical coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. For specialist visits, patients will pay a $50 copay with no coinsurance, while emergency room visits carry a $130 copay. Inpatient hospital stays require a $325 daily copay for the first seven days and no copay thereafter, with no coinsurance required. This plan also includes valuable supplemental coverage, featuring dental benefits up to $1,000 annually with no copay or coinsurance for most preventive services. Routine hearing exams are available with no copay, while prescription hearing aids require copays ranging from $495 to $1,695. Additionally, members receive up to $100 annually for eyewear and a $60 quarterly allowance for over-the-counter items, both with no copay and no coinsurance.
Inpatient Hospital See details
Medicare Plus Blue + Meijer (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $325 daily copay for days 1 through 7 and no copay for days 8 through 90. Prior authorization is required, and while unlimited additional acute days are covered with no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Medicare Plus Blue + Meijer (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Patients will pay a $150 to $375 copay for outpatient hospital services, a $130 copay per stay for observation services, and a $50 copay for outpatient substance abuse sessions.
Partial Hospitalization See details
Partial hospitalization is covered by Medicare Plus Blue + Meijer (PPO) with a $55 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) covers ground and air ambulance services with a $350 copay and no coinsurance per service. 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, with the copay waived if you are admitted to the hospital within three days. Urgently needed services feature no copay to a $50 copay and no coinsurance, while worldwide emergency services are covered up to $50,000 with copays between $50 and $290 and no coinsurance.
Primary Care See details
Medicare Plus Blue + Meijer (PPO) covers primary care, telehealth, and opioid treatment with no copay and no coinsurance, while specialists, physical therapy, occupational therapy, and speech services require a $50 copay with no coinsurance. Mental health and psychiatric sessions have a $20 copay and no coinsurance, some chiropractic services are covered for a $15 copay and no coinsurance but routine and other chiropractic services are not covered, and podiatry is not covered.
Preventive Services See details
Medicare Plus Blue + Meijer (PPO) offers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay and no coinsurance, covering fitness programs, smoking cessation, and remote access technologies, but excluding health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Medicare Plus Blue + Meijer (PPO) covers annual routine hearing exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $495 to $1,695 for up to two devices per year, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Medicare Plus Blue + Meijer (PPO) offers partially covered vision services, including one annual routine eye exam with a $0 to $50 copay and no coinsurance, while other eye exams are not covered. Eyewear is covered with no copay and no coinsurance up to a $100 annual maximum for contact lenses, eyeglass lenses, and frames, but upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by Medicare Plus Blue + Meijer (PPO) up to a $1,000 annual limit, featuring no copay and no coinsurance for most preventive and comprehensive services, while Medicare-covered dental has a $0 to $50 copay and no coinsurance. Other diagnostic dental, other preventive dental, maxillofacial prosthetics, and orthodontics 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. Covered Medicare Part B chemotherapy and other drugs have no coinsurance to 20% coinsurance, while Part B insulin requires 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
Medicare Plus Blue + Meijer (PPO) covers medical equipment with no copay, though coinsurance ranges from no coinsurance up to 20% and prior authorization is required. This benefit is partially covered, as durable medical equipment, prosthetics, and diabetic supplies are covered, while 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, although prior authorization is required. Diagnostic tests and procedures have a copay ranging from $0 to $150, lab services have no copay, outpatient x-rays require a $35 copay, and therapeutic and diagnostic radiological services carry minimum copays of $35 and $150, respectively.
Home Health Services See details
Home Health Services are covered by the Medicare Plus Blue + Meijer (PPO) plan with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are provided by Medicare Plus Blue + Meijer (PPO) with no coinsurance, and while some services are covered, several primary services are not covered in practice. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and carry a $15 copay, while pulmonary rehabilitation is also not covered and carries a $10 copay.
Skilled Nursing Facility (SNF) See details
Medicare Plus Blue + Meijer (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Medicare Plus Blue + Meijer (PPO) partially covers other services, excluding acupuncture and meal benefits. Covered benefits include over-the-counter items with no copay and no coinsurance up to $60 every three months, mobile mental health services for a $20 copay and no coinsurance, and non-transport ambulance services for a $90 copay and no coinsurance.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved