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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 $17.70. 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 drug deductible and offers competitive savings on generic medications. For Tier 1 preferred generics, there is no copay for 1-month or 3-month supplies at preferred pharmacies and preferred mail order services, while standard options require a $5 or $15 copay. Tier 2 generics have a $7 copay for a 1-month supply and no copay for a 3-month supply at preferred locations, compared to standard pharmacy copays of $12 for 1-month and $36 for 3-month fills. Higher-tier medications are subject to coinsurance rather than flat copays across all pharmacy and mail order 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. Specialty Tier 5 drugs require a 31% coinsurance for a 1-month supply through both preferred and standard channels.
Additional Benefits
The Medicare Plus Blue + Meijer (PPO) plan offers robust coverage with no coinsurance for many core medical services, including inpatient hospital stays, outpatient services, and emergency care. Members enjoy no copay for primary care visits, telehealth, and preventive services, while specialist visits require a $50 copay. Inpatient hospital stays require a $325 daily copay for the first seven days, and skilled nursing facility stays feature no copay for the first 20 days. This plan also includes valuable supplemental benefits, such as dental coverage up to $1,000 annually with no copay for preventive and comprehensive care. Routine hearing and vision exams are available with no copay, alongside an allowance for eyewear and copays for prescription hearing aids. Additionally, members receive a $60 quarterly over-the-counter item allowance and home health services with no copay or coinsurance.
Inpatient Hospital See details
Medicare Plus Blue + Meijer (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, subject to prior authorization. Patients pay a $325 daily copay for days 1 through 7 and no copay for days 8 through 90, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Medicare Plus Blue + Meijer (PPO) covers outpatient hospital services with a $150 to $375 copay and observation services with a $130 copay per stay, both with no coinsurance. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $50 copay and no coinsurance.
Partial Hospitalization See details
Medicare Plus Blue + Meijer (PPO) covers partial hospitalization services with a $55.00 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, and this copay is not waived upon hospital admission. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Medicare Plus Blue + Meijer (PPO) covers emergency services with a $130 copay (waived if admitted within three days) and urgent care with no copay to a $50 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum with no coinsurance and copays ranging from $50 to $290.
Primary Care See details
Medicare Plus Blue + Meijer (PPO) offers primary care, telehealth, and opioid treatment services with no copay and no coinsurance, while specialist, physical therapy, and occupational therapy visits require a $50 copay and no coinsurance. Mental health and psychiatric sessions have a $20 copay and no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Medicare Plus Blue + Meijer (PPO) offers partially covered preventive services with no copay and no coinsurance for covered benefits, which include annual physicals, smoking cessation, and fitness programs. However, sub-services such as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home/bathroom safety devices, and counseling are not covered.
Hearing Services See details
Medicare Plus Blue + Meijer (PPO) offers partially covered hearing services, which include one routine hearing exam and one fitting evaluation annually with no copay and no coinsurance. Up to two prescription hearing aids per year are covered with no coinsurance and a copay between $495.00 and $1,695.00, while over-the-counter (OTC) hearing aids, alongside 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 routine eye exams for a $0 to $50 copay and no coinsurance, and eyewear coverage with no copay or coinsurance up to a $100 annual limit. Other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Medicare Plus Blue + Meijer (PPO) offers partially covered dental services with an annual combined in- and out-of-network maximum benefit of $1,000. Covered preventive and comprehensive services like exams, cleanings, fillings, and root canals have no copay and no coinsurance, while Medicare-covered dental services require 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
Home Infusion bundled services are covered by Medicare Plus Blue + Meijer (PPO) with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs require between no coinsurance and 20% coinsurance, while Part B insulin requires a $35 copay and up 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) partially covers medical equipment with no copay, though coinsurance ranges from no coinsurance to 20% depending on the item. Covered benefits include durable medical equipment, prosthetics, medical supplies, and diabetic supplies, but 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. Lab services have no copay, diagnostic tests range from a $0 to $150 copay, outpatient X-rays and therapeutic radiology require a $35 copay, and diagnostic radiological services carry a minimum $150 copay.
Home Health Services See details
Home health services are covered under the Medicare Plus Blue + Meijer (PPO) plan, offering members access to these medical services with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Medicare Plus Blue + Meijer (PPO) with no coinsurance, but some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require copayments between $10 and $15.
Skilled Nursing Facility (SNF) See details
Medicare Plus Blue + Meijer (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, prior hospital stays of three days are not required for admission, 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 and meal benefits are not covered under this plan.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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