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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 a $0 deductible for prescription drugs. In the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay a $11.00 copay for preferred generic drugs at a preferred pharmacy. After your total drug costs reach $2000.00, you will enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Medicare Plus Blue + Meijer (PPO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have copays, and outpatient services include copays for some services but no copay for others. Emergency services and ambulance services are covered, with copays for each. The plan also covers primary care, preventive, hearing, vision, and dental services, each with specific copays or maximum benefits. Additional benefits include home infusion, dialysis, medical equipment, and diagnostic services with coinsurance or copayments. Home health and skilled nursing facility services are covered, along with other services such as over-the-counter items and a meal benefit for chronic illness.
Inpatient Hospital See details
Inpatient Hospital-Acute has a $425 copay for days 1-7, and no copay for days 8-90. Additional days for Inpatient Hospital-Acute are covered with no copay. Inpatient Hospital Psychiatric has a $300 copay for days 1-7, and no copay for days 8-90. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services with a $375 copay, observation services, and ambulatory surgical center (ASC) services with no copay. Outpatient substance abuse services have a $50 copay for individual and group sessions. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Medicare Plus Blue + Meijer (PPO) plan, but requires prior authorization. You will have a $50 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Medicare Plus Blue + Meijer (PPO), with no coinsurance for any ambulance service. Ground and Air Ambulance Services each have a $350 copay. Transportation Services to any health-related location are covered, including one round trip per year via medical transport.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered under 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. Urgently Needed Services have a copay between $0 and $55.
Primary Care See details
The Medicare Plus Blue + Meijer (PPO) plan covers primary care physician services, chiropractic services with a $15 copay, occupational therapy services with a $40 copay, physician specialist services with a $50 copay, mental health specialty services with a $20 copay for individual and group sessions, other healthcare professional services with a copay between $0 and $50, psychiatric 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.
Preventive Services See details
Preventive Services are covered, including Medicare-covered zero dollar services and annual physical exams. Additional preventive services are partially covered, but do not include 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.
Hearing Services See details
Hearing Services includes hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Hearing exams have no copay, while routine hearing exams have a copay of $0-$50. Prescription hearing aids are covered up to $750 every three years, per ear. Prescription hearing aids - inner ear, outer ear, and over the ear, and 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. The plan also covers contact lenses and eyeglass lenses, as well as eyeglass frames, with a combined maximum benefit of $150 per year, but does not cover eyeglasses (lenses and frames) or upgrades.
Dental Services See details
Dental Services has a yearly maximum benefit of $1,500, and covers services such as oral exams with no copay, and x-rays, cleanings, and fluoride treatments. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Medicare Plus Blue + Meijer (PPO) plan. The plan has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment with a coinsurance between 0% and 20%, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a copay between $0 and $150, Lab Services with no copay, Diagnostic Radiological Services with a copay between $150 and $250, Therapeutic Radiological Services with a $35 copay, and Outpatient X-Ray Services with a $35 copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the Medicare Plus Blue + Meijer (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Medicare Plus Blue + Meijer (PPO) plan. This includes Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
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, and for days 21-100, there is a $214 copay. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items with a $160 maximum benefit every three months and a meal benefit for a chronic illness. Acupuncture, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and several other services are not covered.
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