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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 $15.90. 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) prescription drug plan features an annual drug deductible of $150. For Tier 1 preferred generic drugs, there is 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 1 month. Tier 2 generic drugs cost a $7 copay for a 1-month supply at preferred locations, but there is no copay if you fill a 3-month supply. For brand-name and specialty medications, costs transition to a percentage-based coinsurance. Tier 3 preferred brands require 20% coinsurance, and Tier 4 non-preferred drugs require 30% coinsurance at both preferred and standard pharmacies. Specialty drugs in Tier 5 carry a 31% coinsurance for a 1-month supply, regardless of whether you use a preferred or standard pharmacy.
Additional Benefits
The Medicare Plus Blue + Meijer (PPO) plan offers comprehensive medical coverage with no coinsurance for many key services, including inpatient hospital stays and outpatient care. Members pay a $325 daily copay for the first seven days of an inpatient stay, while subsequent days, primary care visits, and preventive services require no copay. Outpatient surgical services also feature no copay, though emergency care carries a $130 copay and ambulance services require a $350 copay. This plan also includes valuable supplemental benefits such as dental, vision, and hearing coverage, featuring no copays for routine exams and cleanings. Dental services are covered up to a $1,000 annual maximum, and members receive up to $60 every three months for over-the-counter items with no copay. Additionally, essential services like home health care and the first 20 days of skilled nursing facility care are fully covered with no copays or coinsurance.
Inpatient Hospital See details
Medicare Plus Blue + Meijer (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $325 daily copay for days 1 through 7 and no copay for days 8 through 90 for both acute and psychiatric stays. Unlimited additional acute days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Medicare Plus Blue + Meijer (PPO) covers outpatient services with no coinsurance, including no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $150 to $375, while observation services have a $130 copay per stay and outpatient substance abuse sessions require a $50 copay.
Partial Hospitalization See details
Medicare Plus Blue + Meijer (PPO) covers partial hospitalization with a $55.00 copay and no coinsurance. Prior authorization is required for some of these 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, and this copay is not waived upon hospital admission. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Medicare Plus Blue + Meijer (PPO) emergency services are covered with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within three days. Urgently needed services have no coinsurance and a copay ranging from no copay to $50, while worldwide emergency services are covered up to a $50,000 limit with no coinsurance and copays ranging from $50 to $290.
Primary Care See details
Medicare Plus Blue + Meijer (PPO) covers primary care physician services, telehealth, and opioid treatment with no copay and no coinsurance. Specialist visits, physical therapy, occupational therapy, and speech therapy require a $50 copay and no coinsurance, mental health services have a $20 copay and no coinsurance, and podiatry is not covered.
Preventive Services See details
Medicare Plus Blue + Meijer (PPO) covers preventive services, such as annual physical exams, kidney disease education, and diabetes self-management, with no copay and no coinsurance. Additional preventive benefits are partially covered, including fitness benefits and remote access technologies, though services like health education, in-home safety assessments, and weight management programs are not covered.
Hearing Services See details
Medicare Plus Blue + Meijer (PPO) covers annual routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay of $495 to $1,695 for up to two aids per year, though inner ear, outer ear, over the ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Medicare Plus Blue + Meijer (PPO), offering one annual routine eye exam with a copay ranging from no copay to $50 and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay or coinsurance up to a $100 annual limit for contacts, standard lenses, and frames, though upgrades and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Medicare Plus Blue + Meijer (PPO) partially covers dental services with a $1,000 annual maximum benefit for both in- and out-of-network care, featuring no copay and no coinsurance for most covered cleanings, exams, and restorative treatments. Medicare-covered dental services have a $0 to $50 copay and no coinsurance, while other diagnostic services, other preventive services, 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 and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs feature no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under Medicare Plus Blue + Meijer (PPO) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is partially covered by Medicare Plus Blue + Meijer (PPO) with no copay for covered items, though diabetic therapeutic shoes and inserts are not covered. Covered durable medical equipment and diabetic supplies have between no coinsurance and 20% coinsurance, while prosthetic devices and medical supplies carry a 20% coinsurance.
Diagnostic and Radiological Services See details
Medicare Plus Blue + Meijer (PPO) covers diagnostic and radiological services with no coinsurance, although prior authorization is required. Members pay no copay for lab services, $0 to $150 for diagnostic procedures, $35 for outpatient X-rays, and copays starting at $35 for therapeutic radiological services and $150 for diagnostic radiological services.
Home Health Services See details
Home Health Services are covered under the Medicare Plus Blue + Meijer (PPO) plan with no copay and no coinsurance. This ensures you can access essential in-home medical care at no additional cost.
Cardiac Rehabilitation Services See details
Medicare Plus Blue + Meijer (PPO) offers Cardiac Rehabilitation Services with no copay and no coinsurance. While some services are covered, cardiac rehabilitation, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
Medicare Plus Blue + Meijer (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Medicare Plus Blue + Meijer (PPO) offers partially covered Other Services, excluding acupuncture, meal benefits, and Dual Eligible SNP services. Covered services include over-the-counter (OTC) 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.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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