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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 $4.00. 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. There is no deductible for prescription drugs. During the initial coverage phase, you will pay a copay for your prescriptions, 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. Once your total drug costs reach $2000.00, you enter the next coverage phase. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for covered drugs.
Additional Benefits
The Medicare Plus Blue + Meijer (PPO) plan offers a range of benefits, including coverage for inpatient and outpatient services, emergency care, and various therapies like physical and occupational therapy. This plan includes no copay for many services, such as routine eye exams and hearing exams, and offers a $150 annual vision benefit. You will also have access to dental, with a maximum benefit of $1500 per year. This plan provides additional coverage for ambulance and transportation services, with copays ranging from $90 to $350. It also covers home infusion services, and skilled nursing facility (SNF) services. However, it's important to note that some services like podiatry, some dental services, and cardiac rehabilitation are not covered.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $425 copay for days 1-7 and no copay for days 8-90, and for Inpatient Hospital Psychiatric you will pay a $300 copay for days 1-7 and no copay for days 8-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a $375 copay, and Ambulatory Surgical Center (ASC) Services with no copay. Outpatient Substance Abuse Services, including individual and group sessions, have a copay between $50 and $50. Outpatient Blood Services are also covered.
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 this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with no coinsurance. Ground and air ambulance services have a $350 copay. Transportation services to a plan-approved health-related location are covered, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered by the Medicare Plus Blue + Meijer (PPO) plan. For emergency services, the copay is $125, and there is no coinsurance. For Worldwide Emergency Coverage, the copay is $125, for Worldwide Urgent Coverage the copay is $55, and for Worldwide Emergency Transportation, the copay is $290.
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 health care professional services with a copay between $0-$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, including Medicare-covered services and annual physical exams, are covered, with additional services like smoking cessation counseling, a fitness benefit, and remote access technologies also covered. However, services like health education, in-home safety assessments, and several others are not covered.
Hearing Services See details
Hearing Services include hearing exams, which have no copay. Routine Hearing Exams are covered once per year, and Fitting/Evaluation for Hearing Aid is covered once every three years. Prescription Hearing Aids (all types) are covered up to $750 every three years. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear, as well as OTC Hearing Aids are not covered.
Vision Services See details
Vision Services includes coverage for eye exams with a copay of $0-$50, and routine eye exams with no copay. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, and the plan provides a $150 maximum benefit every year for frames or elective contact lenses. However, eyeglass frames and upgrades are not covered.
Dental Services See details
Dental Services includes coverage for a variety of services, such as oral exams with no copay, dental x-rays, and prophylaxis (cleaning), each with a limited number of visits per year; the plan also offers fluoride treatment, with a limit of one visit per year. This plan's maximum benefit coverage is $1500 per year. Maxillofacial Prosthetics and Orthodontics are not covered, and some services, such as implant services, are optional supplemental benefits, so you may have to pay more for access.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and 0-20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 0-20% coinsurance.
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), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has no copay and a coinsurance between 0% and 20%, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have no copay and a coinsurance for Medicare-covered Prosthetic Devices and Medical Supplies. Diabetic Equipment benefits have no copay and are not limited to specific manufacturers, but 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 copay of $35, 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 Medicare Plus Blue + Meijer (PPO) with no copay and no coinsurance; however, additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the plan. Although the plan covers some Cardiac Rehabilitation Services, 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 Medicare Plus Blue + Meijer (PPO), with prior authorization required. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The Medicare Plus Blue + Meijer (PPO) plan does not cover 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, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, 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, or Self-Directed Personal Assistance Services. Over-the-counter items are covered with a maximum benefit of $160 every three months, and meals are covered for chronic illnesses. Other services include mobile mental health with a $20 copay, and ambulance (no transport) with a $90 copay.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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