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Medicare Plus Blue Giveback (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Medicare Plus Blue Giveback (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 Giveback (PPO) in 2026, please refer to our full plan details page.
Medicare Plus Blue Giveback (PPO) is a PPO plan offered by Blue Cross Blue Shield of Michigan Mutual Ins. Co. available for enrollment in 2026 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 Giveback (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 Giveback (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 Giveback (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 $70.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $650.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 $11000.00 (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 $11000.00 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 Giveback (PPO) plan features a $150 annual drug deductible. You can save on prescriptions with no copay for Tier 1 preferred generic drugs filled at preferred pharmacies or through preferred mail order. For Tier 2 generic drugs, costs are also low, featuring a $7 copay for a 1-month supply and no copay for a 3-month supply at preferred locations. For higher-tier medications, the plan transitions to coinsurance costs across all pharmacy types. Tier 3 preferred brands carry a 20% coinsurance, Tier 4 non-preferred drugs require 30% coinsurance, and Tier 5 specialty drugs have a 31% coinsurance. Standard pharmacies and standard mail order services are also available with slightly higher copays for generic tiers.
Additional Benefits
The Medicare Plus Blue Giveback (PPO) plan offers robust coverage for essential medical services, featuring no copay and no coinsurance for primary care visits, telehealth, and home health services. For hospital care, inpatient stays require a $385 copay for the first seven days of acute care with no copay for days 8 through 90, while emergency services carry a $115 copay that is waived upon admission. Outpatient hospital services are covered with a $425 copay and no coinsurance. Routine dental preventive care and annual hearing exams are available with no copay and no coinsurance, though comprehensive dental and eyewear are not covered. Skilled nursing facility stays feature no copay for the first 20 days, followed by a $218 daily copay up to day 100. Diagnostic lab services and cardiac rehabilitation also feature no copay, making everyday wellness highly affordable.
Inpatient Hospital See details
Medicare Plus Blue Giveback (PPO) covers inpatient hospital services with no coinsurance, requiring a $385 copay for days 1 to 7 of acute stays and a $295 copay for days 1 to 7 of psychiatric stays, with no copay for days 8 to 90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Medicare Plus Blue Giveback (PPO) covers outpatient hospital services with a $425 copay, ambulatory surgical center services with a $325 copay, and observation services with a $115 copay per stay, all with no coinsurance. Outpatient substance abuse services carry a $55 copay per session with no coinsurance, while outpatient blood services are available with no copay and no coinsurance.
Partial Hospitalization See details
Medicare Plus Blue Giveback (PPO) covers partial hospitalization benefits 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 Giveback (PPO) covers Medicare-covered ground and air ambulance services with a $360 copay and no coinsurance, and this copayment is not waived upon hospital admission. Routine transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Medicare Plus Blue Giveback (PPO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within three days. Urgently needed services require no copay to a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $50,000 lifetime limit with no coinsurance and copays of $115 for emergency care, $45 for urgent care, and $360 for emergency transportation.
Primary Care See details
Medicare Plus Blue Giveback (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist, physical therapy, and speech-language services require a $55 copay and no coinsurance. Occupational therapy ($35 copay), mental health and psychiatric sessions ($50 copay), and opioid treatment ($40 copay) also feature no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Medicare Plus Blue Giveback (PPO) partially covers preventive services with no copay and no coinsurance for covered care, including annual physical exams and kidney disease education. However, many additional preventive services are not covered, such as fitness benefits, health education, weight management, and personal emergency response systems.
Hearing Services See details
Medicare Plus Blue Giveback (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 ranging from $495 to $1,695 for up to two devices per year, though OTC hearing aids alongside inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by Medicare Plus Blue Giveback (PPO), which includes one routine eye exam per year with no copay to a $55 copay and no coinsurance. Other eye exams and eyewear, including contact lenses and eyeglasses, are not covered.
Dental Services See details
Dental services are partially covered by Medicare Plus Blue Giveback (PPO), offering preventive care such as cleanings, exams, fluoride, and x-rays with no copay and no coinsurance. Medicare-covered dental services have a copay of $0 to $55 and no coinsurance, while comprehensive treatments like restorative, endodontics, periodontics, prosthodontics, implants, and oral surgery are not covered.
Home Infusion bundled Services See details
Medicare Plus Blue Giveback (PPO) covers Home Infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs require from no coinsurance up to 20% coinsurance, while Part B insulin has a $35 copay and from no coinsurance up to 20% coinsurance.
Dialysis Services See details
Medicare Plus Blue Giveback (PPO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Medicare Plus Blue Giveback (PPO) partially covers medical equipment with no copays, though prior authorization is required. Covered durable medical equipment and diabetic supplies carry between no coinsurance and 20% coinsurance, while prosthetics and medical supplies require a 20% coinsurance; diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Medicare Plus Blue Giveback (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Members pay no copay for lab services, up to a $150 copay for diagnostic tests, a $35 copay for outpatient X-rays, and minimum copays of $45 for therapeutic radiology and $150 for diagnostic radiology.
Home Health Services See details
Medicare Plus Blue Giveback (PPO) covers home health services with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Medicare Plus Blue Giveback (PPO) offers cardiac rehabilitation services with no copay and no coinsurance. While some services are covered, specific sub-services including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Medicare Plus Blue Giveback (PPO) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a 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 days beyond the 100-day Medicare limit are not covered.
Other Services See details
Medicare Plus Blue Giveback (PPO) partially covers other services, excluding acupuncture, over-the-counter items, and meal benefits. Covered services include statewide mobile mental health crisis solutions for a $40 copay and no coinsurance, and non-Medicare ambulance services with no transport for a $90 copay and no coinsurance.
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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.
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