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Medicare Plus Blue Secure (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Medicare Plus Blue Secure (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 Secure (PPO) in 2026, please refer to our full plan details page.
Medicare Plus Blue Secure (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 Secure (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 Secure (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 Secure (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 $2.00. 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 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 Secure (PPO) prescription drug plan features an annual drug deductible of $150. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply when using a preferred pharmacy or preferred mail-order service. Tier 2 generic drugs are also highly affordable, costing as little as a $7 copay for a 1-month supply or no copay for a 3-month supply through preferred network channels. For higher-tier medications, the plan transitions to a coinsurance model across all pharmacy and mail-order options. You will pay a 20% coinsurance for Tier 3 preferred brand drugs and a 30% coinsurance for Tier 4 non-preferred drugs. Specialty medications in Tier 5 require a 31% coinsurance for a 1-month supply.
Additional Benefits
The Medicare Plus Blue Secure (PPO) plan offers robust medical coverage with predictable out-of-pocket costs, featuring no copays for primary care visits and no coinsurance for inpatient hospital stays. Specialist visits, outpatient services, and emergency care are covered with flat copayments, while home health services require no copay or coinsurance. Additionally, routine preventive services, annual physicals, and fitness benefits are available with no copays. For supplemental care, the plan provides dental coverage up to a $1,000 annual limit and vision exams with up to $100 yearly for eyewear, with most of these services requiring no copay. Routine hearing exams also have no copay, and the plan covers up to two prescription hearing aids per year with fixed copayments. Finally, members benefit from a quarterly over-the-counter item allowance of $40 with no copay or coinsurance.
Inpatient Hospital See details
Medicare Plus Blue Secure (PPO) covers inpatient acute hospital stays with no coinsurance and a $375 daily copay for days 1 through 7, and inpatient psychiatric stays with a $290 daily copay for days 1 through 7, both with no copays for days 8 through 90. 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 Secure (PPO) covers outpatient services with no coinsurance, including outpatient hospital visits for a $400 copay, observation services for a $130 copay per stay, and ambulatory surgical center services for a $50 copay. Outpatient substance abuse sessions require a $45 copay with no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Medicare Plus Blue Secure (PPO) covers partial hospitalization services with a $105.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services under Medicare Plus Blue Secure (PPO) cover ground and air ambulance trips with a $400 copay and no coinsurance, which is not waived if you are admitted to the hospital. Additional transportation services to health-related locations are not covered by this plan.
Emergency Services See details
Medicare Plus Blue Secure (PPO) covers emergency services with a $130 copay, no coinsurance, and no deductible, with the copay 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 $40, while worldwide emergency services are covered up to $50,000 with no coinsurance and copays ranging from $40 to $400.
Primary Care See details
Medicare Plus Blue Secure (PPO) primary care benefits feature no copay and no coinsurance for primary care physician and telehealth services, while specialist visits require a $45 copay and no coinsurance. Physical, occupational, and speech therapy services carry a $50 copay and no coinsurance, while podiatry is not covered. Mental health and psychiatric sessions require a $45 copay with no coinsurance, and chiropractic services are partially covered, excluding routine and other chiropractic care.
Preventive Services See details
Preventive Services under Medicare Plus Blue Secure (PPO) are partially covered, offering annual physical exams, fitness benefits, remote access technologies, smoking cessation, and other screenings with no copay and no coinsurance. Kidney disease education is covered with a $25 copay and no coinsurance, but services like health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by Medicare Plus Blue Secure (PPO), which provides annual routine exams and fitting evaluations with no copay and no coinsurance. Up to two prescription hearing aids are covered per year with no coinsurance and a copay ranging from $495.00 to $1,695.00, though OTC hearing aids as well as 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 Secure (PPO), excluding other eye exam services, eyeglasses (lenses and frames), and upgrades. Covered eye exams require no copay to a $45 copay with no coinsurance, while eligible eyewear has no copay, no coinsurance, and no deductible up to a $100 annual maximum.
Dental Services See details
Medicare Plus Blue Secure (PPO) partially covers dental services up to a $1,000 annual limit for both in-network and out-of-network care, with most covered services requiring no copay and no coinsurance. While Medicare-covered dental services have a $0 to $45 copay and no coinsurance, other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Medicare Plus Blue Secure (PPO) with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, require no copay and no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Medicare Plus Blue Secure (PPO) with no copay and a 20% coinsurance.
Medical Equipment See details
Medicare Plus Blue Secure (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copays and required prior authorizations. While there is no copay, coinsurance ranges from no coinsurance up to 20% for DME and diabetic supplies, and a flat 20% coinsurance applies to prosthetic devices, medical supplies, and diabetic therapeutic shoes.
Diagnostic and Radiological Services See details
Medicare Plus Blue Secure (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Copays range from no copay to $155 for diagnostic tests, $40 for lab services, $45 for X-rays, and start at $80 for therapeutic and $120 for diagnostic radiology. If multiple services are received at the same location on the same day, only the maximum copay applies.
Home Health Services See details
Medicare Plus Blue Secure (PPO) covers Home Health Services with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Medicare Plus Blue Secure (PPO) covers some cardiac rehabilitation services with no coinsurance, but standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered and require copays of $40, $50, $30, and $25 respectively.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by Medicare Plus Blue Secure (PPO) with no coinsurance, as additional days beyond the standard 100-day Medicare limit are not covered. Covered days require prior authorization and feature no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no prior three-day hospital stay required.
Other Services See details
Medicare Plus Blue Secure (PPO) partially covers Other Services, offering over-the-counter (OTC) items with no copay and no coinsurance up to a $40 reimbursement every three months. Acupuncture, meal benefits, and other additional services under this category are not covered.
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