2012 Medicare plans (Switch plan year)

Medicare Plus Blue PPOSM

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What do you get when you enroll in Medicare Plus Blue PPO? The confidence that comes with affordable, all-in-one coverage that is simple to understand. You also get value for your health care dollar with coverage that includes vision, dental, hearing and fitness benefits – more than Original Medicare!

You can choose from three plan options that feature no referrals, Part D prescription drug coverage and the freedom to choose any doctor or hospital that accepts Original Medicare.

With Medicare Plus Blue PPO you get the coverage you want from the company you trust.

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You'll like our plan:

  • Lower out-of-pocket costs when you receive services from a doctor or hospital in our network
  • Out-of-pocket maximums help limit your annual expense
  • One ID card for health, drug and preventive dental coverage
  • Available statewide
  • No referrals needed to see specialists
  • Worldwide emergency care coverage
  • Virtually no paperwork

You'll like our benefits*:

  • Vision benefits
  • Hearing benefits
  • Fitness benefits
  • Medicare Part D prescription drug coverage
  • Preventive dental services
  • Preventive tests and physicals
  • Office visits
  • Hospitalization
  • Outpatient surgery and services
  • Lab and radiology services
  • Home health care
  • Immunizations
  • Podiatry
  • Chiropractic services
  • Prostate cancer screening exams
  • Ambulance services

View a chart with premiums by county for more information.

In addition to our medical and prescription drug plans, Medicare Plus Blue PPOSM offers members a variety of programs designed to promote good health, safety and savings.

Choose from three Medicare Plus Blue PPO plans

Click here to learn more.

* Limits and copayments apply. Refer to the Summary of Benefits for additional information.

Your plan provider is required to notify the plan or arrange for prior authorization/certification in all applicable instances including: Inpatient Admission notification, High-Tech Radiology prior authorization, and Skilled Nursing, Long Term Acute Care, and Inpatient Rehabilitation prior certification. If a claim is denied, you will not be held responsible for the charge if the denial is due to a lack of prior notification, authorization, or certification.

Contact your Blues contracted agent

Contact your Blues contracted agent or an independent agent licensed to sell Blues Medicare Advantage plans, or call us for more information:

Member Services representatives are available 8 a.m. to 8 p.m. seven days a week.

Turning 65?

If you're turning 65 or qualify for Medicare under special circumstances, you don't have to wait for Medicare's annual enrollment period, from Oct. 15 through Dec. 7. Call the Member Service number above for more information.

You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:

Medicare Plus Blue PPO information

Let us help you

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People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for up to seventy-five (75) percent of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don't even know it. For more information about the Extra Help program, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days per week. TTY users should call 1-877-486-2048.

Important information about these plans

Medicare Plus Blue PPOSM is a health plan with a Medicare contract.

Medicare Plus Blue PPO is available to all Medicare beneficiaries who are Michigan residents and are entitled to receive services under Medicare Part A and enrolled in Part B.

With the exception of emergency or urgent care, it will cost more to get care from non-plan or non-preferred providers. Your responsibility will be greater out-of-network when the out-of-network coinsurance is based on the Medicare allowed amount and the contracted amount is lower. You may receive services from any provider who accepts Original Medicare. Your out-of-pocket costs will be lower if you choose a network provider. To find a network provider, visit www.bcbsm.com/medicare/provdirectory.shtml.

Premiums vary by county. You must continue to pay your Medicare Part B premium.

Limitations, copayments and restrictions may apply.

Our network includes approximately 2,300 Michigan retail pharmacies, of which 86 percent are network pharmacies. Nationwide, most chain pharmacies are in our network, as well as long-term care and home infusion pharmacies and Indian/Tribal/Urban (Indian Health Service) pharmacies.

In general, benefits are only available at contracted network pharmacies. Plan drugs may be covered in special circumstances, for instance, illness while traveling outside of the plan's service area where there is no network pharmacy. You may have to pay more than your normal cost sharing amount if you get your drugs at an out-of-network pharmacy. Quantity limitation and restrictions may apply. In addition, you will likely have to pay the pharmacy's full charge for the drug and submit documentation to receive reimbursement from Blue Cross Blue Shield of Michigan. For additional information on network pharmacies, please call Member Services at 1-877-469-2583, 8 a.m. to 8 p.m. seven days a week. TTY users should call 1-800-481-8704. You may also write to: Blue Cross Blue Shield of Michigan, 600 E. Lafayette Blvd., Mail Code X435, Detroit, MI 48226.

If you decide to have your plan premium withheld from your Social Security check or deducted from your checking or savings account, it may take up to three months for the automatic deduction to begin. If your premium amount is currently withheld from your Social Security check or deducted from your checking or savings account and you wish to receive a monthly bill instead, the change may also take up to three months to become effective. During this time, you will be responsible for paying your premium.

The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on Jan. 1, 2013.

Medicare beneficiaries may enroll in Medicare Plus Blue PPO through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. For more information, please contact Blue Cross Blue Shield of Michigan at 1-877-469-2583, 8 a.m. to 8 p.m. seven days a week. TTY users should call 1-800-481-8704. To learn more about enrollment periods, please contact Member Services.