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PPO Plans

Blue Preferred PPO

The BCBSM Blue Preferred PPO program is designed to encourage members to receive medical services from a statewide network of providers and pay little or no out-of-pocket costs. Known as the BCBSM TRUST, The Responsible Use System of Treatment, the statewide network consists of physicians, hospitals, laboratories and other providers who have agreed to deliver quality care while managing cost and medical services.


Blue Preferred PPO plans provide hospital, surgical, and medical coverage similar to the basic benefits found under Traditional BCBSM coverage. Blue Preferred allows members to enjoy the same benefits available under BCBSM's Traditional Plan. Members will receive benefits paid at the maximum level when they utilize PPO network providers.


Blue Preferred plan members are not required to select a primary care physician and they do not need a referral to see another PPO network provider. Blue Preferred members do not have to notify BCBSM when changing physicians. When you choose to receive services from a provider who is not a member of the PPO network, the copay amount for which you are responsible increases. In addition to increased copayment amounts, some services are not payable when rendered by non-PPO providers. If a member goes to a non-PPO provider with a referral from a PPO provider, out-of-network copayments are waived.

Blue Preferred Plus PPO

Blue Preferred Plus is the preferred provider organization administered by Blue Cross Blue Shield of Michigan for more than 112,000 auto-industry enrollees. Blue Preferred Plus has a network of more than 7,000 MDs and DOs, 149 hospitals and other health care providers conveniently located throughout Michigan.


Blue Preferred Plus PPO does not require members to designate a primary care physician. Just select a physician from our network of more than 7,000. And, members don't need a referral from a doctor to see any of the specialists in the Blue Preferred Plus PPO panel of providers.


Members receive the highest level of benefits when using Blue Preferred Plus physicians, and can lower out-of-pocket costs by receiving services only from Blue Preferred Plus PPO panel providers. Members can receive services from a physician or provider who isn't in Blue Preferred Plus, as long as they're willing to pay additional out-of-pocket costs.

Blue Value Options PPO

Benefit Plan Deductible Network Copays* Copay Maximum Lifetime Maximum Minimum Enrollment
    In Network Out of Network In
Network		 Out of Network   Sponsored Area
Plan 2 None 30% 50% $5,000/$10,000 $8,000/$16,000 None 2+ 2+
Plan 6 None 40% 60% $5,000/$10,000 $8,000/$16,000 None 2+ 2+

* Mental health, substance abuse and private duty nursing copays are 50%.

Community Blue PPO

Community Blue eliminates paperwork because BCBSM pays network MDs and DOs directly for office visits and other preventive services. Members don't have to pay up front, submit a claim form and then wait for reimbursement.


Through our network of PPO physicians (MDs, DOs), the Community Blue PPO benefit design covers members for office visits and preventive care, including:

  • Annual physical exams
  • Annual gynecological exams
  • Pap smear screening
  • Well-baby and well-child visits
  • Immunizations
  • Flexible sigmoidoscopy
  • Prostate specific antigen screening
  • Fecal occult blood screening
  • Urinalysis
  • EKG
  • Chest x-ray
  • Blood chemistry profile

As added incentive for members to stay within the PPO network, preventive services are covered up to $250 per member annually with no deductibles or copayments. If members go outside the network for preventive services, they are not covered.


Office visits to network physicians require only a small copayment — usually $10. Office visits to non-network physicians cost members more.


Other covered services from network providers, such as mammography, pre-natal and post-natal care by a physician, and voluntary sterilization, do not require deductibles or copayments. Members can use non-network providers for these services, but they're required to pay the deductibles and copayments.


Benefit Plan Deductible Network Copayments* Lifetime Maximum Minimum Enrollment
  In-Network Out-of-Network In-Network Out-of-Network   Sponsored Area
Plan 1 None $250/$500 None 20% $5 million 2+ 2+
Plan 2 $100/$200 $250/$500 10% 30% $5 million 2+ 2+
Plan 3 $250/$500 $500/$1,000 20% 40% $5 million 2+ 2+
Plan 4 $500/$1,000 $1,000/$2,000 20% 40% $5 million 2+ 2+
Plan 10 $250/$500 $500/$1,000 10% 40% $5 million 2+ 2+
Plan 12 $1,000/$2,000 $2,000/$4,000 20% 40% $5 million 2+ 51+

Community Blue PPO — One Subscriber Plan

Benefit Plan Deductible Network Copayments* Lifetime Maximum
  In-Network Out-of-Network In-Network Out-of-Network  
Plan 8 $500/$1,000 $1,000/$2,000 20% 40% $5 million

* Mental health, substance abuse and private duty nursing copays are 50%.


Healthy Blue PPO

Benefit Plan Deductible Network Copays* Copay Maximum Lifetime Maximum Minimum Enrollment
    In Network Out of Network In
Network		 Out of Network   Sponsored Area
Healthy Blue 80 None 20% 30% $2,500/$5,000 $5,000/$10,000 $5 million 2+ 2+
Healthy Blue 70 None 40% 60% $2,000/$10,000 $8,000/$16,000 $5 million 2+ 2+

* Mental health, substance abuse and private duty nursing copays are 50%.