Medicare Plus Blue Group PPOSM offers comprehensive health coverage through a group plan sponsor. Medicare Plus Blue Group combines Original Medicare Part A (hospital) and Part B (medical) coverage and expands your coverage to include additional preventive services and much more. (Some group plans may also include Medicare Part D prescription drug coverage.*)
With Medicare Plus Blue Group PPOSM, you'll get:
- Freedom to choose any doctor or hospital that accepts Original Medicare
- Lower out-of-pocket costs when you receive services from a doctor or hospital in our network
- Nationwide coverage
- No referrals needed to see specialists
- Virtually no paperwork
- One ID card for health services
- Groups have the option of adding benefits not covered by original Medicare. For more information, please contact us.
Our benefits include:
- Preventive tests and physical exams
- More preventive services with no cost share
- Office visits
- Outpatient surgery and services
- Lab and radiology services
- Home health care
- Chiropractic services
- Prostate cancer screening exams
- Ambulance services
- Medicare Part D prescription drug coverage (for some group plans)*
If your employer or union group is currently enrolled in a Medicare Plus Blue Group PPO product, limitations and cost-sharing may apply. Consult your Evidence of Coverage for specific information about your benefits and cost-sharing responsibilities or contact us.
In addition to our medical and prescription drug plans, Medicare Plus Blue Group PPOSM offers members a variety of programs designed to promote good health, safety and savings. We also offer a Blue Advantage Rewards program — our way of thanking you for proactively taking care of your health.
* Not all Medicare Plus Blue Group PPOSM plans provide Medicare Part D prescription drug coverage. If you are unsure whether your plan includes Medicare Part D prescription drug coverage, please contact your plan benefit administrator.
Other Helpful Information
Find a network provider
You can go to any doctor or hospital that accepts your Medicare Plus Blue Group PPOSM ID card. And, if you choose to see doctors and hospitals in our network, you'll minimize your out-of-pocket costs. To find a network provider in the state of Michigan:
- Use our online provider directory search
Care outside of Michigan
If you need medical care outside of the state of Michigan, you may obtain care from any provider that accepts Medicare. If you receive services outside the state of Michigan, in-network cost sharing will apply for all medical services (except durable medical equipment, prosthetics and orthotics). To locate a provider outside the state of Michigan, please call Member Services at 1-866-684-8216 from 8:30 a.m. to 5 p.m. Eastern time Monday through Friday. TTY users should call 1-800-579-0235.
Part D Prescription Drug coverage
If you are unsure whether your plan includes Medicare Part D prescription drug coverage, please contact your plan benefit administrator.
- Group Comprehensive Formulary (PDF)
- Group Assure Comprehensive Formulary (PDF)
- Group Essential, Vitality, Signature Comprehensive Formulary (PDF)
- Group Enhanced Comprehensive Formulary (PDF)
- Group Formulary Changes
- Group Essential, Vitality, Signature Formulary Changes
- Group Assure Formulary Changes
- Group PPO/PDP Pharmacy Directory (PDF)
- Group PDP Pharmacy Directory (PDF)
- Utilization Management
- Medication Therapy Management Program
- Mail Order Pharmacy Services
- Claims Forms
- Part D prescription drug transition policy
- Grievances and Appeals processes
- Prescription Drug Determination Request (PDF)