State of Michigan retirees join our Medicare Advantage PPO plan

State of Michigan retirees became members of our Medicare Plus Blue^SM plan, effective Jan. 1, 2020. Their plan, called State Health Plan MA, provides coverage for medical and surgical benefits (Part C). OPTUMRx^® administers their prescription drug benefits (Part D).

How do I recognize a State Health Plan MA member?

State Health Plan MA members have Blue Cross Blue Shield of Michigan identification cards with the Medicare Plus Blue Group PPO logo at the top and State Health Plan MA in the middle on the right side. They use group number 35894 and have the XYL alpha prefix.

The PPO logo shows that the member is enrolled in a preferred provider organization plan; however, you should verify eligibility and coverage at every visit.

For benefit information, view their 2020 Summary of Benefits here. State Health Plan MA members have some additional enhanced benefits not offered to other groups. Refer to Blue Cross’ Medicare Advantage Enhanced Benefits Fee Schedule and search for State Health Plan MA for more information.

What do I need to know about prior authorization or precertification for State Health Plan MA members?

Like other Medicare Plus Blue PPO members, State Health Plan MA benefits require prenotification for all acute admissions, prior authorization for specified high-tech radiology services and precertification for skilled nursing, long-term acute care and inpatient rehabilitation admissions. Refer to the Medicare Plus Blue PPO Manual for prior authorization and precertification requirements.