Blue Cross® Premier PPO Value

2020 plan year

You can buy this plan if you live in any Michigan county.

About this plan

This is a plan that doesn't cost a lot, but gives you coverage when you really need it. It has a low monthly payment and three doctor visits per year for $30 each. But you’ll pay full price for most other services until you meet your deductible.

Availability

You can buy this plan if you live in any Michigan county. Look for doctors and hospitals that take this plan

Plan Type

PPO. You choose the doctors you want to see. No referrals needed. What’s the difference between HMO and PPO plans?

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Health Savings Account

This plan is not eligible to be paired with a Health Savings Account.

Related Documents

For this plan's most-used benefits, see theSummary of Benefits (PDF)

For even more details about this plan, see the Certificate of Coverage (PDF) Certificates are legal documents that describe the benefits of a health insurance plan. Your plan might have different benefits and limitations than those listed in this document.

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Overview

Monthly Premiums

To give you an accurate price, we'll need some information. Find a plan to get a quote.

Deductible

If you have a family plan, and one member meets the individual deductible, Blue Cross will start paying covered benefits for that member only. The remainder of the family deductible has to be met by the remaining family members before Blue Cross will start paying covered benefits for the rest of the members on the plan.

In network

Individual:$8,150
Family:$16,300

Out of network

Individual:$16,300
Family:$32,600

Coinsurance

In network

You pay 0%.

Out of network

You pay 0%.

Out-of-pocket maximum

If you have a family plan, and one member meets the individual out-of-pocket maximum, Blue Cross will start paying 100% of the approved amount for covered benefits for that member only. The remainder of the family out-of-pocket maximum has to be met by the remaining family members before Blue Cross will start paying 100% of the approved amount for covered benefits for the rest of the members on the plan.

In network

Individual:$8,150
Family:$16,300

Out of network

Individual:$16,300
Family:$32,600

Office Visits

Primary Care

You pay $30 for the first three visits.

Specialist

You pay $0 after deductible.

Urgent care center

You pay $0 after deductible.

Emergency Room

You pay $0 after in-network deductible.

Prescriptions

You pay $0 after you meet your deductible.

Dental

This plan doesn't include dental coverage. To view our Dental plans please click.

Vision

This plan only includes vision coverage for children. To view our Vision plans please click.

Notes

Depending on the health care services you need, your provider might have to get approval before providing that service. Use our website to find more information and a list of services that need approval.

Estimated pricing information for various procedures by in-network providers can be obtained by calling the Customer Service number listed on the back of your BCBSM ID card and providing the procedure code. Your provider can also provide this information upon request.