- Vaccinations, annual visit, wellness visits for kids
- 24/7 medical virtual visits through selected vendor app (medical urgent care visits)
- Diabetes test strips, lancets and connected devices with diabetes, pre-diabetes and hypertension management programs
- Maternity and menopause programs
- App - access to cost and transparency tools
- Mental health coaching self-guided content in the Teladoc app
- Primary Care, Outpatient Behavioral Health, Urgent care, Laboratory Services and Tier 1 Prescription Drugs
- Gyms (access to over 20,000 gyms)
- Blue365 on vitamins, food, retailers etc.
This is a Silver 73 plan. That means it covers about 73 percent of your health care costs. Depending on your income, you may be eligible for a silver plan that covers more of your costs. Find a plan to see if you qualify.
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.
- Vaccinations, annual visit, wellness visits for kids
- 24/7 medical virtual visits through selected vendor app (medical urgent care visits)
- Diabetes test strips, lancets and connected devices with diabetes, pre-diabetes and hypertension management programs
- Maternity and menopause programs
- App - access to cost and transparency tools
- Mental health coaching self-guided content in the Teladoc app
- Primary Care, Outpatient Behavioral Health, Urgent care, Laboratory Services and Tier 1 Prescription Drugs
- Gyms (access to over 20,000 gyms)
- Blue365 on vitamins, food, retailers etc.
This is a Silver 73 plan. That means it covers about 73 percent of your health care costs. Depending on your income, you may be eligible for a silver plan that covers more of your costs. Find a plan to see if you qualify.
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.
Open enrollment is coming soon
Enroll from Nov. 1, 2026, to Jan. 15, 2027, for coverage in 2027.
Plan details
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.
Any coupon, rebate or other credits received directly or indirectly from an assistance program or the drug manufacturer may not be applied to a consumer's deductible, cost-sharing or out of pocket maximum.
Individual: $4,500
Family: $9,000
Individual: $9,000
Family: $18,000
You pay 40% after deductible for most services.
You pay 50% after deductible for bariatric, temporomandibular joint, infertility, prosthetic and orthotic, and durable medical equipment services.
You pay 60% after deductible for most services.
You pay 70% after deductible for bariatric, temporomandibular joint, infertility, prosthetic and orthotic, and durable medical equipment services.
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.
Any coupon, rebate or other credits received directly or indirectly from an assistance program or the drug manufacturer may not be applied to a consumer's deductible, cost-sharing or out of pocket maximum.
Individual: $7,100
Family: $14,200
Individual: $14,200
Family: $28,400
When you go to a doctor or hospital that accepts this plan, that's called getting your care in network. Look for doctors and hospitals that take this plan.
Because this plan is a PPO, you're covered when you go to a doctor or hospital that doesn't take this plan, but you'll pay more. That's called getting your care out of network.
If you have an emergency or accidental injury outside of Michigan, your care is covered with in-network cost sharing. Any scheduled services you receive outside of Michigan have out-of-network cost sharing.
Online visits and prescription drugs have nationwide coverage with in-network cost-sharing.
You pay $0 before deductible.
You pay 60% after deductible.
Primary care: You pay $60 before deductible including virtual and retail health visits and medical evaluations at an affiliated immunization pharmacy.
Specialist: You pay $110 after deductible.
You pay 60% after deductible.
You pay $0 before deductible for 24/7 medical virtual visits through selected vendor app.
You pay $60 before deductible for mental health virtual visits through selected vendor app.
You pay $60 before deductible for virtual primary care visits through selected vendor app nationwide.
You pay 60% after deductible.
Laboratory services
You pay $30 before deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay $75 before deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay $60 before deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay $60 before deductible.
You pay 60% after deductible.
You pay $60 before deductible.
You pay 60% after deductible.
Quantity limits per fill may apply for 30-day retail, 90-day retail and 90-day mail order. Opioid-containing medications are limited to no more than a 30-day supply per fill and first fills of select opioid containing medications will be limited to a five-day-supply. Refer to drug list for quantity limits and other exclusions.
Any coupon, rebate or other credits received directly or indirectly from an assistance program or the drug manufacturer may not be applied to a consumer's deductible, cost-sharing or out of pocket maximum.
Out-of-network drugs are limited to a 30-day supply. Mail order is not available.
60-day supply (mail order only): You pay $0 before deductible.
90-day supply: You pay $0 before deductible.
This tier includes mostly non-specialty generic drugs and select non-specialty brand-name drugs and select specialty generic drugs.
60-day supply (mail order only): You pay up to $200 after deductible.
90-day supply: You pay up to $300 after deductible.
This tier includes mostly non-specialty brand-name drugs and select specialty brand-name drugs.
60-day supply (mail order only): You pay up to $300 after deductible.
90-day supply: You pay up to $450 after deductible.
This tier includes mostly non-specialty brand-name drugs and select high cost nonpreferred generic drugs for which there’s more cost-effective, generic alternatives or preferred brand-name drugs available.
You pay 45% after deductible. Specialty drugs are limited to a 30-day supply. Some specialty drugs are limited to a 15-day supply.
This tier includes mostly specialty drugs that are used to treat difficult health conditions. It also includes select high cost non-specialty generic and brand-name drugs. They usually need special handling and approval. You'll need to use Walgreens Specialty Pharmacy to fill these types of prescriptions.
You pay 50% after deductible. Specialty drugs are limited to a 30-day supply. Some specialty drugs are limited to a 15-day supply.
This tier includes mostly high cost specialty brand-name drugs that are used to treat difficult health conditions. It also includes very high cost non-specialty generic and brand-name drugs. You'll need to use Walgreens Specialty Pharmacy to fill these types of prescriptions.
- Weight management programs, organic groceries and fresh produce.
- Yoga classes, workout gear and gym memberships.
- Discounted admission to Michigan attractions.
- Call our 24-Hour Nurse Line and speak to a registered nurse.
- View our weekly Virtual Well-BeingSM webinars. Topics include mindfulness, finances, emotional health and more.
- Use our online well-being tools and resources through Blue Cross Well-Being.
- Take part in our Tobacco Coaching program.®.
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.
Any coupon, rebate or other credits received directly or indirectly from an assistance program or the drug manufacturer may not be applied to a consumer's deductible, cost-sharing or out of pocket maximum.
Individual: $4,500
Family: $9,000
Individual: $9,000
Family: $18,000
You pay 40% after deductible for most services.
You pay 50% after deductible for bariatric, temporomandibular joint, infertility, prosthetic and orthotic, and durable medical equipment services.
You pay 60% after deductible for most services.
You pay 70% after deductible for bariatric, temporomandibular joint, infertility, prosthetic and orthotic, and durable medical equipment services.
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.
Any coupon, rebate or other credits received directly or indirectly from an assistance program or the drug manufacturer may not be applied to a consumer's deductible, cost-sharing or out of pocket maximum.
Individual: $7,100
Family: $14,200
Individual: $14,200
Family: $28,400
When you go to a doctor or hospital that accepts this plan, that's called getting your care in network. Look for doctors and hospitals that take this plan.
Because this plan is a PPO, you're covered when you go to a doctor or hospital that doesn't take this plan, but you'll pay more. That's called getting your care out of network.
If you have an emergency or accidental injury outside of Michigan, your care is covered with in-network cost sharing. Any scheduled services you receive outside of Michigan have out-of-network cost sharing.
Online visits and prescription drugs have nationwide coverage with in-network cost-sharing.
You pay $0 before deductible.
You pay 60% after deductible.
Primary care: You pay $60 before deductible including virtual and retail health visits and medical evaluations at an affiliated immunization pharmacy.
Specialist: You pay $110 after deductible.
You pay 60% after deductible.
You pay $0 before deductible for 24/7 medical virtual visits through selected vendor app.
You pay $60 before deductible for mental health virtual visits through selected vendor app.
You pay $60 before deductible for virtual primary care visits through selected vendor app nationwide.
You pay 60% after deductible.
Laboratory services
You pay $30 before deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay $75 before deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay $60 before deductible.
You pay 60% after deductible.
You pay 40% after deductible.
You pay 60% after deductible.
You pay $60 before deductible.
You pay 60% after deductible.
You pay $60 before deductible.
You pay 60% after deductible.
Quantity limits per fill may apply for 30-day retail, 90-day retail and 90-day mail order. Opioid-containing medications are limited to no more than a 30-day supply per fill and first fills of select opioid containing medications will be limited to a five-day-supply. Refer to drug list for quantity limits and other exclusions.
Any coupon, rebate or other credits received directly or indirectly from an assistance program or the drug manufacturer may not be applied to a consumer's deductible, cost-sharing or out of pocket maximum.
Out-of-network drugs are limited to a 30-day supply. Mail order is not available.
60-day supply (mail order only): You pay $0 before deductible.
90-day supply: You pay $0 before deductible.
This tier includes mostly non-specialty generic drugs and select non-specialty brand-name drugs and select specialty generic drugs.
60-day supply (mail order only): You pay up to $200 after deductible.
90-day supply: You pay up to $300 after deductible.
This tier includes mostly non-specialty brand-name drugs and select specialty brand-name drugs.
60-day supply (mail order only): You pay up to $300 after deductible.
90-day supply: You pay up to $450 after deductible.
This tier includes mostly non-specialty brand-name drugs and select high cost nonpreferred generic drugs for which there’s more cost-effective, generic alternatives or preferred brand-name drugs available.
You pay 45% after deductible. Specialty drugs are limited to a 30-day supply. Some specialty drugs are limited to a 15-day supply.
This tier includes mostly specialty drugs that are used to treat difficult health conditions. It also includes select high cost non-specialty generic and brand-name drugs. They usually need special handling and approval. You'll need to use Walgreens Specialty Pharmacy to fill these types of prescriptions.
You pay 50% after deductible. Specialty drugs are limited to a 30-day supply. Some specialty drugs are limited to a 15-day supply.
This tier includes mostly high cost specialty brand-name drugs that are used to treat difficult health conditions. It also includes very high cost non-specialty generic and brand-name drugs. You'll need to use Walgreens Specialty Pharmacy to fill these types of prescriptions.
- Weight management programs, organic groceries and fresh produce.
- Yoga classes, workout gear and gym memberships.
- Discounted admission to Michigan attractions.
- Call our 24-Hour Nurse Line and speak to a registered nurse.
- View our weekly Virtual Well-BeingSM webinars. Topics include mindfulness, finances, emotional health and more.
- Use our online well-being tools and resources through Blue Cross Well-Being.
- Take part in our Tobacco Coaching program.®.
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.
Conditions covered by workers’ compensation or similar law; services or supplies not specifically listed as covered under your benefit plan; services received before your effective date or after coverage ends; services you wouldn’t have to pay for if you did not have this coverage; services or supplies that are not medically necessary; physical exams for insurance, employment, sports or school; any amounts in excess of BCBSM’s approved amount; cosmetic surgery, admissions and hospitalizations; dental care, dental implants or treatment to the teeth except as specifically stated in your benefit plan; hearing aids; infertility-related drugs; private duty nursing; telephone, fax machine or any other type of electronic consultation; educational services, except as specifically provided or arranged by BCBSM or specifically stated in your benefit plan; care or treatment furnished in a nonparticipating hospital, except as specifically stated in your benefit plan; personal comfort items; custodial care; services or supplies supplied to any person not covered under your benefit plan; services while confined in a hospital or other facility owned or operated by state or federal government, unless required by law; voluntary abortions or vasectomy reversals; RK, PRRK, or Lasik; services provided by a professional provider to a family member; services provided by any person who ordinarily resides in the covered person’s home or who is a family member; any drug, medicine or device that is not approved by the Food and Drug Administration, unless required by law; vitamins, dietary products and any other nonprescription supplements except as specifically stated in your benefit plan; dental services, except for dental injury; appliances, supplies or services as a result of war or any act of war, whether declared or not; communication or travel time, lodging or transportation, except as stated in your benefit plan; foot care services, except as stated in your benefit plan; health clubs or health spas, aerobic and strength conditioning, work-hardening programs and related material and products for these programs; hair prosthesis, hair transplants or implants; experimental treatments, except as stated in your benefit plan; and alternative medicines or therapies.
This document is intended to be an easy-to-read summary. It is not a contract. Additional limitations and exclusions may apply to covered services. A complete description of benefits is contained in the applicable Blue Cross Blue Shield of Michigan certificate and riders. In the event of a conflict between this document and the applicable certificate and riders, the certificate and riders will rule. Payment amounts are based on the BCBSM-approved amount, less any applicable deductible, copay and/or coinsurance amounts required by the plan. This coverage is provided pursuant to a contract entered into in the state of Michigan and shall be construed under the jurisdiction and according to the laws of the state of Michigan.
Actions
Print your plan details or save them as a PDF.
Health plan advisors
Call us at 1-855-237-3501 for help choosing the right plan
Have questions? Our Health Plan Advisors are ready to help. TTY users call 711.