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2020 Medicare Plus BlueSM PPO Vitality

Medicare Advantage plan

Is this plan for you?
  • If you go to the pharmacy a lot and you want the freedom to choose any doctor or hospital that accepts Medicare, this plan might be right for you.
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This plan costs $0.00 per month in County.

(Change ZIP code.)

About this plan

With this plan, you'll get the flexibility of a PPO network at an affordable cost. You'll pay a little more each month, but you're get the freedom to choose from the largest doctor network in Michigan. Plan benefits include:

  • Coverage beyond Original Medicare
  • Part D prescription drug coverage
  • Routine dental and vision care
  • Blue Cross Online VisitsSM
  • Nationwide access to SilverSneakers® fitness

 

Plan highlights

Here's what sets this plan apart:

  • $0 medical deductible
  • $100 prescription drug deductible
  • $10 copay for primary care office visits
  • $25 quarterly allowance for over-the-counter items

Availability

You can enroll in this plan if you live anywhere in Michigan at least six months of the year. Use these tools to make sure this plan accepts your doctor and pharmacy and is available in your area.

Related documents

Learn more about the important features and rules for this plan.

Summary of Benefits (PDF)

 

This booklet explains how to use this plan's benefits. It also lists some of the things this plan doesn't cover.

Evidence of Coverage (PDF)

 

Medicare rates plans based on quality and performance every year. Called Medicare Star Ratings, these documents show you how well a plan is performing. 

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Check out your coverage options to find the plan that’s right for you.


More plan details

Learn more about the benefits of this plan so you can tell if it fits your needs.

Overview

Deductible

Medical

In network services: $0
Out-of-network services: $65

Pharmacy

Most generic drugs: $0
All other drugs: $100

Out-of-pocket maximum

In-network services: $5,000

Combined in- and out-of-network services: $7,100

Optional supplemental benefits don't count toward your out-of-pocket maximum.

Office visits

Primary care physician

You pay $10.

Specialist

You pay $40.

Urgent care

You pay $50.

Pharmacy

Copays start at $0 for certain generic drugs filled at a preferred network pharmacy.

You'll need to meet your $100 pharmacy deductible for drugs on tiers 2-5. Some drugs may cost more if you choose a pharmacy in our standard network.

Find your pharmacy.

Drug list

See if this plan covers your medication. Find your prescription (PDF).

You get more than Original Medicare

All benefits required by Original Medicare and more, including:

• A quarterly allowance for free over-the-counter drugs and health products
• Blue Cross Online VisitsSM
• Part D prescription drug coverage
• Coverage while traveling outside of Michigan with the BlueCard® program (PDF).
• SilverSneakers® fitness program
• Lasik and radial keratotomy for a $40 copay in network.

 

 

Looking for extra dental and vision coverage?

You can add an optional supplemental package to your Medicare Advantage plan for an extra monthly cost.
This package will enhance your dental and vision benefits. It offers:

  • Extra coverage for dental work including fillings, fluoride treatments and root canals
  • A generous allowance for elective contact lenses or glasses (lenses and frames)

You can add a coverage package when you enroll in your plan.
Learn more by reading the Optional Supplemental Brochure (PDF)

 

 

You may also be interested in

Medicare Plus BlueSM PPO Signature

This is one of our more affordable PPO plans. It has no in-network medical deductible, low doctor copays and the largest network of doctors and hospitals in Michigan.

BCN Advantage HMO-POS Classic

This HMO plan offers a high level of coverage that travels with you. This plan costs about $100 less per month than our most expensive HMO plan

Medicare Plus BlueSM PPO Essential

This is one of our more affordable PPO plans. It offers strong benefits, covers prescription drugs and has a wide network of doctors.

 

Still have questions? We have answers.

Use our Frequently Asked Questions to learn which plan will fit your needs.