2026 Medicare Plus BlueSM PPO Vitality

This Blue Cross Blue Shield of Michigan plan offers great coverage at an affordable price. You'll pay less for office visits, have a lower out-of-pocket maximum and access to doctors without a referral.

Plan highlights

 

  • Offers dental care annual maximum 
  • Hearing aid coverage through the TruHearing® network
  • $0 in-network primary care office visits
  • Coverage while traveling outside of Michigan
  • Free access to qualified gyms nationwide through SilverSneakers®

NETWORK SIZE

Network Size

MONTHLY PREMIUM

$

Medical deductible

$0

Availability

You can enroll in this plan if you live anywhere in Michigan at least six months of the year. Learn more by viewing our map.

View map (PDF)

Use these tools to make sure this plan accepts your doctor and pharmacy and is available in your area.

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Plan documents

Summary of Benefits (PDF)

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

Evidence of Coverage (PDF)

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

Blue Cross Blue Shield of Michigan Star Rating for 2026 (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. For 2025, Blue Cross PPO received 4 1/2 out of 5 stars.

Medicare Plan Comparison Guide (PDF)

This brochure gives you an overview of all our Medicare plans to help you compare.

Plan star rating

Medicare rates plans based on quality and performance every year. This is called Medicare Star Ratings and shows you how well a plan is performing. For 2025, Blue Cross PPO received 4 1/2 out of 5 stars.

Monthly premium

You'll need to give us your ZIP code to get an accurate price for this plan.

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This is the amount you'll pay each month in addition to your Medicare Part B premium.

Plan details

Deductible
Medical

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

Pharmacy

$0

Out-of-pocket maximum

In-network services: $5,000

Combined in- and out-of-network services: $6,700

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

Office visits
Primary care physician

You pay $0.

Specialist

You pay $30.

Urgent care

You pay $0-$50.

Pharmacy

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

  • $0 telehealth visits for primary care and behavioral health
  • Advantage Dollars quarterly allowance of $50 for over-the-counter drugs, food and produce (for qualified members) and health products
  • Worldwide emergency, urgent care and emergency transportation coverage
  • Meals benefit following hospital discharge for qualifying members
  • SilverSneakers® fitness program
  • Coverage for ambulance services not requiring transportation
  • Mobile crisis and crisis stabilization for behavioral health
  • Coverage while traveling outside of Michigan with the nationwide network of Blue Plan Providers (PDF).

Overview
Deductible
Medical

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

Pharmacy

$0

Out-of-pocket maximum

In-network services: $5,000

Combined in- and out-of-network services: $6,700

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

Office visits
Primary care physician

You pay $0.

Specialist

You pay $30.

Urgent care

You pay $0-$50.

Pharmacy

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

  • $0 telehealth visits for primary care and behavioral health
  • Advantage Dollars quarterly allowance of $50 for over-the-counter drugs, food and produce (for qualified members) and health products
  • Worldwide emergency, urgent care and emergency transportation coverage
  • Meals benefit following hospital discharge for qualifying members
  • SilverSneakers® fitness program
  • Coverage for ambulance services not requiring transportation
  • Mobile crisis and crisis stabilization for behavioral health
  • Coverage while traveling outside of Michigan with the nationwide network of Blue Plan Providers (PDF).
A woman and a child, each with glasses, smile as they look up from a book they're reading together.

Enhance your dental and vision coverage

You can add an optional supplemental package to your Medicare Advantage plan for an additional monthly cost. It offers:

  • Extra coverage for dental work including dentures, bridges and implants.
  • A generous allowance for elective contact lenses or glasses (lenses and frames). Polycarbonate lenses and anti reflective coating are covered in network.

Upgrade your coverage

Ready to enroll?

Discover why we're the No. 1 choice for Medicare plans in Michigan.

Enroll now

To get help choosing a plan, call 1-866-875-1375. TTY users dial 711.

Frequently asked questions

There are four parts of Medicare. Each one helps pay for different health care costs.

Parts A and B

This is what's called Original Medicare. It helps pay for hospital and facility costs, including hospice care and home health care. It also helps pay for medical costs outside a hospital, including doctor visits and preventive care.

Part C

This is called Medicare Advantage. It covers everything Original Medicare does, but it also puts a limit on your out-of-pocket costs. Some of these plans also cover preventive dental, vision and hearing costs. They're only available through private health insurance companies, like Blue Cross.

Part D

This plan type helps pay for prescription drugs. It covers commonly used brand-name and generic drugs. Some plans cover more drugs than others. These plans are also only available through private health insurance companies.

These terms all describe money you pay toward health care when you have a health insurance plan.

Copays and coinsurance

A copay is a fixed amount of money you pay for a certain service. Your health insurance plan pays the rest of the cost.

Coinsurance refers to percentages.

Our Medicare Advantage plans use copays for most services. You pay 20 percent coinsurance for most services with Original Medicare. 

Deductible

A deductible is the amount of money you pay for care before your plan starts paying. For most services, you'll pay the full cost until you reach the deductible. After you reach your deductible, you’ll still have to pay any copays or coinsurance.

Most Medicare Advantage plans have separate medical and pharmacy deductibles. Original Medicare has its own deductibles, but if you have a Medicare Advantage plan, you don't have to worry about them. We pay the Original Medicare deductibles for you.

How they all work together

When you have a Blue Cross plan, we track all the costs you pay – deductible, copays and coinsurance. When you reach a certain amount, we pay for most covered services. This is called the out-of-pocket maximum.

Original Medicare doesn’t have an out-of-pocket maximum. There's no cap on what you pay out of pocket. And if you're in the hospital or a skilled nursing facility, Original Medicare only pays for a certain number of days. After that point, you pay the full amount each day.

These acronyms all signify different health plan types:

  • PPO stands for preferred provider organization.
  • HMO stands for health maintenance organization.
  • POS stands for point of service.

PPO plans

PPO plans have more flexibility than HMO plans. You don’t need a primary care physician. You can see doctors inside or outside your network. But if you stay in your network, you’ll pay less.

If you want to be able to coordinate your own health care, a PPO plan might be right for you.

HMO plans

When you have an HMO plan, you choose a primary care physician who works as your partner. They coordinate all your care and can refer you to trusted doctors and specialists in your network. It's important to note that, with an HMO plan, most health care isn't covered outside your network. 

If you want low monthly premiums and copays and you don’t travel much, an HMO plan might be right for you.

HMO-POS plans

HMO-POS plans work a lot like HMO plans. The main difference is that you can see doctors outside your network in some cases. That's where the "POS," or "point of service," part comes in. With our HMO-POS plans, it means you can get routine health care when you travel nationwide.

If you do a lot of traveling within the U.S. and you want one doctor coordinating all your care, an HMO-POS plan might be right for you.

Explore other plan options

Medicare Plus Blue PPO Giveback

This affordable PPO plan puts $900 back into your Social Security check yearly.

Medicare Plus Blue PPO Signature

This PPO plan offers generous coverage at an affordable price, and there are no deductibles..

Medicare Plus Blue PPO Assure

This plan has a higher monthly premium but you'll pay less for out-of-pocket costs like office visits.

Need help choosing a Medicare plan?

Our experienced advisors and agents can help find the right Blue Cross plan for you.
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Information about SilverSneakers

SilverSneakers® is a registered trademark of Tivity Health, Inc.© 2025 Tivity Health, Inc. All rights reserved. Tivity Health is an independent corporation retained by Blue Cross Blue Shield of Michigan and Blue Care Network to provide health and fitness services to our members.

Information about TruHearing

TruHearing is an independent company contracted to provide hearing services on behalf of Blue Cross Blue Shield of Michigan and Blue Care Network.

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  • Page Last Updated Mon Oct 06 14:19:50 EDT 2025