Blue Care Network HMO Non-Medicare

This is a Blue Care Network HMO plan for State of Michigan retirees who are not eligible for Medicare.

Plan highlights
  • Choosing a primary care provider, or PCP, to coordinate your care means less paperwork and lower out-of-pocket costs
  • You need a referral from your PCP before seeing a specialist except in an emergency
  • Out-of-network services are usually not covered

In-network Individual Deductible

$125

In-network Family Deductible

$250

What this plan offers

  • In-network preventive services are 100% covered
  • Manage your account 24 hours a day, seven days a week with the BCBSM app

2024 plan details

See what's covered and how much you'll pay.

In-network deductible

$125 per individual, $250 per family

In-network out-of-pocket maximum

$2,000 per individual, $4,000 per family

PCP office visit copay

$20 per visit

$125

$250

$2,000

$4,000

None

$20 copay

$200 copay (waived if admitted as inpatient)

100% after deductible

$125

$250

$2,000

$4,000

None

$20 copay

$200 copay (waived if admitted as inpatient)

100% after deductible

Plan documents