State Health Plan PPO Non-Medicare

The State Health Plan PPO Non-Medicare health plan is a self-insured benefit plan administered by Blue Cross Blue Shield of Michigan under the direction of the Michigan Civil Service Commission.

Plan highlights
  • The flexibility to see specialists without a referral from a primary care provider
  • Staying inside the network means lower out-of-pocket costs 
  • Many services are covered outside of your network for higher out-of-pocket costs

In-network Individual Deductible

$400

In-network Family Deductible

$800

What this plan offers

• Retirees get access to our extensive PPO network as well as out-of-network doctors and hospitals

• Coverage is included for emergency room care and behavioral health services including substance use disorders

• Value-added services such as Blue Cross Coordinated Care, Blue Cross Health & Well-BeingSM and 24-Hour Nurse Line

• Manage your account 24 hours a day, seven days a week with the BCBSM app

2023 plan details

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

In-network deductible

$400 per individual, $800 per family

In-network out-of-pocket maximum

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

PCP office visit copay

$20 per visit

Individual deductible

In network

$400

Out of network

$800

Family deductible

In network

$800

Out of network

$1,600

Individual out-of-pocket maximum

In network

$2,000

Out of network

$3,000

Family out-of-pocket maximum

In network

$4,000

Out of network

$6,000

Coinsurance

In network

10% for most services

Out of network

20% for most services

Office and urgent care visits, medical eye exam, medical hearing exam, osteopathic, and chiropractic manipulation

In network

$20 copay

Out of network

80% after deductible

Emergency room

In network

$200 (waived if admitted as inpatient)

Out of network

$200 (waived if admitted as inpatient)

Hospital care

In network

90% after deductible

Out of network

80% after deductible

$400 $800

$800 $1,600

$2,000 $3,000

$4,000 $6,000

10% for most services 20% for most services

$20 copay 80% after deductible

$200 (waived if admitted as inpatient) $200 (waived if admitted as inpatient)

90% after deductible 80% after deductible

Plan documents