UAW Trust: Medicare Plus BlueSM Group PPO

This is the Medicare Advantage PPO plan from Blue Cross Blue Shield of Michigan. It combines all the benefits of Medicare Part A and Part B plus extra benefits and services. This plan includes Medicare Part D prescription drug coverage. With this plan, you can get all of your medical and prescription drug services in one convenient member ID card.

Plan highlights
  • Available for UAW Trust members who qualify for Medicare and live in Alabama, Florida, Indiana, Michigan, Missouri or Tennessee
  • No monthly payments to the Trust — pay only your Medicare Part B premium
  • Prescription drug coverage is included

Eligibility

Medicare

PLAN TYPE

PPO

Availability

AL, FL, IN, MI, MO, TN

What this plan offers

  • A 24-hour nurse line access
  • SilverSneakers® gym membership included
  • In-Home Visit with a doctor, nurse practitioner or physician assistant through Signify Health® 
  • A personal advisor to help coordinate your care
  • Only one membership card and prescription card to carry
  • Manage your account 24/7 with the BCBSM app 

2024 Plan details

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

Monthly contribution

$0 per person

Deductible

$0 per person

Out-of-pocket maximum

$0 per person

PCP office visit copay

$0 per visit

$0

$490

0%

30% after deductible

0%

0%

$0

$1,395

$0

50% after deductible

$10

50% after deductible

$15

$15

$50

$50

$0

$0

Covered at participating SilverSneakers locations

Covered at participating SilverSneakers locations

$0 $490

0% 30% after deductible

0% 0%

$0 $1,395

$0 50% after deductible

$10 50% after deductible

$15 $15

$50 $50

$0 $0

Covered at participating SilverSneakers locations Covered at participating SilverSneakers locations

Plan documents for 2024

  • Benefit book (PDF)
    Download
  • Resource Guide (PDF)
    Download
  • Evidence of Coverage (PDF)
    Download
  • 2024 Member Presentation - General (PDF)
    Download
  • Comprehensive formulary (PDF)
    Download
  • Prior authorization and step therapy program (PDF)
    Download
  • Benefit book (PDF)
    Download
  • Resource Guide (PDF)
    Download
  • Evidence of Coverage (PDF)
    Download
  • 2024 Member Presentation - General (PDF)
    Download
  • Comprehensive formulary (PDF)
    Download
  • Prior authorization and step therapy program (PDF)
    Download
  • Benefit book (PDF)
    Download
  • Resource Guide (PDF)
    Download
  • Evidence of Coverage (PDF)
    Download
  • 2024 Member Presentation - Missouri and Tennessee - General (PDF)
    Download
  • Comprehensive formulary (PDF)
    Download
  • Prior authorization and step therapy program (PDF)
    Download

Plan documents for 2023

  • Benefit book (PDF)
    Download
  • Resource Guide (PDF)
    Download
  • Evidence of Coverage (PDF)
    Download
  • Comprehensive formulary (PDF)
    Download
  • Medical Drug and Step Therapy Prior Authorization List for Medicare Plus Blue and BCN Advantage members (PDF)
    Download
  • Explanation of benefits guide (PDF)
    Download
  • Prior authorization and step therapy program (PDF)
    Download

2023 Addendum

Find a Pharmacy

With Medicare Plus Blue Group you have access to thousands of network pharmacies nationwide. Our extensive network gives you the flexibility to fill your prescriptions close to your home or when you’re on the go. Plus, many retail pharmacies will fill a 90-day prescription.

Opt Out From Various Initiatives

If you don't wish to participate in campaigns/programs or no longer want to receive communications from Blue Cross Blue Shield of Michigan or their vendor partners; call 1-888-322-5616, have your membership ID available and indicate which campaigns you wish to opt of.

Need help?

Prospective enrollees
Call 1-877-396-1893
TTY users call 711
8:30 a.m. to 6 p.m.
Monday through Friday

Retiree Health Care Connect
Call 1-866-637-7555
TTY users call 711
8:30 a.m. to 4:30 p.m.
Monday through Friday

Current members
Call 1-800-222-5992
TTY users call 711
8 a.m. to 5:30 p.m.
Monday through Friday

Medicare Plus BlueSM and BCN AdvantageSM are PPO, HMO, and HMO-POS plans with Medicare contracts. Enrollment in Medicare Plus Blue and BCN Advantage depends on contract renewal.

With the exception of emergency or urgent care, it will cost more to get care from non-plan or non-preferred providers. You may receive services from any provider who accepts Original Medicare. Your out-of-pocket costs will be lower if you choose a network provider. To find a network provider, visit Find a Doctor.

Limitations, copayments and restrictions may apply. You must continue to pay your Medicare Part B premium. Consult your Evidence of Coverage for specific information about your benefits and cost-sharing responsibilities.

The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan's Customer Service center. Benefits, premium, copayments or coinsurance may change on Jan. 1 of each year.

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