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
Individual deductible
In network
$0
Out of network
$490
Coinsurance for Michigan, Alabama, Florida and Indiana residents
In network
0%
Out of network
30% after deductible
Coinsurance for Missouri and Tennessee residents
In network
0%
Out of network
0%
Individual out-of-pocket maximum
In network
$0
Out of network
$1,395
Primary care office visits
In network
$0
Out of network
50% after deductible
Specialist office visits
In network
$10
Out of network
50% after deductible
Urgent care copay
In network
$15
Out of network
$15
Emergency room copay
In network
$50
Out of network
$50
Tier 1 pharmacy copay and immunizations
In network
$0
Out of network
$0
SilverSneakers
In network
Covered at participating SilverSneakers locations
Out of network
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
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
-
Part B Addendum (PDF)Download
Find a Pharmacy
Helpful resources
Find a doctor
Use our online search tool to find a doctor or hospital who works with your plan. You can search by name, location, specialty and more. You can even read reviews from other patients.
Speak with a representative
Schedule a one-on-one appointment with one of our experienced representatives today.
Part D Drug Coverage
Starting in 2023, Medicare Plus Blue PPO will include Part D prescription drug coverage.
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.