BCBS Michigan

Your Medical Coverage

Explore your Blue Cross Blue Shield medical plan options, find care, and access plan resources.

Benefits at a Glance

BlueCross BlueShield of Michigan Plans Both the PPO Medical Plan and High-Deductible Health Plan (HDHP) allow plan members to choose their own physicians, including specialists, without a referral.

The amount you will pay for healthcare services will be determined by whether the provider you see is an in-network provider or an out-of-network provider. You will get the greatest value by finding an in-network provider.

Services	PPO (In-Network)	HDHP (In-Network)
Individual Calendar Year deductible	$1,000	$3,500
Family Calendar Year deductible	$2,000	$7,000
Coinsurance (plan pays)	20% after deductible	20% after deductible
Individual Out-of-Pocket Maximum	$6,350	$6,350
Family Out-of-Pocket Maximum	$12,700	$12,700
Pharmacy Benefits (Retail)	PPO (In-Network)	HDHP (In-Network)
Generic	$15 Copay	$15 Deductible/Copay
Preferred Brand	$50 Copay	$50 Deductible/Copay
Non-Preferred Brand	$100 Copay	$100 Deductible/Copay
Specialty	Retail Copays Apply	Retail Deductible/Copays Apply
Pharmacy Benefits (Mail Order)	PPO (In-Network)	HDHP (In-Network)
Generic	$30 Copay	$30 Deductible/Copay
Preferred Brand	$100 Copay	$100 Deductible/Copay
Non-Preferred Brand	$200 Copay	$200 Deductible/Copay
Specialty	Retail Copay Apply	Retail Deductible/Copays Apply

Medical Rates

	PPO	HDHP
Employee Only	$173.40	$136.61
Employee + 1	$552.32	$404.98
Employee + 2 or more	$690.41	$506.23

Plan Documents

Resources

• Online Account Access
• Member Handbook
• Virtual Care Options
• Plan Certificate