The 2018 Best Blue Cross Medicare Plans in Michigan

Blue Cross Blue Shield is certainly not the only Medicare provider in Michigan but it is one of the largest. This post compares the different Blue Cross Medicare Advantage plans available to us here in Michigan. All information is pulled from the BCBS website and you can compare different plans there. For a primer in healthcare in retirement and your different Medicare options please check out  Healthcare in Retirement.

HMO Plans

HMO plans are typically the least expensive plans but also the most limited. The biggest negative of an HMO is that if you need medical help outside of your local network of doctors, you are typically not covered and costs can really add up. Also, HMO plans have a primary care physician which all care must be coordinated.  For example, if you have a hurt knee, you wouldn’t go straight to a knee specialist, rather the primary care physician.  This physician could then refer you to the specialist if he thinks it is necessary.  The benefit of the HMO is that if you don’t travel a lot and only visit local doctors in your network, the costs can stay very low.

BCN Advantage HMO HealthyValue BCN Advantage HMO HealthySaver BCN Advantage HMO ConnectedCare BCN Advantage HMO MyChoice Wellness
Network Size Small Small Small Small
Plan Availability 15 counties 15 counties 11 Counties Kent, Muskegon, Oceana, and Ottawa Counties
Medical Deductible $300 $0 $0 $0
Pharmacy Deductible Tier 1 & 2 Generic

$0

All Other Drugs

$250

Tier 1 & 2 Generic

$0

All Other Drugs

$100

$0 $0
Out-of-Pocket Maximum In-network: $4,700 In-network: $4,500 In-network: $3,800 In-network: $3,800
Office Visit Copay $10 $5 $0 $0
Specialist Visit CoPay $50 after deductible $50 after deductible $45 $45
Pharmacy Starts at $2 through preferred network Starts at $2 through preferred network Starts at $1 through preferred network Starts at $1 through preferred network
Dental Yes Yes Yes Yes
Vision Yes Yes Yes Yes
Hearing Yes Yes Yes Yes

HMO – POS Plans

HMO-POS plans are actually more like a PPO than an HMO. The POS stands for point of service, and it addresses the main drawback of an HMO, which is that you are limited to doctors in your network.  The BCBS HMO-POS plans allow you to get additional routine coverage outside of your local network.  For example, if you are going to spend the winter in Florida, you could work with a pre-approved doctor in Florida, while you are away from Michigan.  Still, like traditional HMO plans, you still must work through your primary care physician.  

BCN Advantage HMO-POS Basic BCN Advantage HMO-POS Elements BCN Advantage HMO-POS Classic BCN Advantage HMO-POS Prestige
Network Size Medium Medium Medium Medium
Plan Availability 69 counties 69 counties 69 counties 69 counties
Medical Deductible In-network: $405

Point of Service: $200

In-network: $160

Point of Service: $200

In-network: $125

Point of Service: $200

In-network: $0

Point of Service: $200

Pharmacy Deductible Tier 1 Generic:

$0

All Other Drugs:

$395

This plan doesn’t cover prescription drugs $0 $0
Out-of-Pocket Maximum In-network: $4,700 In-network: $4,500 In-network: $3,800 In-network: $3,800
Office Visit Copay $25 after deductible $20 after deductible $15 after deductible $10
Specialist Visit CoPay $50 after deductible $40 after deductible $35 after deductible $30
Pharmacy Starts at $3 through preferred network N/A Starts at $1 through preferred network Starts at $1 through preferred network
Dental Yes Yes Yes Yes
Vision Yes Yes Yes Yes
Hearing Yes Yes Yes Yes

PPO Plans

PPO plans are the most robust Medicare Advantage insurance you can purchase, but it also carries the highest monthly premium. PPO plans cover you, no matter where or which doctor you get medical assistance. If you travel frequently, or maybe a snowbird, you may want to spend the extra money and get the PPO plan so that you are completely insured. You are still incentivized to stay in your local network, but you are covered if you are out of network.

Medicare Plus Blue PPO Essential Medicare Plus Blue PPO Vitality Medicare Plus Blue PPO Signature Medicare Plus Blue PPO Assure
Network Size Large Large Large Large
Plan Availability All Michigan Counties All Michigan Counties All Michigan Counties All Michigan Counties
Medical Deductible $160 combined in and out of network $100 combined in and out of network In-network: $0

Out-of-network: $750

In-network: $0

Out-of-network: $250

Pharmacy Deductible Tier 1 Generic:

$0

All Other Drugs:

$405

Tier 1 Generic:

$0

All Other Drugs:

$405

Tier 1 Generic:

$0

All Other Drugs:

$105

$0
Out-of-Pocket Maximum In-network: $6,400

Combined in and out of network: $8,100

In-network: $5,400

Combined in and out of network: $7,100

In-network: $4,700

Combined in and out of network: $6,500

In-network: $4,000

Combined in and out of network: $6,000

Office Visit Copay $25 after deductible $20 after deductible $15 $10
Specialist Visit CoPay $50 after deductible $50 after deductible $50 $30
Pharmacy Starts at $3 through preferred network Starts at $2 through preferred network Starts at $1 through preferred network Starts at $1 through preferred network
Dental No Yes Yes Yes
Vision Yes Yes Yes Yes
Hearing Yes Yes Yes Yes

Pricing

It should come as no surprise that the more coverage and greater network and doctor choices results in higher premiums.  Of course, the trade off for the higher monthly premium is more robust coverage but the higher monthly premium isn’t for everyone.  If you are healthy and comfortable visiting only local doctors and working through a primary care physician, an HMO plan may actually be the best option for you.  Here are example of the pricing for certain cities here in Michigan.  Where N/A is shown, that plan is not available in that city or county. Remember, these premiums are on top of the Medicare Part B monthly premium, which is $134 for most people in 2018.  

HMO Plans 

City County BCN Advantage HMO HealthyValue BCN Advantage HMO HealthySaver BCN Advantage HMO ConnectedCare BCN Advantage HMO MyChoice Wellness
Troy Oakland $0 $23 $56 N/A
Detroit Wayne $0 $23 $56 N/A
Ann Arbor Washtenaw $0 $23 $56 N/A
Brighton Livingston $0 $23 $56 N/A
Grand Rapids Kent $0 $13 N/A $30
Kalamazoo Kalamazoo $0 $23 $56 N/A
Lansing Ingham N/A N/A N/A N/A
Traverse City Grand Traverse N/A N/A N/A N/A
Flint Genesee $0 $23 $56 N/A

HMO – POS Plans 

City County BCN Advantage HMO-POS Basic BCN Advantage HMO-POS Elements BCN Advantage HMO-POS Classic BCN Advantage HMO-POS Prestige
Troy Oakland $0 $69 $164 $301.50
Detroit Wayne $0 $69 $164 $301.50
Ann Arbor Washtenaw $0 $69 $164 $301.50
Brighton Livingston $0 $40 $137 $278.50
Grand Rapids Kent $0 $20 $113 $200
Kalamazoo Kalamazoo $0 $20 $113 $200
Lansing Ingham $0 $58 $145 $306.50
Traverse City Grand Traverse $0 $40 $137 $278.50
Flint Genesee $0 $40 $137 $278.50

PPO Plans

City County Medicare Plus Blue PPO Essential Medicare Plus Blue PPO Vitality Medicare Plus Blue PPO Signature Medicare Plus Blue PPO Assure
Troy Oakland $24 $109.50 $172.50 $312.50
Detroit Wayne $24 $109.50 $172.50 $312.50
Ann Arbor Washtenaw $24 $109.50 $172.50 $312.50
Brighton Livingston $29 $84 $179.50 $262.50
Grand Rapids Kent $29 $84 $179.50 $262.50
Kalamazoo Kalamazoo $19.50 $44 $129.50 $209.50
Lansing Ingham $24 $86 $179.50 $269.50
Traverse City Grand Traverse $29 $84 $179.50 $262.50
Flint Genesee $29 $84 $179.50 $262.50

One of the hardest parts in selecting a Medicare Advantage plan, is the shear amount of choices available.  If you think this is a lot of choices, this is just from one company.  There are going to be many companies and many different plans available in your area.  https://www.medicare.gov/ is the best place to explore all of the plans available in your zip code.  Here are my choices for the best BCBS plans given different conditions, but you may find a different plan or even a different company is a better choice for yourself.  

Healthy

If you are relatively healthy and don’t travel somewhere for the winter (or summer) I would strongly suggest a basic HMO plan. The BCN Advantage HMO ConnectedCare has a modest monthly premium, low or no copays, and a low out of pocket max of only $3,800. Also, you have basic dental, vision, and hearing care and for an additional fee you can purchase additional coverage in these areas. Not a bad deal for less than $60 per month where available.  

Snowbird

If you spend a lot of time outside of Michigan or even if you spend time in a cottage in Michigan which may be outside of the normal BCBS network, you probably want a PPO or HMO-POS plan. The best bang for the buck appears to be Medicare Plus Blue PPO Vitality. You will pay around $100 per month but will be covered both in and out of network, helping avoid huge medical bills. This plan is not too different than the BCN Advantage HMO ConnectedCare which was mentioned above.  You are paying an extra $40 per month with the PPO Vitality plan compared the ConnectedCare HMO in order to get out of network coverage, as well as extra dental, vision, and hearing coverage.  

Poor Health

I don’t see a scenario in which you I would recommend buying the most expensive PPO or HMO-POS plan. You are paying well over $200 and in some cases $300 for these plans. I would suggest instead purchasing a Medigap F policy in this instance, which covers all medical costs at any doctor in the country. Typically these plans will cost less than $200 per month and will be more robust than even the best BCBS plan. The negative of the Medigap policy is that you will need to purchase a drug plan and dental, vision, or hearing are covered. Still I think you can purchase all of these separately and get a better deal than the top end BCBS policies.

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