GradCare, an HMO with low out-of-pocket costs, is exclusively available to benefit-eligible graduate students, including Graduate Student Instructors (GSIs), Graduate Student Staff Assistants (GSSAs), Graduate Student Research Assistants (GSRAs), benefit-eligible fellowship holders, medical school students, and their eligible dependents. GradCare is administered by Blue Care Network (BCN). As with all U-M health plans, prescription drug coverage is included with enrollment.

To help you better understand your GradCare coverage, view the following two-minute video.

Not eligible for GradCare? U-M students enrolled in classes or between semesters (e.g., during spring/summer session) at the Ann Arbor, Dearborn or Flint campuses who are not eligible for GradCare may be eligible to enroll in the domestic student health insurance plan. 

Summary of Benefits

Level 1 Providers (On Campus)

• No annual deductible
• No out-of-pocket cost to you for preventive care
• $25 copay for office visit for injury or illness ($0 copay at University Health Service)
• $30 copay for specialist visit
• $25 copay for urgent care
• $100 copay for emergency care (waived if admitted)
• $25 copay for mental health, behavioral health or substance abuse services
• No out-of-pocket cost to you for inpatient services
• No out-of-pocket cost to you for outpatient surgery
• $3,000 individual/$6,000 family out-of-pocket maximum (Levels 1, 2, and 3 combined)

Level 2 Providers (Off-Site Academic Study or Field Placement)

Level 2 benefits are the same as Level 1, except inpatient services are only covered in case of medical emergency. Registration with BCN and prior authorization are required. Care must be medically necessary.

Level 3 Providers (Traveling or During Non-Working School Breaks)

Level 3 benefits are the same as Levels 1 and 2, except you are responsible for any charges above the BCN fee schedule. Prior authorization is required and care must be medically necessary.

For complete information on benefits and coverage, please refer to the plan documents.

Emergency Care

In a life-threatening emergency, visit any hospital and notify BCN as soon as possible, preferably within 48 hours. Elective hospitalizations and substance abuse care are not covered unless provided by GradCare network providers or approved by BCN in view of special circumstances.

Transgender Community

Like all U-M health plans, GradCare covers medically necessary gender-affirming services for members with gender dysphoria. The university’s coverage of gender-affirming services follows the health plan's medical policy, which incorporates standards of care defined by the World Professional Association for Transgender Health (WPATH) and other professional organizations. As standards change over time, the health plan may re-evaluate coverage and medical necessity criteria, as needed.

The Benefits Office has designated a specific staff member who is a member of the LGBT Ally Program, and is knowledgeable about and sensitive to the unique benefit-related issues that transgender members of our community may encounter. GradCare members with questions about benefit issues related to transgender status are encouraged to contact Brian Vasher at [email protected].

Coverage of Neurodevelopmental Disorders 

Grad Care covers evaluation and standard medical care for diagnosis and treatment for ADHD, ASD, and neurodevelopmental conditions. Coverage for ASD may include any or a combination of Applied Behavioral Analysis, PT/OT/ST, outpatient mental health therapy, skills training, genetic testing, nutritional therapy, and medications. Coverage for ADHD may include any or a combination of psychotherapy, cognitive behavioral therapy and medications. GradCare follows BCN medical policy for determining medical necessity. Treatments including medications vary depending on the diagnosis, severity of illness, and provider treating the condition. Some but not all treatments and medications require prior authorization. 

Hearing Services Coverage 

Effective Jan. 1, 2021, U-M’s hearing services benefits include a Hearing Services Value Network for GradCare and U-M Premier Care health plan members.

Coverage for hearing services has not changed. However, out-of-pocket costs may be less if you receive services from a provider in the Value Network for hearing services.

Providers in the Value Network have agreed to offer standard hearing aid options that will not result in out-of-pocket costs. Members may “buy up” to advanced or premium hearing aid options. The cost difference between what the provider charges for these buy-up options and the amount the plan pays for a standard hearing aid will be the member’s responsibility.

Value Network providers include Michigan Medicine Audiology Services and TruHearing providers.

Contact Michigan Medicine Audiology Services at (734) 936-8051 for more information or to locate a Michigan Medicine audiology provider, or view information online at Hearing Loss and Hearing Testing.

TruHearing has an extensive nationwide network of highly qualified hearing aid providers who offer affordable hearing aid options. Contact TruHearing at (844) 815-7195 to speak with a hearing consultant or to locate a TruHearing provider, or go to truhearing.com/choice.

Members will continue to have access to Blue Cross Network (BCN) hearing services providers who are not in the Value Network. However, members should keep in mind that they may have additional, out-of-pocket costs for services from these providers, even for a standard hearing aid.

Using the Plan

GradCare members must select a Primary Care Physician (PCP) from a network that includes Michigan Medicine, University Health Service, and all U-M Premier Care Network 1 providers. If you do not choose a PCP, BCN will assign one to you. You can change your PCP at any time by calling BCN Customer Service at (800) 658-8878.

When you enroll in GradCare you will receive an ID card from BCN. The card will show the U-M Premier Care logo on the right hand corner.

Coverage Levels and Rates

2025 Rates 

Spring and Summer Benefits Continuation for GSIs, GSSAs, and GSRAs

If you are a GEO member or a GSRA and were enrolled in benefits during the previous fall and the current winter terms, you are eligible for university contributions during the spring/summer terms.

If you are a GEO member or a GSRA, you are participating in any U-M benefit plans during the winter term (Term II), and you will be re-employed for the following fall term (Term I) with a one-quarter or greater employment fraction, benefits may continue during spring/summer term (Term III).

To ensure continuation of your benefits, your department must confirm your eligible Term I appointment in writing with the Benefits Office by April 10. The cost of your benefits will be charged to your Winter Term II department/unit.

Review your April pay stub to see if benefits premiums have been deducted for the summer.

Find a Participating Provider

Search here to locate a participating GradCare provider or find out if your doctor accepts this plan.

Plan Documents and Forms

• Summary of Benefits and Coverage (SBC)
• Benefits-at-a-Glance
• 2024 GradCare Certificate of Coverage
• GradCare Off-Site Registration Form (required for Level 2 care) 
  The department administrators can email the completed form to BCN at [email protected], however, they should be aware that the form must include the specific program date span (begin date mm/dd/yyyy, end date mm/dd/yyyy) and the department head signature. If the department head is unable to sign, the department administrator should include in the body of the email that the form is "an approved off-site registration for (name and ID)." 
• Benefits Enrollment Change Form (for benefit-eligible fellowship holders and medical students) (STV)

Plan Contact Information

bcbsm.com

(800) 658-8878

Blue Care Network
20500 Civic Center Dr.
Southfield, MI 48076

Group number: 001243160002