Health Plan Coverage Comparison

Health Plan Eligibility

Eligible employees and retirees may select from Comprehensive Major Medical, U-M Premier Care and Community Blue PPO.

Michigan Care is a new U-M health plan option available for coverage beginning January 1, 2021. Access to the plan will be limited to faculty, staff and retirees who live in a specific geographic area within southeast Michigan. Find out now if your zip code is included in the coverage area. If eligible, you may enroll during Open Enrollment.

GradCare is exclusively available to benefit-eligible graduate students.

Important Information about the Terms Used in This Chart

Covered: For Michigan Care, U-M Premier Care, and GradCare, "Covered" means your services must be provided or authorized by a Primary Care Physician (PCP). The plan co-insurance amount is 100% unless stated otherwise or unless a co-pay is indicated for the covered service. Co-pay means a set dollar amount you pay for a covered service.; For the BCBSM Community Blue PPO Plan, both in-network and out-of-network, "Covered" means the plan payment amount for covered charges is 100% unless stated otherwise. You pay costs that exceed the BCBSM fee schedule or balance billing when non-participating providers are used. Co-pay means the set dollar amount you pay for a covered service.
Partially Covered: For Comprehensive Major Medical, "Partially Covered" means you pay a $500/$1,000 deductible, 20% co-insurance up to the annual out-of-pocket maximums, and costs that exceed the BCBSM fee schedule or balance billing when non-participating providers are used. Co-insurance means the percentage amount of the provider’s charge you pay for a covered service.

Please note that under all plans, co-pays for bargained-for groups may differ. There is no out-of-pocket cost to you for preventive care under any U-M health plan.

Health Coverage Comparison for Mental Health Care
Plan Name	Preauthorization Required	Inpatient Days of Care	Outpatient Individual Psychiatric Care	Group Therapy	Psychological Testing
Michigan Care ¹	Prior authorization is required for some services. Contact plan for additional information.	Covered	Covered with a $25 co-pay	Covered with a $25 co-pay	Covered with a $25 co-pay
GradCare	Prior authorization is required for some services. Contact plan for additional information.	Covered	Covered with a $25 co-pay	Covered with a $25 co-pay	Covered with a $25 co-pay
U-M Premier Care Provider Network 1 ¹ ²	Prior authorization is required for some services. Contact plan for additional information.	Covered	Covered with a $25 co-pay	Covered with a $25 co-pay	Covered with a $25 co-pay
Comprehensive Major Medical ¹	Prior authorization is required for some services. Contact plan for additional information.	Partially Covered	Partially Covered	Partially Covered	Partially Covered
Blue Cross Blue Shield of Michigan Community Blue PPO: In Network ¹	Prior authorization is required for some services. Contact plan for additional information.	Covered	Covered with a $25 co-pay	Covered with a $25 co-pay	Covered with a $25 co-pay
Blue Cross Blue Shield of Michigan Community Blue PPO: Out of Network ¹	No	Covered at 50%	Covered at 50%	Covered at 50%	Covered at 50%
BCBSM Consumer-Directed Health Plan	Prior authorization is required for some services. Contact plan for additional information.	Partially Covered	Partially Covered	Partially Covered	Partially Covered

Footnotes

These plans will coordinate with Medicare. The benefits listed show your costs after Medicare has paid its portion to your physician or hospital.
Coverage described applies to the U-M Premier Care Provider Network 1. Additional providers are available through BCN's statewide network, (Provider Network 2). Network 2 providers are covered with a $2,000 annual deductible for individual, $4,000 annual deductible per family. A Network 1 PCP referral is required to access Network 2 providers.)

Questions About Your Benefits?

Call the SSC Contact Center at 5-2000 from the Ann Arbor campus, (734) 615-2000 locally, or (866) 647-7657 toll free, Monday through Friday from 8 a.m. to 5 p.m. or submit your questions online through an eForm.

Limitations

The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend, or terminate them. Every effort has been made to ensure the accuracy of the benefits information in this site. However, if any provision on the benefits plans is unclear or ambiguous, the Benefits Office reserves the right to interpret the plan and resolve the problem. If any inconsistency exists between this site and the written plans or contracts, the actual provisions of each benefit plan will govern.

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