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 in full	$25 co-pay per visit	$25 co-pay per visit	$25 co-pay per visit
GradCare	Prior authorization is required for some services. Contact plan for additional information.	Covered in full	$25 co-pay per visit	$25 co-pay per visit	$25 co-pay per visit
U-M Premier Care Provider Network 1 ¹ ²	Prior authorization is required for some services. Contact plan for additional information.	Covered in full	$25 co-pay per visit	$25 co-pay per visit	$25 co-pay per visit
Comprehensive Major Medical ¹	Prior authorization is required for some services. Contact plan for additional information.	20% coinsurance per visit after deductible is met	20% coinsurance per visit after deductible is met	20% coinsurance per visit after deductible is met	20% coinsurance per visit after deductible is met
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 in full	$25 co-pay per visit	$25 co-pay per visit	$25 co-pay per visit
Blue Cross Blue Shield of Michigan Community Blue PPO: Out of Network ¹	Prior authorization is required for some services. Contact plan for additional information.	Covered at 50% of allowed amount	Covered at 50% of allowed amount	Covered at 50% of allowed amount	Covered at 50% of allowed amount
BCBSM Consumer-Directed Health Plan	Prior authorization is required for some services. Contact plan for additional information.	10% coinsurance per visit after deductible is met	10% coinsurance per visit after deductible is met	10% coinsurance per visit after deductible is met	10% coinsurance per visit after deductible is met

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.)

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Health Plan Coverage Comparison

Health Plan Eligibility

Important Information about the Terms Used in This Chart

Footnotes

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