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 |