Medicare Advantage Plans

Retiree/Survivor Health Plans

For benefit-eligible retirees and survivors, the health plan options available are determined on the eligibility and enrollment in Medicare for everyone enrolled in your university health plan. 

You will want to review the appropriate section based on your individual situation.

IMPORTANT: Your address must be current to ensure you do not encounter delays in services or billing.

Follow these steps to view or update your address:

  1. Visit wolverineaccess.umich.edu 
  2. Select the ‘Employee Self Service’ tile or enter ‘Employee Self-Service’ in the search bar
  3. Click ‘Campus Personal Information’
  4. Click ‘Addresses’
  5. Click ‘Current Local’
  6. Review ‘Current Local’ address and edit if needed

Medicare Enrolled

For Medicare eligible retirees and survivors, enhanced Medicare Advantage Plans will replace Medicare supplemental plans January 1, 2024.

  • Copays will be the same, in some cases less, than the supplemental plans
  • Provides the same coverage but includes added benefits like Silver Sneakers
  • Most of the providers you currently see accept Medicare Advantage, but be sure to confirm before selecting your health plan  

Services will be provided by:

  • PHP - Michigan Care Advantage
  • BCN - U-M Premier Care Advantage
  • BCBS - Medicare Advantage PPO

View more information about the Michigan Care Advantage plan on the PHP website. 

View more information about the Medicare Advantage PPO and Premier Care Advantage plans on the BCBSM website. 

PHP Michigan Care Advantage Webinars

PHP representatives will participate in virtual meetings about its Michigan Care Advantage plan on the following dates:

  • Thursday, Oct. 5, 10 a.m.
  • Friday, Oct. 6, 10 a,m. 
  • Monday, Oct. 16, 12 p.m. 
  • Tuesday, Oct. 17, 12 p.m. 
  • Thursday, Oct. 19, 12 p.m. 
  • Monday, Oct. 23, 12 p.m. 
  • Tuesday, Oct. 24, 12 p.m. 
  • Thursday, Oct. 26, 12 p.m. 
  • Friday, Oct. 27, 12 p.m. 

Register here. 

BCBSM/BCN Medicare Advantage Webinars

BCBSM/BCN representatives will introduce the Medicare Advantage PPO and U-M Premier Care Advantage plans during the following dates and times: 

  • Thursday, Oct. 5, at noon
  • Monday, Oct. 16, through Friday, Oct. 20, at noon and 4 p.m. each day
  • Monday, Oct. 23, through Friday, Oct. 27, at noon each day

Register here. 

Enrollment is based on your residential state/county. Members living in Michigan have the option to choose Michigan Care Advantage (if you live within the service area), U-M Premier Care Advantage or Medicare Advantage PPO. Members living outside of Michigan must enroll in the Medicare Advantage PPO. In addition, Medicare members must provide a residential address, not a P.O. box. 

All members currently enrolled in Comprehensive Major Medical (CMM) with Medicare MUST move to one of the Medicare Advantage plans. 

Members can be enrolled in only one Medicare Advantage plan. Please take the time to think about which plan to continue enrollment in. 

Failure to enroll in Medicare Part A and Part B will result in disenrollment from your University of Michigan retiree health plan. In addition, there could be a penalty added to your Medicare premium.

Medicare Enrolled Health Plan Profiles
Plan Name Michigan Care Advantage (PHP) U-M Premier Care Advantage (BCN) Medicare Advantage PPO (BCBSM)
Service Area Includes  the counties of Bay, Calhoun, Clinton, Eaton, Gratiot, Huron, Ingham, Ionia, Jackson, Kalamazoo, Livingston, Montcalm, Saginaw, Sanilac, Shiawassee, Tuscola, and Washtenaw. Use the Michigan Care eligibility tool to see if you are eligible. Michigan Available throughout the U.S.
Residency Requirement Must live within the service area.  Must live within the service area.  Must live within the service area. 
PCP selection required Yes Yes No
Phone Number

844-529-3757

800-658-8878

855-669-8040
Website member.phpmedicare.com bcbsm.com/UMichMAplans bcbsm.com/UMichMAplans
Medicare Enrolled Health Plan Coverage Comparison
Plan Name Michigan Care Advantage (PHP) U-M Premier Care Advantage (BCN) Medicare Advantage PPO (BCBSM)
Deductible $0 $0 $0
Maximum Annual Out-of-Pocket Amount $3,000 for each individual member each calendar year $3,000 for each individual member each calendar year $3,000 for each individual member each calendar year
Preventive and Outpatient Services

No out-of-pocket cost for preventive care.

$25 copay per office visit with a primary care physician. $30 co-pay per office visit with a specialist.

No out-of-pocket cost for preventive care.

$25 copay per office visit with a primary care physician. $30 co-pay per office visit with a specialist.

No out-of-pocket cost for preventive care.

$25 copay per office visit with a primary care physician. $30 co-pay per office visit with a specialist.
Emergency Care

$65 copay for emergency room visits (co-pay waived if admitted as inpatient).

Ambulance covered for emergencies when medically necessary.

Inpatient hospital care covered at 100%. 

$65 copay for emergency room visits (co-pay waived if admitted as inpatient).

Ambulance covered for emergencies when medically necessary.

Inpatient hospital care covered at 100%. 

$65 copay for emergency room visits (co-pay waived if admitted as inpatient).

Ambulance covered for emergencies when medically necessary.

Inpatient hospital care covered at 100%. 
Mental Health Care

Inpatient covered for acute conditions. 

Outpatient psychiatric care, group therapy and psychological testing covered; $25 copay may apply. 

Inpatient covered for acute conditions. 

Outpatient psychiatric care, group therapy and psychological testing covered; $25 copay may apply. 

Inpatient covered for acute conditions. 

Outpatient psychiatric care, group therapy and psychological testing covered; $25 copay may apply. 
Substance Use Care

Inpatient days of care covered.

Outpatient individual and group therapy covered; $25 copay may apply. 

Inpatient days of care covered.

Outpatient individual and group therapy covered; $25 copay may apply. 

Inpatient days of care covered.

Outpatient individual and group therapy covered; $25 copay may apply. 
Hearing Care

Covers one monaural or binaural hearing aid and exam every 36 months.

Hearing aids covered up to allowed amount; monaural or binaural hearing aid
every 36 months. Member may be balance billed for amounts above allowed amount.

Covers one monaural or binaural hearing aid and exam every 36 months.

Hearing aids covered up to allowed amount; monaural or binaural hearing aid
every 36 months. Member may be balance billed for amounts above allowed amount.

Covers one monaural or binaural hearing aid and exam every 36 months.

Hearing aids covered up to allowed amount; monaural or binaural hearing aid
every 36 months. Member may be balance billed for amounts above allowed amount.
Vision Care

Eye exams covered at plan providers — one exam per year; at non-plan providers, covered up to $40. Dilation not covered.

Eyeglasses not covered. 

Eye exams covered at plan providers — one exam per year; at non-plan providers, covered up to $40. Dilation not covered.

Eyeglasses not covered. 

Covered; one exam per year; dilation not covered. 

Eyeglasses not covered. 
Nursing Care

Visiting nurse home care covered. 

Private duty nursing not covered. 

Home health aides covered. 

Visiting nurse home care covered. 

Private duty nursing not covered. 

Home health aides covered. 

Visiting nurse home care covered. 

Private duty nursing covered at 70% when medically necessary and approved by plan.

Home health aides covered. 
Other Services

Hospice care covered when authorized by the plan. 

Durable medical equipment, prosthetic appliance covered when authorized by the plan. 

Chiropractic spinal manipulation $25 copay; manipulation services only. 

Hospice care covered when authorized by the plan. 

Durable medical equipment, prosthetic appliance covered when authorized by the plan. 

Chiropractic spinal manipulation $20 copay per office visit; manipulation services only. 

Hospice care covered.  

Durable medical equipment, prosthetic appliance covered when medically necessary. 

Pre-Medicare

For retirees and survivors and their covered dependents who are not eligible for Medicare, eligible retirees and survivors health plan options are the same as active employees.

Services will be provided by:

Special Notes for Retirees/Survivors Considering Consumer Directed Health Plan:

  • The university will not contribute to the Health Savings Account
  • If you are nearing age 65 and retiring
  • If you contribute to the Health Savings Account, and are nearing age 65 and enroll in Medicare Part A, please read and take action as needed regarding a conflict between IRS regulations and Medicare requirements.
    • The issue: Anyone nearing age 65 who is enrolled in a qualified high-deductible health plan (Consumer Directed Health Plan) with a Health Savings Account (HSA), who enrolls in Medicare Part A, will experience a Medicare-required “look-back period” of 6 months. That “look-back period” overlaps with the timeframe during which you may have had either or both employer and employee contributions made to your HSA. IRS regulations state that an individual cannot receive or contribute to a HSA if covered by Medicare or any other health care insurance. If the individual were to be audited by the IRS, taxes and penalties could apply to the amount contributed to the HSA.
    • The proposed solution: In order to avoid potential tax issues, you want to STOP YOUR HSA CONTRIBUTIONS so that you have 6 months of NO contributions before you FILE FOR MEDICARE.
Pre-Medicare
Plan Feature Michigan Care U-M Premier Care BCBCM Community Blue PPO Comprehensive Major Medical BCBSM Consumer-Directed Health 
Service Area Limited to those who live in a specific geographical area in southeast Michigan. Access the eligibility tool. Must live in Michigan, or within Fulton, Lucas, Williams or Wood counties in Ohio. All providers, facilities and services are rendered in Michigan. Nationwide/Worldwide.  Nationwide/Worldwide. Nationwide/Worldwide. 
Network No. No. Yes.  Yes. Yes.
Preventive Care No out-of-pocket cost for preventive care. No out-of-pocket cost for preventive care. No out-of-pocket cost for preventive care. No out-of-pocket cost for preventive care. No out-of-pocket cost for preventive care.
Deductible No annual deductible.

Network 1 providers: No annual deductible

Network 2 providers: $2,000 individual, $4,000 family

 No annual deductible. $500 individual, $1,000 family $1,600 individual, $3,200 family (combined medical and Rx)
Out-of-Pocket Maximum $3,000 individual, $6,000 family $3,000 individual, $6,000 family

In-network: $3,000 individual, $6,000 family

Out-of-network: $5,000 individual, $10,000 family

 $3,000 individual, $6,000 family $5,500 individual, $6,000 family
Health Savings Account No. No. No. No. Yes.

Medicare Enrolled and Pre-Medicare

For retirees and covered dependents who have a mixture of individuals that are eligible and enrolled in Medicare and not eligible for Medicare, the retiree will make the plan election for the member(s) that are not eligible for Medicare. The Medicare-eligible member will then be enrolled in the Medicare Advantage plan associated with the vendor for the plan that is selected.

A primary factor in the selection of the health plan will depend on your eligibility based on your current residency.

Physicians Health Plan – Michigan Care and Michigan Care Advantage

You must live in the Michigan Care service area to enroll in the Michigan Care plan. Access the Michigan Care eligibility tool.

  • Medicare Enrolled Members will be in the Michigan Care Advantage plan
  • Pre-Medicare Members will be in the Michigan Care plan

Blue Care Network – U-M Premier Care and U-M Premier Care Advantage

The U-M Premier Care Advantage plan is a Michigan based plan, you must reside in Michigan to enroll.

  • Medicare Enrolled Members will be in the U-M Premier Care Advantage plan
  • Pre-Medicare Members will be in the U-M Premier Care plan

Blue Cross Blue Shield of Michigan – Medicare Advantage PPO and Community Blue PPO; Comprehensive Major Medical; Consumer-Directed Health Plan

The Blue Cross Blue Shield of Michigan plans do not have residency restrictions within the United States. 

Please refer to the 'Medicare Enrolled' and 'Pre-Medicare' charts above.