U-M Premier Care

U-M Premier Care offers the lower costs of an HMO with the flexibility to access a state-wide network of providers if needed. U-M Premier Care is administered by Blue Care Network (BCN) and offered only to the University of Michigan community. Members save money in Network 1, which includes Michigan Medicine providers along with several other provider groups, but can also visit other Michigan BCN providers with an annual deductible in Network 2.

Summary of Benefits

Network 1 Providers

  • No annual deductible
  • No out-of-pocket cost to you for preventive care
  • $25 copay for office visit for injury or illness
  • $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 (Networks 1 and 2 combined)

Network 2 Providers (referral needed)

  • $2,000 individual/$4,000 family annual deductible
  • No out-of-pocket cost to you for preventive care
  • No out-of-pocket cost to you after meeting the deductible for:
    • Office visit for injury or illness
    • Specialist visit
    • Inpatient services
    • Outpatient surgery
    • Mental health, behavioral health or substance abuse services
  • $25 copay for urgent care
  • $100 copay for emergency care (waived if admitted)
  • $3,000 individual/$6,000 family out-of-pocket maximum (Networks 1 and 2 combined)

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

Using the Plan

U-M Premier Care is a managed care plan. Members must choose a Primary Care Physician (PCP) from Network 1. In order to visit a specialist or a Network 2 provider, you will need a referral from your PCP. Services received outside of Network 1 or Network 2 are not covered, except in the event of emergency (refer to plan documents for details).

Members must live in the state of Michigan, though the plan provides coverage for dependents who reside outside the network service area and meet eligibility guidelines. Pre-certification is required for certain services, and the member must register with BCN to obtain approval for out-of-area dependent coverage by calling 800-658-8878.

Hearing Services Coverage 

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

If You Move Out of Michigan

You must live in the state of Michigan to be eligible for U-M Premier Care. If you are enrolled in the plan and move out of Michigan, you must change your health plan.

To enroll in a different health plan, download the Moving out a Managed Care Service Area form and submit your signed and completed within 30 days of the date of your move. Your new coverage will become effective the first day of the month following the move or the receipt of this form, whichever is later. Please remember to update your home address with the university.

Find a Participating Provider

Search here to locate a participating U-M Premier Care provider or find out if your doctor accepts this plan.

Plan Documents & Forms

Plan Contact Information

bcbsm.com

(800) 658-8878

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

Group number: 001243160001

Consider a Health Care Flexible Spending Account

If you are eligible, you may want to consider enrolling in a pre-tax health care Flexible Spending Account (FSA) to complement your health plan.