The University of Michigan offers a choice of health plans as part of a high-quality benefits package that helps you stay well and protect yourself and your family. Eligible employees and retirees can select from four health plans: Comprehensive Major Medical, U-M Premier Care, Community Blue PPO, and Health Alliance Plan HMO. Another plan, GradCare, is offered for benefits eligible graduate students only. Prescription drug coverage is included when you enroll in any U-M health plan.
Choosing a Plan
We want to help you find the health plan that offers the most advantages to you and your family, and then to use it wisely. Before choosing a plan, consider all the costs involved (including both premiums and out-of-pocket expenses like deductibles, coinsurance, and copays), access to doctors and hospitals, and your anticipated health and financial needs over the next year. Please note that there is no out-of-pocket cost to you for preventive care under any U-M health plan. View your health plan rates or the 2015 health plan coverage comparison chart.
|Type of Expense||Comprehensive Major Medical (BCBSM)||U-M Premier Care (BCN)||Health Alliance Plan HMO||Community Blue PPO (BCBSM)|
|Office visit copay||Deductible and coinsurance apply||$25||$25||$25|
|Specialist visit copay||Deductible and coinsurance apply||$30||$30||$30|
|Coinsurance||20% after deductible||$0||$0||50% if out of network|
*No deductible in U-M Premier Care Network 1. $2,000 individual/$4,000 family deductible in Network 2.
|Plan Feature||Comprehensive Major Medical (BCBSM)||U-M Premier Care (BCN)||Health Alliance Plan HMO||Community Blue PPO (BCBSM)|
|You must select a primary care physician||No||Yes||Yes||No|
|You can visit any doctor||Yes||No||No||Yes|
|You need a referral to visit a specialist||No||Yes||Yes||No|
|You can use out-of-network providers||Yes, but will pay more||No||No||Yes, but will pay more|
|You are required to live in a particular service area||No||Yes||Yes*||No|
|Coverage is available for dependents who live in a different location||Yes||Yes, with approval from BCN||No||Yes|
*Genesee, Lapeer, Livingston, Macomb, Monroe, Oakland, St. Clair, Washtenaw, and Wayne counties only
Health Plan Definitions
- The premium is the amount that must be paid for your health plan. You pay a portion of the monthly health plan premium through automatic payroll deductions.
- Your deductible is the amount you owe for health care services before your health plan begins to pay. For example, if your deductible is $500, your plan won’t pay anything until you have paid $500 out-of-pocket for covered health care services subject to the deductible. The deductible may not apply to all services.
- A copay is a fixed dollar amount (for example, $25) you pay for a covered health care service, such as an office visit, at the time you receive the service. The amount can vary by the type of service.
- Coinsurance refers to your share of the cost of a covered health care service, calculated as a percent of the allowed amount for the service (for example, 20%). You pay coinsurance in addition to any deductible you owe for your plan. The health plan pays the rest of the allowed amount.
Pair Your Health Plan with a Flexible Spending Account
You may want to consider a pre-tax health care Flexible Spending Account (FSA) to complement your health plan, particularly if you choose an option with higher out-of-pocket expenses.