Medicare Plus Blue Vitality (PPO) 2026 Plan Details for Berrien County, Michigan Residents
Medicare Plus Blue Vitality (PPO) 2026 Plan Details for Berrien County, Michigan Residents
When selecting a Medicare Advantage plan in Berrien County for 2026, it's important to compare all your options. Medicare Plus Blue Vitality (PPO) is among the plans you can review side-by-side with others, ensuring you find the coverage that suits your needs. You can easily enroll online or reach out to a licensed agent for personalized guidance.
Based on the most recent CMS data, plan enrollments topped 13,823 members, with 186 in Berrien County, Michigan.
Medicare Plus Blue Vitality Overview
| Plan ID H9572-002-2 Overview | |
|---|---|
| Health Plan ID: | H9572-002-2 |
| Medicare Advantage Plan Type: | PPO |
| Plan Year: | 2026 |
| Monthly Premium: | $66.80 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $5000.00 (In-Network) |
| Part B Give Back: | Not offered |
| Part D Drug Plan Benefit: | Enhanced, $0.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Berrien County, MI |
| Insured By: | Blue Cross Blue Shield of Michigan |
Explore the Benefits of Medicare Plus Blue Vitality
This MAPD PPO Medicare Advantage plan offers broad coverage with the freedom to choose your providers. With a monthly premium of $66.80, it includes all core benefits under Medicare Part A and Part B, plus prescription drug coverage to manage ongoing medications. The annual Part D deductible is $0.00. You can see any Medicare-approved provider — in or out of network — though in-network care typically costs less.
Primary care visits have a $0 copay | Out-of-network: 40% coinsurance, and specialist visits come with a $30 copay | Out-of-network: 40% coinsurance. Urgent care services carry a $0-$50 copay, and ground ambulance transportation is $325 copay | Out-of-network: $325 copay, 40% coinsurance. These costs all count toward your annual maximum out-of-pocket (MOOP) limit of $5000.00. After that limit is reached, all in-network care is fully covered through the end of the year.
CMS recognizes this plan as H9572-002-2. A detailed breakdown of cost sharing is available below. Still have questions? Check the FAQ section for more insights.
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Out-of-Pocket Expenses
Medicare Plus Blue Vitality has cost-sharing, meaning you'll have out-of-pocket costs when using approved healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H9572-002-2.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: 40% coinsurance |
| Specialist: | In-network: $30 copay | Out-of-network: 40% coinsurance |
Medicare Advantage plans often include preventive and wellness benefits designed to help members stay healthy, identify risks early, and maintain an active lifestyle.
| Service | Enrollee Cost (in-network) |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | In-network: $30 copay | Out-of-network: 40% coinsurance |
| Fitness benefits: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over the counter drug benefits: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Health transportation (non-emergency): | Not covered |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $130 copay |
| Wordwide emergency care: | $130 copay |
| Urgent care: | $0-$50 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $250 per day for days 1-7 | $0 per day for days 8-90 | $0 per stay | Out-of-network: | $0 and 40% per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $218 per day for days 21-100 | Out-of-network: | 40% per stay |
| Ground ambulance: | In-network: $325 copay | Out-of-network: $325 copay, 40% coinsurance |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | In-network: $20 copay | Out-of-network: 40% coinsurance |
| Outpatient group therapy: | In-network: $20 copay | Out-of-network: 40% coinsurance |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $250 per day for days 1-7 | $0 per day for days 8-90 | $0 per stay | Out-of-network: | $0 and 40% per stay |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $40 copay | Out-of-network: 40% coinsurance |
| Occupational therapy: | In-network: $40 copay | Out-of-network: 40% coinsurance |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | In-network: 0%-20% coinsurance | Out-of-network: 0%-40% coinsurance |
| Durable medical equipment: | In-network: 0%-20% coinsurance | Out-of-network: 0%-40% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 40% coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | In-network: $100-$150 copay | Out-of-network: 40% coinsurance |
| Lab services: | In-network: $0-$40 copay | Out-of-network: 40% coinsurance |
| Outpatient x-rays: | In-network: $35-$150 copay | Out-of-network: 40% coinsurance |
| Diagnostic tests and procedures: | In-network: $0-$150 copay | Out-of-network: $0 copay, 40% coinsurance |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 0%-40% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 0%-40% coinsurance |
This section details the dental services covered under your plan including Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Dental x-rays: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Cleaning: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Periodontics: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Endodontics: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Restorative services: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: $0 copay | Out-of-network: 50% coinsurance |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Fitting/evaluation: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Prescription hearing aids: | In-network: $495-$1695 copay | Out-of-network: $495-$1695 copay |
| OTC hearing aids: | Not covered |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Contact lenses: | Not covered |
| Eyeglass frames only: | Not covered |
| Eyeglass lenses only: | Not covered |
| Eyeglasses (frames & lenses): | Not covered |
| Upgrades: | Not covered |
Medicare Advantage plans may include extra benefits and special needs services designed to support members with chronic conditions, mobility limitations, or other complex health needs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Adult day health services: | Not covered |
| Home based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| 'Wigs for chemotherapy hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
Certain preventive services are covered 100% by Medicare Plus Blue Vitality as a Part B benefit.
Part D Prescription Drug Costs & Benefits
Medicare Plus Blue Vitality includes an enhanced benefit Medicare Part D plan (PDP), which offers greater coverage than basic plans. An enhanced benefit plan has a higher actuarial value, meaning it covers a larger percentage of your healthcare costs.
Part D Plan Premium
The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.
| Basic Part D Premium: | $30.70 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $30.70 |
| Low-Income Premium Subsidy: | $8.75 |
| Low-Income Premium Subsidy Paid by CMS: | $8.80 |
| Low-Income Subsidy Premium: | $21.90 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $0.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Blue Cross Blue Shield of Michigan starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Medicare Plus Blue Vitality may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $11.00 copay | Coming soon |
| Preferred Brand | 20% coinsurance | Coming soon |
| Non-Preferred Drug | 25% coinsurance | Coming soon |
| Specialty Tier | 33% coinsurance | Coming soon |
| *Deductible does not apply. | ||
How CMS Star Ratings Guide Your Choice
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Am I Eligible for Medicare Plus Blue Vitality?
To enroll in Medicare Plus Blue Vitality, you must meet the following criteria:
- Be eligible for Medicare Part A and Part B.
- Reside in the plan’s service area.
If you meet these requirements, you are eligible to enroll in Medicare Plus Blue Vitality and benefit from its comprehensive coverage options.
When Can I Enroll in Medicare Plus Blue Vitality?
To ensure you don’t miss your chance to enroll in Medicare Plus Blue Vitality, be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to get assistance from a licensed insurance agent.
How to Sign Up for Medicare Plus Blue Vitality
Enrolling in Medicare Plus Blue Vitality is easy. Choose the option that works best for you:
- Online through MedicareEnrollment.com: Visit the enrollment page and complete your enrollment through their Secure Online Enrollment Form.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent can assist you with the enrollment process and provide answers to any questions.
- Through Medicare.gov: Go to Medicare.gov, log in or create an account, and follow the instructions to join Medicare Plus Blue Vitality through the official Medicare website.
- Directly with Medicare Plus Blue Vitality: You can also enroll directly with the plan. The necessary contact details are provided below in the "Contact" section.
Remember to enroll during the correct enrollment period to ensure your coverage starts on time.
Here are some of the most frequently asked questions people have about plan ID H9572-002-2:
What’s the monthly premium for Medicare Plus Blue Vitality (PPO)?
The 2026 premium is $66.80 each month, and you must continue to pay your Part B premium.
What’s the MOOP for Medicare Plus Blue Vitality in 2026?
For 2026, the maximum you’d spend out-of-pocket in-network is $5000.00.
Is there a Part D deductible with this plan?
You’ll pay the first $0.00 in drug costs before coinsurance kicks in.
Is this a 4-star or 5-star plan?
The latest CMS score is ★4.5 out of 5 stars; anything 4 or higher earns quality bonuses.
How many members does Medicare Plus Blue Vitality have?
Enrollment stands at roughly 13,823 members.
Contact Blue Cross Blue Shield of Michigan
| Contact Type | Details |
|---|---|
| Website: | Blue Cross Blue Shield of Michigan Plan Page |
| New Members: | 1-855-425-7720 |
| Existing Members: | 1-877-241-2583 |
| Plan Address: | 600 East Lafayette Blvd. | MC 1401 | Detroit, MI 48226 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 14, 2025
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed October 13, 2025
Learn more about how we use CMS data.
- Blue Cross Blue Shield of Michigan, http://www.bcbsm.com/medicare — Last accessed October 13, 2025
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Explore your Medicare coverage options" — Last accessed 25 May, 2025
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Page content managed by David Bynon, Medicare Analyst.
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