Blue Cross Blue Shield of Michigan Keep Fit 2500 – Michigan Health Insurance Plan

A detailed comparison of the Blue Cross Blue Shield of Michigan Keep Fit 2500 health insurance plan as offered in Michigan is listed below for both Network and Non-Network coverage. This is a review of the coverage for this specific Blue Cross Blue Shield of Michigan plan. However, GoHealthInsurance offers a large variety of health insurance options to fit your needs. If you wish, get a new Blue Cross Blue Shield of Michigan health insurance quote for Michigan now or view all of our Blue Cross Blue Shield of Michigan health insurance quotes.

  Network Non-Network
Copay $40 Not Covered
OfficeVisit Physician Office Services:
  • Office visits: $40 Copay (2 visits per member per calendar year)
  • Outpatient presurgical second opinion consultations: Included in the office visit benefit. Visits count toward the office visit limit.
  • Office consu
Physician Office Services:
  • Office visits: Not covered
  • Outpatient presurgical second opinion consultations: Not Covered
  • Office consultations: Not covered
Deductible true
  • Inpatient services (facility and professional) - Individual: $2,500 / Family: $5,000 (contract per calendar year)
  • Outpatient and emergency services (facility and professional) - Individual: $6,000 / Family: $12,000 (contract per calendar year)
  • Inpatient services (facility and professional) - Individual: $5,000 / Family: $10,000 (contract per calendar year)
  • Outpatient and emergency services (facility and professional) - Individual: $12,000 / Family: $24,000 (contract per calendar year)
  • Coinsurance 70% 50%
    Coinsurance Limit
    Out-of-Pocket Maximum
    Lifetime Maximum No lifetime maximum No lifetime maximum
    Prescription Drugs
  • Prescription drug: $1,000 per individual contract, $2,000 per family contract.
  • Tier 1 (generic and specialty drugs): Generic: Covered- $10 copay per prescription, before prescription drug deductible; Specialty: Covered- 50% copay per prescription,
  • Prescription drug: Not Covered.
  • Tier 1 (generic and specialty drugs): Not Covered
  • Tier 2 (formulary brand and specialty): Not Covered.
  • Tier 3 (all non-formulary and specialty): Not Covered
  • Emergency Room
  • Emergency services in an emergency room: Facility: Covered- 100% after outpatient deductible plus $250 copay (copay waived if admitted); Professional: Covered- 100% after outpatient deductible
  • Ambulance service: Covered- 100% after outpatient deduc
  • Emergency services in an emergency room: Facility: Covered- 100% after outpatient deductible plus $250 copay (copay waived if admitted); Professional: Covered- 100% after outpatient deductible
  • Ambulance service: Covered- 100% after outpatient deduc
  • Adult Preventative Care
  • Preventive medical services and immunizations: Covered 100% with no deductible, coinsurance or flat dollar copay.(Includes health maintenance exam, select laboratory services, gynecologic exam, Pap smear screening, and other adult preventive services
  • Preventive medical services and immunizations: Not Covered
  • Mammography screening: Covered 100% with no deductible
  • Child Preventative Care
    Lab / X-Ray Diagnostic and Radiation Services:
  • Ultrasound: Covered - 70% after inpatient deductible; 100% after outpatient deductible
  • Laboratory tests and pathology: Covered - 70% after inpatient deductible; 100% after outpatient deductible
  • EKGs: Covered
  • Diagnostic and Radiation Services:
    • Ultrasound: Covered - 50% after inpatient deductible; 100% after outpatient deductible
    • Laboratory tests and pathology: Covered - 50% after inpatient deductible; 100% after outpatient deductible
    • EKGs: Cove
    Maternity Not covered Not covered
    Physical Therapy
  • Outpatient physical, occupational and speech therapy (12 visits per member per calendar year, all therapies combined): Covered - 100% after outpatient deductible
  • Spinal manipulations-Not covered
  • Outpatient physical, occupational and speech therapy (12 visits per member per calendar year, all therapies combined): Covered - 100% after outpatient deductible
  • Spinal manipulations-Not covered
  • Home Health Care
  • Home health care (BCBSM-participating providers only): Covered - 100% after outpatient deductible up to 30 visits per member per calendar year
  • Hospice care (BCBSM-participating providers only): Covered - 100% after inpatient or outpatient deductib
  • Home health care (BCBSM-participating providers only): Covered - 100% after outpatient deductible up to 30 visits per member per calendar year
  • Hospice care (BCBSM-participating providers only): Covered - 100% after inpatient or outpatient deductib
  • Mental Health Mental Health and Substance Abuse Treatment:
    • Inpatient mental health (BCBSM-approved facilities only): Covered - 70% after deductible, up to 30 days of unused 180 inpatient hospital days, per member per calendar year
    • Outpatient mental health:
    Mental Health and Substance Abuse Treatment:
    • Inpatient mental health (BCBSM-approved facilities only): Covered - 50% after deductible, up to 30 days of unused 180 inpatient hospital days, per member per calendar year
    • Outpatient mental health:
    Hospital Care Inpatient Hospital Care:
    • Semi-private room (BCBSM-approved facilities only), long term acute care hospital and skilled nursing facility: Covered - 70% after inpatient deductible (up to 180 days combined, per member per calendar)
    • Inpatient cons
    Inpatient Hospital Care:
    • Semi-private room (BCBSM-approved facilities only), long term acute care hospital and skilled nursing facility: Covered - 50% after inpatient deductible (up to 180 days combined, per member per calendar)
    • Inpatient cons
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