View 2025 Plans

McLaren Medicare Inspire (HMO)

McLaren Medicare Inspire Plus (HMO)

McLaren Medicare Inspire Flex Region 1 * (HMO-POS)

* Available for people who reside in the following Michigan counties: Bay, Charlevoix, Cheboygan, Clare, Clinton, Eaton, Emmet, Genesee, Ingham, Lapeer, Macomb, Oakland, Ogemaw, Sanilac, Shiawassee, St. Clair, and Tuscola counties

McLaren Medicare Inspire Flex Region 2 ** (HMO-POS)

** Available for people who reside in the following Michigan counties: Alcona, Allegan, Alpena, Antrim, Arenac, Barry, Benzie, Berrien, Branch, Calhoun, Cass, Crawford, Gladwin, Grand Traverse, Gratiot, Hillsdale, Huron, Ionia, Iosco, Jackson, Kalamazoo, Kalkaska, Kent, Lake, Leelanau, Livingston, Manistee, Mecosta, Midland, Missaukee, Montcalm, Montmorency, Newaygo, Osceola, Oscoda, Otsego, Ottawa, Presque Isle, Roscommon, Saginaw, Van Buren, Washtenaw, Wayne, and Wexford counties

McLaren Medicare Inspire (HMO)

Health Maintenance Organization (HMO) plans give you great health care benefits. These Medicare Advantage plans in Michigan offer low monthly premiums to keep your health care affordable. Benefits include all the same coverage as Original Medicare Part A and Part B, as well as prescription drug coverage and dental and vision coverage.

When you enroll in the McLaren Medicare Inspire (HMO) plan, you’ll choose a primary doctor to be your care partner. This HMO plan covers in-network care and has a large network of care providers.

Plan Premiums and Other Costs
Monthly premium $0
Maximum out of pocket limit $4,200
Annual deductible $0

Benefits and Costs
Primary care physician visit $0 copay
Specialist visits $40 copay
Preventive care $0 copay
Inpatient hospital coverage $275 per day for days 1 - 7
$0 per day for days 8 and after
Outpatient surgery - hospital $200 copay
Outpatient surgery - ambulatory surgical center $200 copay
Emergency care $100 copay anywhere in the United States or its territories
Urgent care $50 copay in or out of network
Ambulance $220 copay
Lab services $0 copay
Diagnostic tests & procedures $20 copay
Diagnostic radiology services (MRI, CT scan) $200 copay
Standard X-rays $25 copay
Physical therapy $25 copay
Over-the-counter (OTC) allowance $140/quarter with no rollover
Meals after discharge $0 copay for 28 meals (2 meals per day for 14 days) delivered directly to your home after each discharge from an inpatient acute or a skilled nursing facility stay. Annual limit of 5 discharges for a total of 140 meals per year.
Preventive dental

$0 copay for:

  • 2 exams and 2 cleanings (regular or periodontal) each year
  • 1 fluoride treatment each year
  • One set of bitewing X-rays each year (not payable in the same calendar year as a full mouth X-ray)
  • Full mouth X-rays once every 5 years
  • Emergency palliative treatment
Comprehensive dental

50% coinsurance for:

  • Fillings and crown repair
  • Periodontal non-surgical procedures (covered once per quadrant per 24-month period)
  • Simple extractions

$0 copay for brush biopsies

$40 copay for Medicare-covered dental services
Vision

$40 copay for each Medicare-covered exam to diagnose and treat diseases or conditions of the eye.

$0 copay for a Medicare-covered glaucoma screening.

$0 copay for a Medicare-covered diabetic retinopathy screening.

$0 copay for Medicare-covered eyeglasses or contact lenses after cataract surgery.

$0 copay for a non-Medicare-covered routine eye exam
Eyewear $0 copay for up to a maximum of $100 each year for routine corrective eyeglasses (lenses and frames) or contact lenses.
Chiropractic services $20 copay
Acupuncture services $25 copay
Fitness membership Up to $100 annually
Virtual care with McLarenNow or McLaren Now+Clinic $0 copay
Hearing aid             

$699 copayment per aid for Advanced Aids

$999 copayment per aid for Premium Aids

$50 additional cost per aid for optional hearing aid rechargeability

Up to two TruHearing-branded hearing aids, one per ear every two years. Benefit is limited to TruHearing’s Advanced and Premium hearing aids. Must use TruHearing providers.
Transportation $0 copay for up to 20 one-way non-emergency trips per year to plan approved health-related locations. 50 mile limit one-way.

Part D Prescription Drug Coverage
Deductible Stage There is no Part D deductible
Initial Coverage Stage
Tier 1 (preferred generics) $0
Tier 2 (generics) $12  Insulin: $10
Tier 3 (preferred brand) $47  Insulin: $35
Tier 4 (non-preferred brand) $100
Tier 5 (specialty drugs) 33% of the cost
Tier 6 (select care drugs) $0
Catastrophic Coverage Stage Once your yearly out-of-pocket drug costs total $2,000, our plan will pay the full cost for your covered Part D drugs.

McLaren Medicare Inspire Plus (HMO)

The McLaren Medicare Inspire Plus is another HMO Medicare plan in Michigan. When you enroll in this plan, you’ll find a primary care provider.

The Inspire Plus plan offers all the same benefits as the Inspire plan. It also includes extra benefits, worldwide emergency care and the option to receive a Personal Emergency Response System. This plan has no annual deductible, so your benefits start right away. The McLaren Medicare Inspire Plus also has a low out-of-pocket maximum, so you don’t need to worry about your health care budget.

Plan Premiums and Other Costs
Monthly premium $25
Maximum out of pocket limit $3,500
Annual deductible $0

Benefits and Costs
Primary care physician visit $0 copay
Specialist visits $25 copay
Preventive care $0 copay
Inpatient hospital coverage $225 per day for days 1 - 7
$0 per day for days 8 and after
Outpatient surgery - hospital $200 copay
Outpatient surgery - ambulatory surgical center $150 copay
Emergency care $100 copay anywhere in the United States or its territories
Urgent care $50 copay in or out of network
Ambulance $220 copay
Lab services $0 copay
Diagnostic tests & procedures $20 copay
Diagnostic radiology services (MRI, CT scan) $150 copay
Standard X-rays $25 copay
Physical therapy $25 copay
Over-the-counter (OTC) allowance $145/quarter with no rollover
Preventative dental

$0 copay for:

  • 2 exams and 2 cleanings (regular or periodontal) each year
  • 1 fluoride treatment each year
  • One set of bitewing X-rays each year (not payable in the same calendar year as a full mouth X-ray)
  • Full mouth X-rays once every 5 years
  • Emergency palliative treatment
Comprehensive dental

50% coinsurance for:

  • Fillings and crown repair
  • Periodontal non-surgical procedures (covered once per quadrant per 24-month period)
  • Simple extractions

$0 copay for brush biopsies

$25 copay for Medicare-covered dental services
Eyewear $0 copay for up to a maximum of $200 each year for routine corrective eyeglasses (lenses and frames) or contact lenses
Chiropractic services $20 copay
Acupuncture services $25 copay
Fitness membership Up to $200 annually
Virtual care with McLarenNow or McLaren Now+Clinic $0 copay
Hearing aid             

$699 copayment per aid for Advanced Aids

$999 copayment per aid for Premium Aids

$50 additional cost per aid for optional hearing aid rechargeability

Up to two TruHearing-branded hearing aids, one per ear every two years. Benefit is limited to TruHearing’s Advanced and Premium hearing aids. Must use TruHearing providers.
Transportation

$0 copay for up to 20 one-way non-emergency trips per year to plan approved health-related locations. 50-mile limit one-way.
Worldwide emergency or urgent care

$100 emergency copay

$50 urgent care copay

You may receive covered emergency and urgent care services anywhere in the world. If you are outside of the United States or its territories, your worldwide emergency and urgent care coverage is limited to $50,000
Personal Emergency Response System (PERS) $0 copay for a Mobile PERS plus device equipped with two-way voice communication, GPS location technology, and the option of auto fall detection with 24/7 monitoring
Meals after discharge $0 copay for 28 meals (2 meals per day for 14 days) delivered directly to your home after each discharge from an inpatient acute or a skilled nursing facility stay. Annual limit of 5 discharges for a total of 140 meals per year.

Part D Prescription Drug Coverage
Deductible Stage There is no Part D deductible
Initial Coverage Stage
Tier 1 (preferred generics) $0
Tier 2 (generics) $12  Insulin: $10
Tier 3 (preferred brand) $47  Insulin: $35
Tier 4 (non-preferred brand) $100
Tier 5 (specialty drugs) 33% of the cost
Tier 6 (select care drugs) $0
Catastrophic Coverage Stage Once your yearly out-of-pocket drug costs total $2,000, our plan will pay the full cost for your covered Part D drugs.

McLaren Medicare Inspire Flex Region 1 (HMO-POS) *

An HMO-POS plan gives you more flexibility to access the care you need. Like McLaren Medicare’s other HMO plans, you’ll choose a primary care physician when you enroll in the plan. This doctor will be your care partner. When you access in-network care, you’ll have low copays for all covered services.

The McLaren Medicare Inspire Flex plan in Michigan also covers out-of-network care. When you visit a health care provider who is not in your network, you’ll pay a Point of Service (POS) coinsurance, and your Inspire Flex plan will pay the rest.

* Available for people who reside in the following Michigan counties: Bay, Charlevoix, Cheboygan, Clare, Clinton, Eaton, Emmet, Genesee, Ingham, Lapeer, Macomb, Oakland, Ogemaw, Sanilac, Shiawassee, St. Clair, and Tuscola counties

Plan Premiums and Other Costs
Monthly premium $0
Maximum out of pocket limit $3,800 INN
$10,000 Combined INN and OON
Annual deductible $0

Benefits and Costs
In-Network Point-of-Service
Primary care physician visit $0 copay 20% coinsurance
Specialist visits $30 copay 20% coinsurance
Preventive care $0 copay 20% coinsurance
Inpatient hospital coverage $200 per day for days 1 - 7
$0 per day for days 8 and after 		20% coinsurance
Outpatient surgery - hospital $150 copay 20% coinsurance
Outpatient surgery - ambulatory surgical center $150 copay 20% coinsurance
Emergency care $100 copay anywhere in the United States or its territories
Urgent care $50 copay in or out of network
Ambulance $200 copay
Lab services $0 copay 20% coinsurance
Diagnostic tests & procedures $10 copay 20% coinsurance
Diagnostic radiology services (MRI, CT scan) $100 copay 20% coinsurance
Standard X-rays $35 copay 20% coinsurance
Physical therapy $30 copay 20% coinsurance
Over-the-counter (OTC) allowance $140/quarter with no rollover 
Preventive dental

$0 copay for:

  • 2 exams and 2 cleanings (regular or periodontal) each year
  • 1 fluoride treatment each year
  • One set of bitewing X-rays each year (not payable in the same calendar year as a full mouth X-ray)
  • Full mouth X-rays once every 5 years
  • Emergency palliative treatment
 Not covered
Comprehensive dental

50% coinsurance for:

  • Fillings and crown repair
  • Periodontal non-surgical procedures (covered once per quadrant per 24-month period)
  • Simple extractions

$0 copay for brush biopsies

$30 copay for Medicare-covered dental services

Not covered
Eyewear $0 copay for up to a maximum of $225 each year for routine corrective eyeglasses (lenses and frames) or contact lenses 20% coinsurance
Chiropractic services $20 copay 20% coinsurance
Acupuncture services $30 copay Not covered
Fitness membership Up to $200 annually
Virtual care with McLarenNow or McLaren Now+Clinic $0 copay Not covered
Hearing Aid

$699 copayment per aid for Advanced Aids

$999 copayment per aid for Premium Aids

$50 additional cost per aid for optional hearing aid rechargeability

Up to two TruHearing-branded hearing aids, one per ear every two years. Benefit is limited to TruHearing’s Advanced and Premium hearing aids. Must use TruHearing providers.

 Not covered
Worldwide emergency or urgent care

$100 emergency copay $50 urgent care copay

You may receive covered emergency and urgent care services anywhere in the world. If you are outside of the United States or its territories, your worldwide emergency and urgent care coverage is limited to $50,000
Personal Emergency Response System (PERS) $0 copay for a Mobile PERS plus device equipped with two-way voice communication, GPS location technology, and the option of auto fall detection with 24/7 monitoring
Transportation $0 copay for up to 20 one-way non-emergency trips per year to plan approved health-related locations. 50-mile limit one-way.
Meals after discharge $0 copay for 28 meals (2 meals per day for 14 days) delivered directly to your home after each discharge from an inpatient acute or a skilled nursing facility stay. Annual limit of 5 discharges for a total of 140 meals per year.

Part D Prescription Drug Coverage
Deductible Stage There is no Part D deductible
Initial Coverage Stage
Tier 1 (preferred generics) $0
Tier 2 (generics) $12  Insulin: $10
Tier 3 (preferred brand) $47  Insulin: $35
Tier 4 (non-preferred brand) $100
Tier 5 (specialty drugs) 33% of the cost
Tier 6 (select care drugs) $0
Catastrophic Coverage Stage Once your yearly out-of-pocket drug costs total $2,000, our plan will pay the full cost for your covered Part D drugs.

McLaren Medicare Inspire Flex Region 2 (HMO-POS) **

An HMO-POS plan gives you more flexibility to access the care you need. Like McLaren Medicare’s other HMO plans, you’ll choose a primary care physician when you enroll in the plan. This doctor will be your care partner. When you access in-network care, you’ll have low copays for all covered services.

The McLaren Medicare Inspire Flex plan in Michigan also covers out-of-network care. When you visit a health care provider who is not in your network, you’ll pay a Point of Service (POS) coinsurance, and your Inspire Flex plan will pay the rest.

** Available for people who reside in the following Michigan counties: Alcona, Allegan, Alpena, Antrim, Arenac, Barry, Benzie, Berrien, Branch, Calhoun, Cass, Crawford, Gladwin, Grand Traverse, Gratiot, Hillsdale, Huron, Ionia, Iosco, Jackson, Kalamazoo, Kalkaska, Kent, Lake, Leelanau, Livingston, Manistee, Mecosta, Midland, Missaukee, Montcalm, Montmorency, Newaygo, Osceola, Oscoda, Otsego, Ottawa, Presque Isle, Roscommon, Saginaw, Van Buren, Washtenaw, Wayne, and Wexford counties

Plan Premiums and Other Costs
Monthly premium $49
Maximum out of pocket limit $3,800 INN
$10,000 Combined INN and OON
Annual deductible $0

Benefits and Costs
In-Network Point-of-Service
Primary care physician visit $0 copay 30% coinsurance
Specialist visits $25 copay 30% coinsurance
Preventive care $0 copay 30% coinsurance
Inpatient hospital coverage $200 per day for days 1 - 7
$0 per day for days 8 and after 		30% coinsurance
Outpatient surgery - hospital $200 copay 30% coinsurance
Outpatient surgery - ambulatory surgical center $150 copay 30% coinsurance
Emergency care $100 copay anywhere in the United States or its territories
Urgent care $50 copay in or out of network
Ambulance $220 copay
Lab services $0 copay 30% coinsurance
Diagnostic tests & procedures $20 copay 30% coinsurance
Diagnostic radiology services (MRI, CT scan) $125 copay 30% coinsurance
Standard X-rays $25 copay 30% coinsurance
Physical therapy $25 copay 30% coinsurance
Over-the-counter (OTC) allowance $135/quarter with no rollover
Preventive dental

$0 copay for:

  • 2 exams and 2 cleanings (regular or periodontal) each year
  • 1 fluoride treatment each year
  • One set of bitewing X-rays each year (not payable in the same calendar year as a full mouth X-ray)
  • Full mouth X-rays once every 5 years
  • Emergency palliative treatment
 Not covered
Comprehensive dental

50% coinsurance for:

  • Fillings and crown repair
  • Periodontal non-surgical procedures (covered once per quadrant per 24-month period)
  • Simple extractions

$0 copay for brush biopsies

$30 copay for Medicare-covered dental services

 Not covered
Eyewear $0 copay for up to a maximum of $200 each year for routine corrective eyeglasses (lenses and frames) or contact lenses 30% coinsurance
Chiropractic services $20 copay 30% coinsurance
Acupuncture services $25 copay Not covered
Fitness membership Up to $200 annually
Virtual care with McLarenNow or McLaren Now+Clinic $0 copay Not covered
Hearing Aid

$699 copayment per aid for Advanced Aids

$999 copayment per aid for Premium Aids

$50 additional cost per aid for optional hearing aid rechargeability

Up to two TruHearing-branded hearing aids, one per ear every two years. Benefit is limited to TruHearing’s Advanced and Premium hearing aids. Must use TruHearing providers.

 Not covered
Worldwide emergency or urgent care

$100 emergency copay

$50 urgent care copay

You may receive covered emergency and urgent care services anywhere in the world. If you are outside of the United States or its territories, your worldwide emergency and urgent care coverage is limited to $50,000
Personal Emergency Response System (PERS) $0 copay for a Mobile PERS plus device equipped with two-way voice communication, GPS location technology, and the option of auto fall detection with 24/7 monitoring
Transportation $0 copay for up to 20 one-way non-emergency trips per year to plan approved health-related locations. 50-mile limit one-way.
Meals after discharge $0 copay for 28 meals (2 meals per day for 14 days) delivered directly to your home after each discharge from an inpatient acute or a skilled nursing facility stay. Annual limit of 5 discharges for a total of 140 meals per year.

Part D Prescription Drug Coverage
Deductible Stage There is no Part D deductible
 Initial Coverage Stage
Tier 1 (preferred generics) $0
Tier 2 (generics) $12  Insulin: $10
Tier 3 (preferred brand) $47  Insulin: $35
Tier 4 (non-preferred brand) $100
Tier 5 (specialty drugs) 33% of the cost
Tier 6 (select care drugs) $0
Catastrophic Coverage Stage Once your yearly out-of-pocket drug costs total $2,000, our plan will pay the full cost for your covered Part D drugs.