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. |