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McLaren Medicare Inspire (HMO)

McLaren Medicare Inspire Plus (HMO)

McLaren Medicare Inspire Select (HMO)

McLaren Medicare Inspire (HMO)

This Medicare Advantage plan offers a low monthly premium 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 added benefits such as dental services through Delta Dental (with optional comprehensive buy-up coverage), hearing care, and virtual care with no cost-share through McLarenNow. You’ll also get a flex card with an annual allowance that you can spend as you like between over-the-counter items, fitness membership, vision or additional out-of-pocket dental costs.

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

Plan Premiums and Other Costs
Monthly premium $0
Maximum out of pocket limit $6,300
Annual deductible Medical Services
$0

Prescription Drug
$615 (Tiers 3-5)

Benefits and Costs
Primary care physician visit $0 copay
Specialist visits $45 copay
Preventive care $0 copay
Inpatient hospital coverage $550 per day for days 1 - 5
$0 per day for days 6 and after
Outpatient surgery - hospital $200 copay
Outpatient surgery - ambulatory surgical center $200 copay
Emergency care $115 copay anywhere in the United States or its territories
Urgent care $40 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 $35 copay
Over-the-counter (OTC) allowance See Flex Card
Meals after discharge $0 copay for 28 meals (two 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 five discharges for a total of 140 meals per year.
Flex Card

You will receive a Benefits Mastercard® Prepaid Card with an annual allowance of $500 that may be spent as you choose between over-the-counter items, fitness membership, vision, or additional out-of-pocket dental costs.
Dental
(Delta Dental Medicare Advantage PPO Network)

$40 copay for Medicare-covered dental services

Non-Medicare covered dental:

Preventive

$0 copay for:

  • Two exams and two cleanings (regular or periodontal) each year
  • One 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 five years
  • Emergency palliative treatment 

Comprehensive

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

Additional out-of-pocket dental costs

See Flex Card
Vision

Medicare-covered services

$45 copay for each visit

$0 copay for eyeglasses or contact lenses after cataract surgery

$0 copay for glaucoma screening

Routine vision services

See Flex Card
Chiropractic services $15 copay
Acupuncture services $25 copay
Fitness membership See Flex Card
Virtual care with McLarenNow $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.
Worldwide emergency or urgent care

$115 emergency copay

$40 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

Part D Prescription Drug Coverage
Deductible Stage $615 on Tier 3, 4 and 5 drugs
Deductible does not apply to insulin products and most Part D vaccines.
Initial Coverage Stage
Tier 1 (preferred generics) $0
Tier 2 (generics) $12
Insulin: $10
Tier 3 (preferred brand) 25%
Insulin: $35
Tier 4 (non-preferred brand) 40%
Insulin: $35
Tier 5 (specialty drugs) 25%
Insulin: $35
Tier 6 (select care drugs) $0
Catastrophic Coverage Stage Once your yearly out-of-pocket drug costs total $2,100, our plan will pay the full cost for your covered Part D drugs.
Enroll Here

McLaren Medicare Inspire Plus (HMO)

The McLaren Medicare Inspire Plus plan offers all the same benefits as the Inspire plan, plus it includes extra benefits such as transportation to and from medical appointments, and the option to receive a Personal Emergency Response System. This plan has no annual medical deductible, so your benefits start right away.

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

Plan Premiums and Other Costs
Monthly premium $8.80
Maximum out of pocket limit $5,900
Annual deductible Medical Services
$0

Prescription Drug
$500 (Tiers 3-5)

Benefits and Costs
Primary care physician visit $0 copay
Specialist visits $35 copay
Preventive care $0 copay
Inpatient hospital coverage $550 per day for days 1 - 5
$0 per day for days 6 and after
Outpatient surgery - hospital $150 copay
Outpatient surgery - ambulatory surgical center $150 copay
Emergency care $115 copay anywhere in the United States or its territories
Urgent care $40 copay in or out of network
Ambulance $200 copay
Lab services $0 copay
Diagnostic tests & procedures $20 copay
Diagnostic radiology services (MRI, CT scan) $300 copay
Standard X-rays $25 copay
Physical therapy $25 copay
Over-the-counter (OTC) allowance See Flex Card
Flex Card

You will receive a Benefits Mastercard® Prepaid Card with an annual allowance of $600 that may be spent as you choose between over-the-counter items, fitness membership, vision, or additional out-of-pocket dental costs.
Dental
(Delta Dental Medicare Advantage PPO Network)

$40 copay for Medicare-covered dental services

Non-Medicare covered dental:

Preventive

$0 copay for:

  • Two exams and two cleanings (regular or periodontal) each year
  • One 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 five years
  • Emergency palliative treatment

Comprehensive

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

Additional out-of-pocket dental costs

See Flex Card
Vision

Medicare-covered services

$35 copay for each visit

$0 copay for eyeglasses or contact lenses after cataract surgery

$0 copay for glaucoma screening

Routine vision services

See Flex Card
Chiropractic services $15 copay
Acupuncture services $35 copay
Fitness membership See Flex Card
Virtual care with McLarenNow $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

$115 emergency copay

$40 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 (two 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 five discharges for a total of 140 meals per year.

Part D Prescription Drug Coverage
Deductible Stage $500 on Tier 3, 4 and 5 drugs
Deductible does not apply to insulin products and most Part D vaccines.
Initial Coverage Stage
Tier 1 (preferred generics) $0
Tier 2 (generics) $12
Insulin: $10
Tier 3 (preferred brand) 25%
Insulin: $35
Tier 4 (non-preferred brand) 40%
Insulin: $35
Tier 5 (specialty drugs) 25%
Insulin: $35
Tier 6 (select care drugs) $0
Catastrophic Coverage Stage Once your yearly out-of-pocket drug costs total $2,100, our plan will pay the full cost for your covered Part D drugs.
Enroll Here

McLaren Medicare Inspire Select (HMO)

The McLaren Medicare Inspire Select plan is a great option if you're looking for an affordable HMO Medicare Advantage plan in Michigan. 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 health care partner. When you access in-network care, you’ll have low copays for all covered services. This plan also includes a $75 Part B buy-down, which reduces your monthly Medicare Part B premium.

Plan Premiums and Other Costs
Monthly premium

$0

$75 Part B buy-down (This plan will reduce your monthly Medicare Part B premium by $75.)
Maximum out of pocket limit $6,750
Annual deductible Medical Services
$0

Prescription Drug
$615 (Tiers 2-5)

Benefits and Costs
Primary care physician visit $0 copay
Specialist visits $50 copay
Preventive care $0 copay
Inpatient hospital coverage $550 per day for days 1 - 5
$0 per day for days 6 and after
Outpatient surgery - hospital $350 copay
Outpatient surgery - ambulatory surgical center $350 copay
Emergency care $115 copay anywhere in the United States or its territories
Urgent care $40 copay in or out of network
Ambulance $350 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 $45 copay
Over-the-counter (OTC) allowance See Flex Card
Flex Card

You will receive a Benefits Mastercard® Prepaid Card with an annual allowance of $250 that may be spent as you choose between over-the-counter items, fitness membership, vision, or additional out-of-pocket dental costs.
Dental
(Delta Dental Medicare Advantage PPO Network)

$40 copay for Medicare-covered dental services

Non-Medicare covered dental:

Preventive

$0 copay for:

  • Two exams and two cleanings (regular or periodontal) each year
  • One 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 five years
  • Emergency palliative treatment

Comprehensive

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

Additional out-of-pocket dental costs

See Flex Card
Vision

Medicare-covered services

$50 copay for each visit

$0 copay for eyeglasses or contact lenses after cataract surgery

$0 copay for glaucoma screening

Routine vision services

See Flex Card
Chiropractic services $15 copay
Acupuncture services $25 copay
Fitness membership See Flex Card
Virtual care with McLarenNow $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.
Worldwide emergency or urgent care

$115 emergency copay

$40 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
Meals after discharge $0 copay for 28 meals (two 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 five discharges for a total of 140 meals per year.

Part D Prescription Drug Coverage
Deductible Stage $615 on Tier 2, 3, 4 and 5 drugs
Deductible does not apply to insulin products and most Part D vaccines.
Initial Coverage Stage
Tier 1 (preferred generics) $0
Tier 2 (generics) $12
Insulin: $10
Tier 3 (preferred brand) 25%
Insulin: $35
Tier 4 (non-preferred brand) 30%
Insulin: $35
Tier 5 (specialty drugs) 25%
Insulin: $35
Tier 6 (select care drugs) $0
Catastrophic Coverage Stage Once your yearly out-of-pocket drug costs total $2,100, our plan will pay the full cost for your covered Part D drugs.
Enroll Here