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.
New for 2027, you will enjoy a tiered network, meaning you may pay less for certain services if you use a Tier 1 provider.
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
|
$6,600 |
|
Annual deductible
|
Medical Services
$0
Prescription Drug
$615 (Tiers 3-5) |
Benefits and Costs
|
|
Primary care physician visit
|
$0 copay
|
|
Specialist visits
|
Tier 1 $40/Tier 2 $45 copay
|
|
Preventive care |
$0 copay
|
|
Inpatient hospital coverage
|
Tier 1 $450/Tier 2 $550 per day for days 1-5;
Tier 1 and Tier 2 $0 per day for days 6-91
|
|
Outpatient surgery - hospital
|
Tier 1 $350/Tier 2 $525 copay
|
|
Outpatient surgery - ambulatory surgical center
|
Tier 1 $350/Tier 2 $450 copay |
|
Emergency care
|
$130 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
|
Tier 1 $20-$200/Tier 2 $20-$375 copay
|
|
Diagnostic radiology services (MRI, CT scan)
|
$200 copay
|
|
Standard X-rays
|
Tier 1 $25-$200/Tier 2 $25-$375 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 $325 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) |
Tier 1 $40/Tier 2 $45 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
Tier 1: $40 copay for each visit/Tier 2: $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 |
$130 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
|
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)
|
25%
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 $2,400, our plan will pay the full cost for your covered Part D drugs.
|
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
|
$20 |
|
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 6-91
|
|
Outpatient surgery - hospital
|
$150 copay
|
|
Outpatient surgery - ambulatory surgical center
|
$150 copay
|
|
Emergency care
|
$130 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
|
|
Diagnostic tests & procedures
|
$20-150 copay
|
|
Diagnostic radiology services (MRI, CT scan)
|
$300 copay
|
|
Standard X-rays
|
$20-$150 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 $450 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)
|
$35 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
|
$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.
|
|
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 |
$130 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 (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)
|
25%
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 $2,400, our plan will pay the full cost for your covered Part D drugs. |
McLaren Medicare Inspire Giveback (HMO)
The McLaren Medicare Inspire Giveback 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 $70 Part B buy-down, which reduces your monthly Medicare Part B premium.
Plan Premiums and Other Costs
|
|
Monthly premium
|
$0
$70 Part B buy-down (This plan will reduce your monthly Medicare Part B premium by $70.)
|
|
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 6-91
|
|
Outpatient surgery - hospital
|
$550 copay
|
|
Outpatient surgery - ambulatory surgical center
|
$450 copay
|
|
Emergency care
|
$130 copay anywhere in the United States or its territories |
|
Urgent care
|
$50 copay in or out of network
|
|
Ambulance
|
$350 copay
|
|
Lab services
|
$0 copay
|
|
Diagnostic tests & procedures
|
$20-$350 copay
|
|
Diagnostic radiology services (MRI, CT scan)
|
$150-$350 copay
|
|
Standard X-rays
|
$25-$350 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)
|
$50 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 |
$130 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
|
|
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)
|
25%
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 $2,400, our plan will pay the full cost for your covered Part D drugs. |