Medicare Plus Blue Essential (PPO) in St. Joseph County, Michigan — 2026 plan details

Plan facts (CMS CY2026 Landscape file)

How this plan is structured

• $25 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
• PPO plan type. Plan-type rules determine in-network use and referrals. See how Medicare Advantage HMO and PPO plans differ.
• $6,250 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
• Service area = St. Joseph County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.

How it compares in St. Joseph County

The CMS CY2026 Landscape file lists 44 Medicare Advantage plans in St. Joseph County, Michigan, of which 0 carry a 5.0-star overall rating and 21 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $247.40 per month, and in-network out-of-pocket maximums range from $4000.00 to $9250.00.

For the full county plan directory, see all Medicare plans in St. Joseph County, Michigan.

How to verify your doctors take this plan

Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:

1. Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H9572-004.
2. Call the plan (Blue Cross Blue Shield of Michigan Mutual Ins. Co.) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
3. Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.

What H9572-004 means

CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H9572-004, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 9572 are the contract number issued to the organization, and the three-digit 004 is the plan benefit package under that contract. The segment ID 2 identifies the service-area segment within the plan (0 = the default single segment).

Frequently asked questions