Medicare Plus Blue PPO — Enhanced Podiatry Benefits in Michigan

Medicare Plus Blue PPO is Blue Cross Blue Shield of Michigan’s flagship Medicare Advantage plan. For podiatry, it often provides BETTER coverage than Original Medicare alone — including benefits for routine foot care that Original Medicare doesn’t cover. Here’s what Michigan seniors with Medicare Plus Blue PPO need to know.

What Medicare Plus Blue PPO Covers for Podiatry

Medicare Plus Blue PPO covers everything Original Medicare Part B covers for podiatry — plus, many plan variants include:

• Routine foot care — nail trimming, callus care, and routine exams even without a qualifying systemic condition (check your specific plan)
• Additional annual podiatry visits — beyond the once-per-year diabetic foot exam covered by Original Medicare
• Lower specialist copays — typically $30-$45 per visit vs. 20% coinsurance under Original Medicare
• No referral required — see a podiatrist directly without PCP authorization

How Medicare Plus Blue PPO Differs from Original Medicare

Original Medicare pays 80% of approved charges after your $257 deductible. With Medicare Plus Blue PPO, you typically pay a fixed specialist copay ($30-$45) with no separate deductible for most visits — making your costs more predictable.

Out-of-Pocket Maximum Protection

Unlike Original Medicare (which has no out-of-pocket maximum), Medicare Plus Blue PPO includes an annual out-of-pocket maximum. Once you reach this limit, the plan covers 100% of covered services for the rest of the year — important protection for patients with multiple podiatric conditions.

How to Verify Your Medicare Plus Blue PPO Benefits

Plan benefits vary by the specific Medicare Plus Blue PPO product you’re enrolled in. Call the member services number on your card, or call us — we verify Medicare Plus Blue benefits for patients regularly.

📞 Call (810) 206-1402 to verify your Medicare Plus Blue PPO benefits at Balance Foot & Ankle.

Medicare Plus Blue PPO Podiatry Coverage Michigan: BCBS Medicare Supplement Guide

Medicare Plus Blue (also called Blue Medicare PPO or Medicare Advantage PPO) is Blue Cross Blue Shield of Michigan’s Medicare Advantage plan product, covering Medicare-eligible Michigan residents in Livingston and Oakland counties. Balance Foot & Ankle participates in Medicare Plus Blue networks and welcomes members at our Howell and Bloomfield Hills locations. Medicare Plus Blue podiatry benefits follow Medicare Part B clinical coverage guidelines — medically necessary evaluation and management, nail care for qualifying systemic conditions, wound care, injections, custom orthotics and diabetic footwear with prior authorization, and surgical procedures — with BCBS-specific cost-sharing that may differ from traditional Medicare’s 80/20 structure.

Michigan Medicare Plus Blue PPO members benefit from the flexibility of a PPO design — access to any Medicare-accepting provider, with lower cost-sharing when using in-network providers like Balance Foot & Ankle. Members transitioning from traditional Medicare to Medicare Plus Blue should understand that their podiatry benefits are similar but cost-sharing and authorization requirements may differ from what they experienced under traditional Medicare. Our billing team at (810) 206-1402 is experienced with Medicare Plus Blue billing and can verify your specific plan’s cost-sharing and authorization requirements before your appointment. Livingston and Oakland county Medicare Plus Blue members are encouraged to schedule their annual diabetic foot examination before the end of the calendar year to ensure the benefit is utilized before the December 31 reset.

Patients covered under this plan who are uncertain about network participation or authorization requirements for specific services are encouraged to call Balance Foot & Ankle at (810) 206-1402 before scheduling. Our insurance team verifies benefits for every new patient — confirming in-network status, identifying specialist cost-sharing, and flagging any prior authorization requirements for planned procedures. This verification call is free and typically takes less than 5 minutes, eliminating the uncertainty that leads many patients to defer necessary foot care. Same-week appointments are available in Howell and Bloomfield Hills for most foot and ankle concerns.

Related Treatment Guides

• Corn & Callus Treatment
• Plantar Fasciitis & Heel Pain Treatment
• Custom 3D Orthotics
• Sports Foot & Ankle Injury Treatment

Michigan patients experiencing foot or ankle problems can schedule an appointment at Balance Foot & Ankle — with locations in Howell (4330 E Grand River) and Bloomfield Hills (43494 Woodward Ave #208). Call (810) 206-1402 for same-week availability.

Medical References & Sources

• American Podiatric Medical Association — Patient Education
• American Orthopaedic Foot & Ankle Society — Foot Conditions

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

Podiatrist

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.