Blue Cross Blue Shield Of Michigan
Avg Star Rating
4.5 ★
Plan
Premium
MOOP
Stars
Type
Compare & Enroll — Part C & Part D
Compare & Enroll in Medicare Plans in St. Clair County, MI
With 74 Medicare Advantage options from 11 insurers, St. Clair County, MI offers above-average plan selection, suggesting a highly competitive market where insurers often lower premiums to attract members. Approximately 74% of local MA plans charge $0 beyond the standard Part B premium, reflecting strong price competition. With 4 hospitals within 25.0 miles, verifying your preferred hospital is in-network is especially important here. We've organized the CMS data below to help you cross-reference plan costs, quality ratings, and local provider access. Compare plans below, and when you're ready, enroll directly at Medicare.gov.
📊 Direct from CMS
🚫 No agents or commissions
✓ Just the data, no sales pitch
Compare Plans at Medicare.gov →
Data freshness: CMS data as of February 2026 •
ACS data as of 2023 •
Reviewed & approved on 2026-02-16
Reviewed by: Wes Ward, Founder & Data Lead •
View our methodology
Important: We are not affiliated with Medicare or any government agency. This site displays publicly available CMS data to help you compare plans. We do not sell insurance or represent any insurance company. For official enrollment and complete plan information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
Important: Plan availability, benefits, and CMS Star Ratings shown here come directly from CMS public files. Plan details can change—always verify with the insurer and at Medicare.gov.
Part C Plans
74
Part D Plans
12
Top MA Star
4.5
Top Drug Star
3.5
Medicare Eligibility in St. Clair County, MI
Approximately 32,007 residents (19.5% of the population) in St. Clair County, MI are 65 or older and likely Medicare-eligible. Whether you're approaching 65, already enrolled, or a caregiver comparing options, the plan data below is organized to help you evaluate Part C (Medicare Advantage) and Part D (prescription drug) coverage side by side.
The median household income in St. Clair County, MI is $73,116 (2.7% below the National Average), which may affect eligibility for Extra Help with Part D drug costs.
Part C: Medicare Advantage Plans
Medicare Advantage (Part C) replaces Original Medicare through private insurers who bundle hospital, medical, and often drug coverage into a single plan. St. Clair County, MI's 74 Medicare Advantage plans are a mix leaning toward PPO networks (39 PPO, 35 HMO). 55 plans offer $0 monthly premiums. The average local star rating is 3.8 out of 5, with the top plan earning 4.5 ★.
Top Medicare Advantage Plans in St. Clair County, MI
We organize CMS plan data into separate leaderboards so you can compare based on what matters most to you. Part C premiums in St. Clair County, MI range from $0 to $163/month. Among rated plans, 42 plans rated 4+ stars.
Highest CMS Star Ratings
Star Ratings are assigned by CMS based on quality measures including customer service, preventive care, and managing chronic conditions.
| Plan Name | Insurer | Star Rating | Premium | Type | |
|---|---|---|---|---|---|
| Medicare Plus Blue Essential (PPO) | Blue Cross Blue Shield Of Michigan | 4.5 ★ | $25.00/mo | PPO | Enroll |
| Medicare Plus Blue Secure (PPO) | Blue Cross Blue Shield Of Michigan | 4.5 ★ | $0.00/mo | PPO | Enroll |
| Humana Full Access Giveback H7617-058 (PPO) | Humana | 4.5 ★ | $0.00/mo | PPO | Enroll |
| Bcn Advantage Prime Value (HMO-POS) | Blue Care Network | 4.5 ★ | $25.40/mo | HMO-POS | Enroll |
| Aetna Medicare Signature Extra (PPO) | Aetna Medicare | 4.5 ★ | $0.00/mo | PPO | Enroll |
Lowest Monthly Premium
Lower premiums can save money, but check total costs including deductibles, copays, and MOOP.
| Plan Name | Insurer | Monthly Premium | MOOP | Star Rating |
|---|---|---|---|---|
| Hap Medicare Prime (PPO) | Hap Senior Plus (Ppo) | $0.00/mo | $5,650 | 4.0 ★ |
| Humana Full Access Giveback H5216-306 (PPO) | Humana | $0.00/mo | $9,150 | 3.5 ★ |
| Humana Gold Plus Snp-De H8908-005 (HMO D-SNP) | Humana | $0.00/mo | $9,250 | 3.0 ★ |
| Medicare Plus Blue Secure (PPO) | Blue Cross Blue Shield Of Michigan | $0.00/mo | $6,750 | 4.5 ★ |
| Humana Full Access Giveback H7617-058 (PPO) | Humana | $0.00/mo | $9,150 | 4.5 ★ |
Lowest Maximum Out-of-Pocket (MOOP)
MOOP caps your financial risk. Once you hit this limit, the plan covers 100% of covered services for the rest of the year.
| Plan Name | Insurer | MOOP (In-Network) | Premium | Star Rating |
|---|---|---|---|---|
| Humana Gold Plus H8908-001 (HMO-POS) | Humana | $3,950 | $19.20/mo | 3.0 ★ |
| Medicare Plus Blue Assure (PPO) | Blue Cross Blue Shield Of Michigan | $4,000 | $99.90/mo | 4.5 ★ |
| Bcn Advantage Prestige (HMO-POS) | Blue Care Network | $4,000 | $163.40/mo | 4.5 ★ |
| Hap Senior Plus (PPO) | Hap Senior Plus (Ppo) | $4,150 | $122.40/mo | 4.0 ★ |
| Prioritymedicare Merit (PPO) | Priority Health Medicare | $4,200 | $8.40/mo | 4.0 ★ |
Plan Type Mix in St. Clair County, MI
HMO plans require referrals and in-network care. PPO plans offer more flexibility. SNP (Special Needs Plans) serve specific populations. MAPD plans include drug coverage.
| Plan Type | Count | Percentage | Description |
|---|---|---|---|
| PPO | 33 | 44.6% | No referrals; in and out-of-network |
| HMO-POS | 16 | 21.6% | HMO with some out-of-network options |
| HMO | 7 | 9.5% | Requires referrals; in-network only |
| HMO D-SNP | 6 | 8.1% | Medicare Advantage plan |
| HMO C-SNP | 3 | 4.1% | Medicare Advantage plan |
| PPO D-SNP | 3 | 4.1% | Medicare Advantage plan |
| Regional PPO | 2 | 2.7% | Medicare Advantage plan |
| HMO-POS D-SNP | 2 | 2.7% | Medicare Advantage plan |
| PPO C-SNP | 1 | 1.4% | Medicare Advantage plan |
| HMO I-SNP | 1 | 1.4% | Medicare Advantage plan |
Choosing the Right Medicare Advantage Plan
The best Part C plan depends on your doctors, medications, and budget. Key factors to evaluate:
- Provider network: Verify your doctors and hospitals near St. Clair County, MI are in-network before enrolling
- Total cost: A $0 premium may have higher copays—calculate your annual cost
- Star Ratings: 4+ stars indicate above-average quality and member satisfaction
Read our full guide on choosing Medicare Advantage → · Print our enrollment checklist →
Medicare Glossary: HMO, PPO, MOOP & more →
Medicare Advantage Insurers in St. Clair County, MI
11 insurance companies offer Medicare Advantage plans in St. Clair County, MI. Below, we group plans by insurer so you can compare options from each company. More insurers generally means more competition and better benefits for consumers.
Blue Care Network
Avg Star Rating
4.5 ★
Plan
Premium
MOOP
Stars
Type
Priority Health Medicare
Avg Star Rating
4.2 ★
Plan
Premium
MOOP
Stars
Type
Hap Senior Plus
Avg Star Rating
4.0 ★
Plan
Premium
MOOP
Stars
Type
Hap Senior Plus (Ppo)
Avg Star Rating
4.0 ★
Plan
Premium
MOOP
Stars
Type
Aetna Medicare
Avg Star Rating
3.9 ★
Plan
Premium
MOOP
Stars
Type
Humana
Avg Star Rating
3.6 ★
Plan
Premium
MOOP
Stars
Type
Wellcare
Avg Star Rating
3.0 ★
Plan
Premium
MOOP
Stars
Type
Mclaren Medicare
Avg Star Rating
3.0 ★
Molina Healthcare Of Michigan
Avg Star Rating
3.0 ★
Plan
Premium
MOOP
Stars
Type
Longevity Health Plan
Avg Star Rating
N/A
Plan
Premium
MOOP
Stars
Type
Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.
Part D: Prescription Drug Plans (PDP)
Part D covers prescription drugs through standalone plans for those on Original Medicare, or as part of a Medicare Advantage bundle. Among the 12 standalone Part D plans in St. Clair County, MI, some offer $0 annual deductibles while others charge up to the 2026 maximum of $590. 3 plans are at or below the regional premium benchmark, making them eligible for Low Income Subsidy auto-enrollment. The 2026 $2,000 out-of-pocket cap means drug costs are now more predictable regardless of which plan you choose, but formulary coverage still varies significantly—always verify your medications are covered before enrolling.
Part D Formulary Notice: Each Part D plan has its own formulary (list of covered drugs). The same medication may be on different tiers—or not covered at all—depending on the plan. Always check that your specific medications are covered before enrolling.
2026 Out-of-Pocket Cap: Thanks to the Inflation Reduction Act, your total out-of-pocket drug costs are capped at $2,000 per year in 2026. Once you reach this limit, you pay nothing more for covered Part D drugs for the rest of the year. This eliminates the old "donut hole" coverage gap that previously caused higher costs.
Low Income Subsidy (LIS / Extra Help): If you have limited income and resources, you may qualify for Extra Help paying Part D costs. Visit SSA.gov or call 1-800-MEDICARE.
Top Part D Drug Plans in St. Clair County, MI
We organize Part D plans by CMS Star Ratings, premiums, and deductibles so you can find the best fit for your prescription needs. Part D premiums in St. Clair County, MI range from $0 to $107/month. Remember: all Part D plans now cap your annual out-of-pocket drug costs at $2,000 thanks to the Inflation Reduction Act.
Highest CMS Star Ratings (Part D)
Part D Star Ratings measure drug pricing, customer service, member complaints, and pharmacy access.
| Plan Name | Insurer | Star Rating | Premium | Deductible | |
|---|---|---|---|---|---|
| Wellcare Value Script (PDP) | Wellcare | 3.5 ★ | $0.00/mo | $615 | Enroll |
| Wellcare Classic (PDP) | Wellcare | 3.5 ★ | $0.00/mo | $615 | Enroll |
| Humana Value Rx Plan (PDP) | Humana | 3.0 ★ | $0.00/mo | $601 | Enroll |
| Silverscript Choice (PDP) | Aetna Medicare | 3.0 ★ | $78.30/mo | $615 | Enroll |
| Humana Basic Rx Plan (PDP) | Humana | 3.0 ★ | $0.00/mo | $615 | Enroll |
Lowest Monthly Premium
Lower premiums help with monthly cash flow, but check drug tier costs and the deductible.
| Plan Name | Insurer | Monthly Premium | Drug Deductible | Star Rating |
|---|---|---|---|---|
| Wellcare Value Script (PDP) | Wellcare | $0.00/mo | $615 | 3.5 ★ |
| Humana Value Rx Plan (PDP) | Humana | $0.00/mo | $601 | 3.0 ★ |
| Wellcare Classic (PDP) | Wellcare | $0.00/mo | $615 | 3.5 ★ |
| Healthspring Assurance Rx (PDP) | Healthspring | $0.00/mo | $615 | 2.5 ★ |
| Humana Basic Rx Plan (PDP) | Humana | $0.00/mo | $615 | 3.0 ★ |
Lowest Annual Drug Deductible
The deductible is what you pay out-of-pocket before the plan starts covering drug costs. The 2026 maximum Part D deductible is $590. Many plans offer $0 deductible options.
| Plan Name | Insurer | Drug Deductible | Monthly Premium | Star Rating |
|---|---|---|---|---|
| Humana Premier Rx Plan (PDP) | Humana | $0 | $98.10/mo | 3.0 ★ |
| Prescription Blue Premium (PDP) | Blue Cross Blue Shield Of Michigan | $0 | $106.70/mo | 2.5 ★ |
| Aarp Medicare Rx Preferred From Uhc (PDP) | Unitedhealthcare | $130 | $78.30/mo | 2.0 ★ |
| Humana Value Rx Plan (PDP) | Humana | $601 | $0.00/mo | 3.0 ★ |
| Wellcare Classic (PDP) | Wellcare | $615 | $0.00/mo | 3.5 ★ |
Understanding drug tiers: Part D plans organize medications into 5 cost tiers — Tier 1 (Preferred Generic) is cheapest; Tier 5 (Specialty) is most expensive. Two plans with the same premium can have very different costs for your drugs depending on tier placement. Learn more about drug tiers →
Choosing the Right Part D Drug Plan
The right Part D plan depends on your specific medications. Key factors to evaluate:
- Formulary: Verify your drugs are covered before enrolling
- Preferred pharmacies: Lower copays at certain locations—check your pharmacy is in-network
- Total annual cost: Premium + deductible + copays for your drugs
Read our full guide on choosing Part D →
What is a formulary? See our Medicare Glossary →
Part D Drug Plan Insurers in St. Clair County, MI
6 insurance companies offer standalone Part D drug plans in St. Clair County, MI. Below, we group plans by insurer.
Wellcare
Avg Star Rating
3.5 ★
Humana
Avg Star Rating
3.0 ★
Aetna Medicare
Avg Star Rating
3.0 ★
Plan
Premium
Deductible
Stars
Type
Blue Cross Blue Shield Of Michigan
Avg Star Rating
2.5 ★
Healthspring
Avg Star Rating
2.5 ★
Unitedhealthcare
Avg Star Rating
2.0 ★
Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.
Ready to Enroll in St. Clair County, MI?
Compare plans side-by-side at Medicare.gov or speak with a licensed Medicare specialist.
📋 Print our Medicare Enrollment Checklist — gather your info before you compare.
📅 Enrollment Dates & Deadlines · 🩺 Questions to Ask Your Doctor
Medicare.gov is the official U.S. government site for Medicare. Available 24/7.
Pharmacy Access in St. Clair County, MI
Part D plans have preferred pharmacy networks where you'll pay lower copays. Here's a look at pharmacy options in and around St. Clair County, MI.
Total Pharmacies
4
within 5.0 miles
Chain Pharmacies
2
CVS, Walgreens, etc.
Independent Pharmacies
2
locally owned
| Pharmacy | Address & Phone | Distance | Type |
|---|---|---|---|
| WADHAMS CORNER PHARMACY, LLC | 5283 LAPEER RD KIMBALL, MI 480741422 810-032-1761 | 2.5 mi | Independent |
| MEIJER INC | 205 S RANGE RD MARYSVILLE, MI 48040 810-038-9610 | 3.3 mi | Chain |
| ST CLAIR PHARMACY INC | 201 N RIVERSIDE AVE STE A1 SAINT CLAIR, MI 480795470 810-032-1233 | 3.9 mi | Independent |
| RITE AID OF MICHIGAN INC | 1750 GRATIOT BOULEVARD MARYSVILLE, MI 480401182 810-036-6200 | 4.3 mi | Chain |
| HURON MEDICAL CENTER P.C. | 2605 ELECTRIC AVE PORT HURON, MI 480606590 810-082-4066 | 6.3 mi | Independent |
| SAMS EAST INC | 1237 32ND ST PORT HURON, MI 480607323 810-098-5791 | 6.6 mi | Independent |
| PERRY DRUG STORES INC AND SUBSIDIARIES | 1607 24TH STREET PORT HURON, MI 480604820 810-098-5108 | 6.8 mi | Independent |
| GENOA HEALTHCARE LLC | 3111 ELECTRIC AVE PORT HURON, MI 480608127 810-082-5120 | 6.8 mi | Chain |
| KROGER CO OF MICHIGAN | 1215 24TH ST PORT HURON, MI 480604812 810-098-7155 | 6.8 mi | Chain |
| PRIME HEALTHCARE SERVICES-PORT HURON LLC | 2601 ELECTRIC AVE PORT HURON, MI 480606587 810-021-3140 | 7.2 mi | Independent |
Pharmacy data from CMS. Network participation varies by plan—always verify with your specific Part D plan.
Local Healthcare Access in St. Clair County, MI
Before choosing a plan, consider the healthcare infrastructure in St. Clair County, MI. Medicare Advantage plans restrict you to in-network hospitals, so understanding local hospital quality helps you pick the right plan — not just the cheapest one.
Note: The facilities below do not indicate which providers are in-network for any specific plan. Always verify network status with your plan before enrolling.
Hospitals Nearby
4
within 25.0 miles
Top-Rated Hospitals near St. Clair County, MI
If hospital access matters to your plan choice, check quality ratings before you enroll. These are the highest CMS-rated hospitals near St. Clair County, MI — click a hospital name to see its full profile and verify it's in your plan's network.
| Hospital | CMS Rating | Distance | Beds |
|---|---|---|---|
| Lake Huron Medical Center | 4 ★ | 7.2 mi | 119 |
| Ascension River District Hospital | 3 ★ | 9.7 mi | 68 |
| Henry Ford Macomb Hospital | 3 ★ | 28.8 mi | 361 |
| Beaumont Hospital, Troy | 3 ★ | 33.8 mi | 254 |
| Mclaren Port Huron | 2 ★ | 8.5 mi | 163 |
| Ascension Providence Rochester Hospital | 2 ★ | 33.7 mi | 290 |
| Henry Ford Health Warren Hospital | 2 ★ | 36.7 mi | 348 |
| Henry Ford Health St John Hospital | 2 ★ | 38.4 mi | 625 |
| Mclaren Macomb | 1 ★ | 28.1 mi | 288 |
| Harbor Oaks Hospital | Not Rated | 19.0 mi | 140 |
View all 4 hospitals near St. Clair County, MI to check quality before you enroll →
Hospital data from CMS Hospital Compare and Provider of Services file. Distance calculated from center of St. Clair County, MI.
Telehealth in St. Clair County, MI: Is Your Internet Ready?
Many Medicare Advantage and some Part D plans now include telehealth benefits, making routine check-ins and prescription refills easier from home. But telehealth requires reliable internet—here's a look at connectivity in St. Clair County, MI. For official guidance on virtual visits, see Telehealth.HHS.gov from the U.S. Department of Health & Human Services.
Check Internet Providers at Your Address
Telehealth works best with reliable internet. Use this tool (provided free by ISP Reports) to see what's available at your address.
Opens ISP Reports in a new tab. This is not a paid relationship. Special thank you to ISP Reports for allowing free use of their address tool.
Internet Coverage in St. Clair County, MI
Fiber Available
23.4%
of households
Cable/DSL Available
99.0%
of households
Top Provider
XFINITY
88.1% coverage
No Broadband
2.0%
of households
Internet coverage data from ISP Reports. View full internet report for St. Clair County, MI.
Medicare-Relevant Demographics in St. Clair County, MI
Understanding St. Clair County, MI's demographics helps contextualize why insurers offer the plans they do. Areas with more seniors and higher incomes tend to attract more insurer competition, while areas with higher Medicaid enrollment may have more Dual-Eligible Special Needs Plans (D-SNP) available.
Total Population
163,833
Population 65+
32,007
19.5% of total
Median Age
44
6.5 years older than the national average
Median Income
$73,116
2.7% below the National Average
On Medicare
28,116
17.2% of residents
On Medicaid
29,571
18.0% of residents
Uninsured
7,652
4.7% of residents
Social Security Recipients
60,676
37.0% of population
Demographic data from U.S. Census Bureau American Community Survey (2023). View full St. Clair County, MI demographics (BestNeighborhood.org).
Local Medicare FAQ: St. Clair County, MI
Common decision points based on St. Clair County, MI's specific plan market and local healthcare landscape.
How does St. Clair County, MI's Medicare Advantage market compare?
St. Clair County, MI has 74 Medicare Advantage plans from 11 insurers. This is above the national average of approximately 57 plans, suggesting healthy competition among insurers in this area. The local mix includes 35 HMO and 39 PPO plans. Plan availability updates annually during the Medicare Annual Enrollment Period (October 15 – December 7).
Should I choose an HMO or PPO Medicare Advantage plan in St. Clair County, MI?
With 4 hospitals nearby, a PPO plan may offer valuable flexibility if your preferred providers aren't all in the same network. HMO plans (35 available) cost less but limit your choices. In St. Clair County, MI, PPO plans are more common, giving you more flexibility options to compare. Always verify your doctors are in-network before enrolling in any plan.
What's the real cost of $0 premium plans in St. Clair County, MI?
55 plans (74% of available options) in St. Clair County, MI charge $0 beyond the standard Part B premium. This high percentage reflects strong insurer competition in the area. However, $0 premium doesn't mean $0 cost. These plans may have higher copays, coinsurance, or out-of-pocket maximums. In St. Clair County, MI, maximum out-of-pocket limits range from $3,950 to an average of $6,441. We recommend calculating your total expected annual cost (premium + copays + drug costs) rather than choosing based on premium alone.
How does the 2026 $2,000 drug cap affect St. Clair County, MI beneficiaries?
The Inflation Reduction Act capped annual out-of-pocket drug spending at $2,000 starting in 2025, eliminating the old "donut hole" coverage gap. This applies to all 12 standalone Part D plans in St. Clair County, MI.
What this means locally:
- Cost predictability — No matter which of the 12 Part D plans you choose, your drug costs are capped at $2,000/year
- $0 deductible options — Some local plans offer $0 deductibles, meaning coverage starts immediately
- Low-income options — 3 plans meet the regional benchmark for Extra Help/LIS eligibility
While the out-of-pocket cap standardizes maximum costs, formulary coverage still varies significantly between plans. A drug that costs $5/month on one plan's formulary might cost $50 on another. Always check that your specific medications are covered and compare tier placement before enrolling.
See all Medicare FAQs in our complete guide → · Enrollment checklist →
Medicare Glossary · Enrollment Dates & Deadlines · Doctor Questions
About the Data & Editorial Team
Wes Ward
Founder & Data Lead
Wes Ward is the founder of InsuranceDataNow.org and reviews all content for data accuracy and methodology compliance.
With 25+ years in data analytics — including work with highly regulated genomic data at Ancestry.com — Wes brings enterprise-level rigor to consumer data tools. He is also a co-founder of BestNeighborhood.org, CrimeGrade.org, and ISPReports.org.
Role: Reviews and approves all content for data accuracy, source verification, and methodology compliance.
Transparency & Disclosures
InsuranceDataNow is an advertising-supported publisher based in South Jordan, Utah. We are not affiliated with or endorsed by Medicare or the U.S. government.
TPMO Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (24 hours a day/7 days a week) to get information on all of your options.
Sources
- CMS Medicare Plan Finder Data (Part C & D): cms.gov
- CMS Provider Directory: Hospital and pharmacy data from data.cms.gov
- American Community Survey: Demographic data from census.gov
- FCC Broadband Map: Internet availability data from broadbandmap.fcc.gov
- ISP Reports: Internet provider coverage for St. Clair County, MI from ispreports.org
- Telehealth.HHS.gov: Official telehealth guidance from U.S. Dept. of Health & Human Services
- BestNeighborhood.org: Community demographic profiles for St. Clair County, MI from bestneighborhood.org
All data is sourced from official government databases and trusted third-party providers. Data is updated regularly—see page header for last refresh dates.