Blue Advantage: Medicare Advantage Plan | Blue Cross and Blue Shield of Alabama - Medicare
Blue Advantage Plans Include:
- Comprehensive Medical Coverage
- Prescription Drug Coverage
- Comprehensive Dental
- Vision Exams & Eyewear
- Hearing Exams & Hearing Aids
- SilverSneakers® Fitness Membership
- Choice of plans, including $0 premium option
- Built-in prescription drug coverage
- Statewide provider network with 100% of Alabama hospitals and over 90% of doctors
- No referral required for network specialists, doctors or hospitals
- In and out of nework covered services
- $0 copay for an annual routine vision and hearing exam
- Significant discounts on hearing aids through TruHearing®
- $100 eyewear and starting at $500 allowance for preventative and comprehensive dental per calendar year
- SilverSneakers® fitness membership
- $0 copay for preventive care, most immunizations, and lab services
- Air medical transportation
- 24-Hour nurses hotline
Comprehensive Medical Coverage
Prescription Drug Coverage
Comprehensive Dental
Vision Exams & Eyewear
Hearing Exams & Hearing Aids
Silver Sneakers® Membership
Blue Advantage makes it easy to stay healthy and save money
- Choice of plans, including $0 premium option
- Built-in prescription drug coverage
- Statewide provider network with 100% of Alabama hospitals and over 90% of doctors
- No referral required for network specialists, doctors or hospitals
- In and out of nework covered services
- $0 copay for an annual routine vision and hearing exam
- Significant discounts on hearing aids through TruHearing®**
- $100 eyewear and starting at $500 allowance for preventative and comprehensive dental per calendar year
- SilverSneakers® fitness membership* Learn More >
- $0 copay for preventive care, most immunizations, and lab services
- Air medical transportation
- 24-Hour nurse hotline
More than 90% of all Alabama physicians are in our network.
Along with 100% of all Alabama hospitals!
More Information:
 |
Blue AdvantageComplete (PPO)$0 per month |
Blue AdvantagePremier (PPO)$170 per month |
|---|---|---|
| Primary Care Doctor Visit Copay | $5 copay per visit | $5 per visit |
| Specialist Visit Copay | $40 per visit | $25 per visit |
| Inpatient Hospital Copay | $225 copay per day for days 1–7; You pay nothing per day for days 8-90; $0 copay for days 91 and after |
$175 copay per day for days 1–5; You pay nothing per day for days 6-90; $0 copay for days 91 and after |
| Outpatient Hospital Copay | $250 copay | $150 copay |
| Lab Services | $0 copay | $0 copay |
| X-rays | $15 copay | $5 copay |
| Emergency Room Visit | $90 copay Waived if admitted |
$120 copay Waived if admitted |
| Ambulance | $275 copay | $150 copay |
| Many Preventive Wellness Services | $0 copay | $0 copay |
| Durable Medical Equipment | 20% of cost | 20% of cost |
| Diabetic Supplies* | $0 copay | $0 copay |
| Eye Exams | $0 copay for routine exam & $30 copay for diagnostic exam | $0 copay for routine exam & $25 copay for diagnostic exam |
| Eyewear Allowance | $100 per calendar year | $100 per calendar year |
| Preventive & Comprehensive Dental Allowance | $500 per calendar year | $750 per calendar year |
| Hearing Exams | $0 copay for routine exam $10 copay for diagnostic exam |
$0 copay for routine exam $10 copay for diagnostic exam |
| Hearing Aids | $699/$999 copay per hearing aid (one per ear, per year) |
$699/$999 copay per hearing aid (one per ear, per year) |
| Maximum Out-of-Pocket Amount | $5,100 (in-network) | $3,400 (in-network) |
| PREFERRED Cost-Sharing Pharmacy Copays/Coinsurance | ||
| Tier 1 - Preferred Generic | $4 | $3 |
| Tier 2 - Generic | $13 | $8 |
| Tier 3 - Preferred Brand | $40 | $40 |
| Tier 4 - Non-Preferred Brand | 45% | 45% |
| Tier 5 - Specialty Tier | 25% | 33% |
| STANDARD Cost-Sharing Pharmacy Copays / Coinsurance | ||
| Tier 1 - Preferred Generic | $11 | $10 |
| Tier 2 - Generic | $20 | $15 |
| Tier 3 - Preferred Brand | $47 | $47 |
| Tier 4 - Non-Preferred Brand | 50% | 50% |
| Tier 5 - Specialty Tier | 25% | 33% |
| Coverage Gap Phase | Once the TOTAL prescription annual spending exceeds $4,130 and YOUR spending is below $6,550 you pay 25% of generic drug costs and 25% of brand-name drug costs. | Once the TOTAL prescription annual spending exceeds $4,130 and YOUR spending is below $6,550 you pay 25% of generic drug costs and 25% of brand-name drug costs. |
| Catastrophic Coverage Phase | Once YOUR out-of-pocket spending on prescriptions reaches $6,550 you pay the greater of $3.70 for generic drugs and $9.20 for brand-name drugs OR 5% coinsurance per prescription for the rest of the year. Blue Advantage pays the rest. | Once YOUR out-of-pocket spending on prescriptions reaches $6,550 you pay the greater of $3.70 for generic drugs and $9.20 for brand-name drugs OR 5% coinsurance per prescription for the rest of the year. Blue Advantage pays the rest. |
*Only Ascensia and LifeScan products are preferred with a $0 copay for diabetic test strips and glucometers at the pharmacy and through mail-order home delivery.
*SilverSneakers is a registered trademark of Tivity Health, Inc. © 2019 Tivity Health, Inc. All rights reserved.
** All content ©2020 TruHearing, Inc. All Rights Reserved. TruHearing® is a registered trademark of TruHearing, Inc. Three follow-up visits must be used within one year after the date of initial purchase. Free battery offer is not applicable to the purchase of rechargeable hearing aid models. Three-year warranty includes repairs and one-time loss and damage replacement. Hearing aid repairs and replacements are subject to provider and manufacturer fees.
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