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 network and out covered services
- $0 copay for an annual routine vision and hearing exam
- Significant discounts on hearing aids through TruHearing®
- $100 eyewear and starting at $1,000 allowance for preventative and comprehensive dental per calendar year
- FREE SilverSneakers® fitness membership
- $0 copay for most preventive services, most immunizations, and lab services
- Air medical transportation**
- 24-Hour nurses hotline
Comprehensive Medical Coverage
More >Comprehensive Medical Coverage
NO referrals required to see specialists.
You can use providers outside the network.
With over 90% of doctors and every Alabama hospital in the Blue Advantage network, it’s easy to get the in-network doctor you want.
NO COST for many health screenings, immunizations, and other Medicare-recommended preventive services.
Prescription Drug Coverage
More >Prescription Drug Coverage
Both Blue Advantage plans have over 1,000+ network pharmacies in Alabama that make it convenient for you to save money.
Your drug cost savings are avaliable at retail pharmacies as well as through Mail-Order. Our Extensive PREFERRED pharmacy networks include Costco, Kroger, Publix, Sam's Club, Walgreens, Walmart, Winn-Dixie plus HUNDREDS of local independent neighborhood pharmacies!
Click here for ways to ensure you are paying the least amount for your prescriptions with Rx Savings Solutions.
Comprehensive & Preventive Dental
More >Comprehensive & Preventive Dental
Our Dental plans are designed to deliver care at an affordable price with no waiting period for Comprehensive and Preventive Services.
$1,000/$1,300 max per calendar year for comprehensive and preventive dental allowance (Blue Advantage Complete / Blue Advantage Premier)
Vision Exams & Eyewear
More >Vision Exams & Eyewear
$0 copay for annual routine vision exam
$100 eyewear allowance per calendar year
Hearing Exams & Hearing Aids
More >TruHearing® Services*
A comprehensive hearing care solution — $0 copay for routine hearing exams, plus you can get state-of-the-art hearing aids as low as $699 or $999 (one per ear, per year) which can save you thousands of dollars.
*All content ©2021 TruHearing, Inc. All rights reserved. TruHearing® is a registered trademark of TruHearing, Inc. All appointments must be performed by a TruHearing network provider for routine hearing exam and hearing aids.
Silver Sneakers® Membership
More >Enjoy a complimentary SilverSneakers® fitness membership!
An innovative health, exercise and wellness program for active seniors. Get fit, have fun and make new friends while enjoying a healthy lifestyle.
- Unlimited gym access at over 300 participating locations in Alabama
- At-home kits available if you can't get to a fitness location due to health reasons
- Online resources and support from trained Advisors
*SilverSneakers is a registered trademark of Tivity Health, Inc. © 2022 Tivity Health, Inc. All rights reserved.
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 network and out of network covered services
- $0 copay for an annual routine vision and hearing exam
- Significant discounts on hearing aids through TruHearing®***
- $100 eyewear and starting at $1,000 allowance for preventative and comprehensive dental per calendar year
- FREE SilverSneakers® fitness membership* Learn More >
- $0 copay for most preventive services, 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 monthView LIS Pricing >
Based on your income, you may qualify for financial help from Medicare to lower your monthly premium.* If you qualify, you will also have no drug coverage gap and lower out-of-pocket costs. If you aren't receiving extra help, the Alabama State Health Insurance Assistance Program (SHIP) provides education and counseling on low-income assistance programs for Medicare. 1-800-AGE-LINE (1-800-243-5463) TTY 1-800-548-2547 Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles, and co-payments related to Medicare prescription drug coverage. https://www.ssa.gov/benefits/medicare/prescriptionhelp
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778; or your State Medicaid Office. *You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. |
Blue AdvantagePremier (PPO)$164 per monthView LIS Pricing >
Based on your income, you may qualify for financial help from Medicare to lower your monthly premium.* If you qualify, you will also have no drug coverage gap and lower out-of-pocket costs. If you aren't receiving extra help, the Alabama State Health Insurance Assistance Program (SHIP) provides education and counseling on low-income assistance programs for Medicare. 1-800-AGE-LINE (1-800-243-5463) TTY 1-800-548-2547 Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles, and co-payments related to Medicare prescription drug coverage. https://www.ssa.gov/benefits/medicare/prescriptionhelp
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778; or your State Medicaid Office. *You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary Care Doctor Visit | $5 copay per visit | $5 copay per visit | ||||||||||||||||||||||||
| Specialist Visit | $40 copay per visit | $25 copay per visit | ||||||||||||||||||||||||
| Inpatient Hospital | $290 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 Services | $0-$245 copay | $0-$150 copay |
| Lab Services | $0 copay | $0 copay |
| X-rays | $15 copay | $5 copay |
| Emergency Room Visit | $110 copay Waived if admitted |
$120 copay Waived if admitted |
| Ambulance | $275 copay per trip | $150 copay per trip |
| Many Preventive Wellness Services | $0 copay | $0 copay |
| Durable Medical Equipment | 20% of cost | 20% of cost |
| Telehealth Primary Care Physician | $5 copay per visit | $5 copay per visit |
| Telehealth Specialist | $40 copay per visit | $25 copay per visit |
| Diabetic Supplies* | $0 copay | $0 copay |
| Eye Exams | $0 copay for annual routine exam & $30 copay for diagnostic exam | $0 copay for annual routine exam & $25 copay for diagnostic exam |
| Eyewear Allowance | $100 per calendar year | $100 per calendar year |
| Preventive & Comprehensive Dental Allowance | $1,000 max per calendar year | $1,300 max per calendar year |
| Hearing Exams | $0 copay for annual routine exam $10 copay for diagnostic exam |
$0 copay for annual 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 Drug | 29% | 42% |
| Tier 5 - Specialty Tier | 30% | 30% |
| Tier 6 - Select Care Tier | $0 | $0 |
| Select Insulins (Tiers 3 & 4) | $28 | $28 |
| 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 Drug | 34% | 47% |
| Tier 5 - Specialty Tier | 33% | 33% |
| Tier 6 - Select Care Tier | $0 | $0 |
| Select Insulins (Tiers 3 & 4) | $35 | $35 |
| Coverage Gap Phase | Once the TOTAL prescription annual spending exceeds $4,660 and YOUR spending is below $7,400 you pay 25% of generic drug costs and 25% of brand-name drug costs. | Once the TOTAL prescription annual spending exceeds $4,660 and YOUR spending is below $7,400 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 $7,400 you pay the greater of $4.15 for generic drugs and $10.35 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 $7,400 you pay the greater of $4.15 for generic drugs and $10.35 for brand-name drugs OR 5% coinsurance per prescription for the rest of the year. Blue Advantage pays the rest. |
*Only Ascensia (Contour) and LifeScan (One-Touch) products are preferred with a $0 copay for up to 204 diabetic test strips for 30 days and glucometers at the pharmacy and through mail-order home delivery.
*SilverSneakers is a registered trademark of Tivity Health, Inc. © 2022 Tivity Health, Inc. All rights reserved.
** Air medical transport services are provided through a contract with AirMed International, LLC. AirMed International, LLC is an independent company that does not provide Blue Cross and Blue Shield of Alabama products. Blue Cross is not responsible for any mistakes, errors or omissions that AirMed, its employees or staff members make. Air medical services terminate if coverage by your health plan ends.
***All content ©2022 TruHearing, Inc. All Rights Reserved. TruHearing® is a registered trademark of TruHearing, Inc. All other trademarks, product names, and company names are the property of their respective owners. Retail pricing based on prices for comparable aids. Follow-up provider visits included for one year following hearing aid 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. For questions regarding fees, contact a TruHearing hearing consultant.
**** Out-of-network/non- contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
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