Blue Cross Blue Shield Medicare Blue Advantage Plans - Medicare
Blue Advantage Plans Include:
- Comprehensive Medical Coverage >
- Prescription Drug Coverage >
- Comprehensive Dental >
- Vision Exams & Eyewear >
- Hearing Exams & Hearing Aids >
- SilverSneakers® Fitness Membership >
- $0 premium options available
- $0 drug deductible depending on plan selection
- 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®
- Eyewear and dental allowance (varies by plan selection)
- FREE fitness allowance FlexCard*, depending on plan selection
- $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
Blue Advantage plans have over 1,000+ network pharmacies in Alabama that make it convenient for you to save money.
Click here for ways to ensure you are paying the least amount for your prescriptions with Rx Savings Solutions.
​
Dental
Coverage
More >Dental Coverage
Our Medicare Advantage plans include a dental allowance designed to provide additional coverage.
$1,000/$1,300 allowance maximum per calendar year for most comprehensive and preventive dental services (Blue Advantage Complete / Blue Advantage Premier).
$375 allowance maximum per calendar year for preventive-only dental services (Blue Advantage Choice).
​
Vision Exams & Eyewear
More >Vision Exams & Eyewear
$0 copay for annual routine vision exam
$100 eyewear allowance per calendar year
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Hearing Exams & Hearing Aids
More >TruHearing® Services*
A comprehensive hearing care solution — $0 copay for an annual routine hearing exam, plus you can get state-of-the-art hearing aids as low as $499, $699 or $999 (one per ear, per year) which can save you thousands of dollars.
*All content ©2023 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.
​
Fitness Allowance FlexCard
More >Fitness Allowance
Depending upon plan selection, your plan may include a Quarterly Fitness Allowance to help you get fit, have fun, and make new friends while enjoying a healthy lifestyle. To see if your plan includes fitness, please see the 2025 Plan Benefits Comparison.
- $90 allowance every three months
- Allowance will be loaded to the FlexCard mailed to you at enrollment
- Your FlexCard can be used toward memberships at over 1,000 health clubs in the state of Alabama
- Any unused amount will not carry over to the next quarter
*The Alabama FlexCard Mastercard® Prepaid card is issued by Stride Bank, N.A., Member FDIC, pursuant to license by Mastercard International.
Blue Advantage makes it easy to stay healthy and save money
- $0 premium options available
- $0 drug deductible, depending upon plan selection
- 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®***
- Eyewear and dental allowance (varies by plan selection)
- FREE fitness allowance FlexCard*, depending on plan selection
- $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 AdvantageChoice (PPO)$0 per monthView Extra Help 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. https://www.ssa.gov/medicare/part-d-extra-help *You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. |
Blue AdvantageComplete (PPO)$0 per month$29.50 per monthView Extra Help 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. https://www.ssa.gov/medicare/part-d-extra-help *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)$153 per monthView Extra Help 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. https://www.ssa.gov/medicare/part-d-extra-help *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 | $0 copay per visit | $5 $0 copay per visit | $0 copay per visit | ||||||||||||||||||
| Specialist Visit | $35 copay per visit | $35$35 copay per visit | $20 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 |
$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-$265 copay | $0-$265$0-295 copay | $0-$150 copay |
| Lab Services | $0 copay | $0 copay | $0 copay |
| X-rays | $20 copay | $15$20 copay | $5 copay |
| Emergency Room Visit | $125 copay Waived if admitted |
$125$125copay Waived if admitted |
$120 copay Waived if admitted |
| Ambulance | $405 copay per trip | $405$320 copay per trip | $175 copay per trip |
| Many Preventive Wellness Services | $0 copay | $0 copay | $0 copay |
| Durable Medical Equipment | 22% of cost | 23%23% of cost | 22% of cost |
| Telehealth Primary Care Physician | $0 copay per visit | $5$0 copay per visit | $0 copay per visit |
| Telehealth Specialist | $35 copay per visit | $35 copay per visit | $20 copay per visit |
| Diabetic Supplies* | $0 copay | $0 copay | $0 copay |
| Eye Exams | $0 copay for annual routine exam & $35 copay for diagnostic exam | $0 copay for annual routine exam & $35 copay for diagnostic exam | $0 copay for annual routine exam & $20 copay for diagnostic exam |
| Eyewear Allowance | $100 per calendar year | $100 per calendar year | $100 per calendar year |
| Dental Allowance | $375 max per calendar year Preventive only | $1,000 max per calendar year Preventive and Comprehensive | $1,300 max per calendar year Preventive and Comprehensive |
| Hearing Exams | $0 copay for annual routine exam $10 copay for diagnostic exam |
$0 copay for annual routine exam $10 copay for diagnostic exam |
$0 copay for annual routine exam $10 copay for diagnostic exam |
| Hearing Aids | $499/$699/$999 copay per hearing aid (one per ear, per year) |
$499/$699/$999 copay per hearing aid (one per ear, per year) |
$499/$699/$999 copay per hearing aid (one per ear, per year) |
| Fitness | $90 quarterly allowance on FlexCard* | N/A $90 quarterly allowance on FlexCard* | $90 quarterly allowance on FlexCard* |
| Maximum Out-of-Pocket Amount
|
$5,500 (in-network) | $5,100 (in-network) | $2,900 (in-network) |
| Drug Deductible
​ This is the most an individual will pay in a year for eligible health services. After paying this amount, your insurance policy will pay for all other covered services.
|
$440 (Tiers 3, 4 and 5) | $0$150 (Tiers 3, 4 and 5) | $0 |
| PREFERRED Cost-Sharing Pharmacy Copays
|
|||
| Tier 1 - Preferred Generic | N/A | $4 | $0 |
| Tier 1 - Preferred Generic at Preferred Mail-order Pharmacies | N/A | $0 | $0 |
| Tier 2 - Generic | N/A | $13 | $8 |
| Tier 3 - Preferred Brand | N/A | $40 | $40 |
| Tier 4 - Non-Preferred Drug | N/A | 38%36% | 33% |
| Tier 5 - Specialty Tier | N/A | 33%31% | 33% |
| Tier 6 - Select Care Tiers | N/A | $0$0 | N/A |
| Select Insulins (Tiers 3 & 4) | N/A | $35 | $35 |
| STANDARD Cost-Sharing Pharmacy Copays
|
|||
| Tier 1 - Preferred Generic | $0 | $11 | $7 |
| Tier 2 - Generic | $13 | $20 | $15 |
| Tier 3 - Preferred Brand | 20% | $47 | $47 |
| Tier 4 - Non-Preferred Drug | 40% | 43%41% | 38% |
| Tier 5 - Specialty Tier | 27% | 33%31% | 33% |
| Tier 6 - Select Care Tiers | N/A | $0$0 | N/A |
| Select Insulins (Tiers 3 & 4) | $35 | $35 | $35 |
| Catastrophic Coverage Phase | Once YOUR out-of-pocket spending on prescriptions reaches $2,000, you pay $0 for the rest of the calendar year. | Once YOUR out-of-pocket spending on prescriptions reaches $2,000, you pay $0 for the rest of the calendar year. | Once YOUR out-of-pocket spending on prescriptions reaches $2,000, you pay $0 for the rest of the calendar year. |
*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.
*The Alabama FlexCard Mastercard® Prepaid card is issued by Stride Bank, N.A., Member FDIC, pursuant to license by Mastercard International.
**Air medical transport services are provided through a contract with AirMed International, LLC, 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 ©2024 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. Savings and retail pricing based on a survey of national average hearing aid prices compared to TruHearing pricing. Savings may vary. Listed hearing aid prices are subject to change. Confirm hearing aid pricing at your appointment with your provider. 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.
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