A non-government entity
Blue Advantage Complete (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue Advantage Complete (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Blue Advantage Complete (PPO) in 2025, please refer to our full plan details page.
Blue Advantage Complete (PPO) is a PPO plan offered by BlueCross BlueShield of Alabama available for enrollment in 2025 to people living in State of Alabama. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Blue Advantage Complete (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Blue Advantage Complete (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Blue Advantage Complete (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $29.50. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $7500.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $7500.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Blue Advantage Complete (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Blue Advantage Complete (PPO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, you'll pay a $13 copay at a preferred pharmacy, and $20 at a standard pharmacy. For specialty tier drugs, there is no copay. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs.
Additional Benefits
The Blue Advantage Complete (PPO) plan offers comprehensive coverage, including inpatient hospital stays with a $290 copay for the first seven days, and no copay for days 8-90. Outpatient services have varying copays, and emergency services have a $125 copay, with worldwide emergency services also covered. The plan also includes coverage for primary care with a $5 copay, hearing and vision services, and dental services with a $40 copay for Medicare dental services and a $1000 annual maximum. Additional benefits include home health services with no copay, and skilled nursing facility (SNF) services with no copay for the first 20 days, and a $214 copay for days 21-100. The plan covers ambulance services with a $405 copay, and durable medical equipment with a 23% coinsurance. However, it's important to note that certain services like cardiac rehabilitation and some outpatient and other services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $290 copay for days 1-7, and no copay for days 8-90, with an out-of-pocket maximum of $2030. For Inpatient Hospital Psychiatric, you will pay a $290 copay for days 1-7, and no copay for days 8-90, with an out-of-pocket maximum of $2030. Additional Days for Inpatient Hospital-Acute are covered with no copay for days 91-999. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the Blue Advantage Complete (PPO) plan. Outpatient Hospital Services and Observation Services have a copay between $0 and $265, Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Substance Abuse Services have a copay of $35 for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $55 copay. There is no coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Blue Advantage Complete (PPO) plan. Ground and air ambulance services have a copay of $405, with no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Blue Advantage Complete (PPO) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $5 and $35; both have no coinsurance. Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a copay between $5 and $35, and Worldwide Emergency Transportation has a $405 copay; all three have no coinsurance, and the maximum plan benefit coverage is $50,000.
Primary Care See details
The Blue Advantage Complete (PPO) plan covers primary care physician services with a $5 copay. Chiropractic services have a $20 copay, but routine care is not covered, while occupational therapy services have a $30 copay.
Preventive Services See details
Preventive services are covered by the Blue Advantage Complete (PPO) plan. However, the annual physical exam, health education, in-home safety assessment, personal emergency response system, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefit, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefit, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing Services include Routine Hearing Exams with a $10 copay, and Fitting/Evaluation for Hearing Aid with no copay. Prescription Hearing Aids are covered with a copay between $499 and $999, but Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered, as well as OTC Hearing Aids.
Vision Services See details
Vision services include coverage for eye exams with a $35 copay. Eyewear is covered with a combined maximum of $100 per year for both in-network and out-of-network services, while contact lenses and eyeglasses (lenses and frames) are also covered. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a $40 copay for Medicare Dental Services. Other Dental Services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered. However, maxillofacial prosthetics, implant services, and orthodontics are not covered. The plan has a maximum benefit of $1000 per year for both in-network and out-of-network services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Blue Advantage Complete (PPO) plan, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Blue Advantage Complete (PPO) plan with a coinsurance of 20%.
Medical Equipment See details
The Blue Advantage Complete (PPO) plan covers Durable Medical Equipment (DME) with a 23% coinsurance and no copay, as well as Prosthetic Devices and Medical Supplies with a 23% coinsurance and no copay. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered under the Blue Advantage Complete (PPO) plan. Diagnostic Procedures/Tests and Lab Services are not covered, while Diagnostic Radiological Services have a copay of at most $95, Therapeutic Radiological Services have a copay of at most $60, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the Blue Advantage Complete (PPO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Blue Advantage Complete (PPO) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Blue Advantage Complete (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services are not covered by the Blue Advantage Complete (PPO) plan, as the plan does not cover acupuncture, over-the-counter items, meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, and other services.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved