Blue Advantage Complete (PPO)

Blue Advantage Complete (PPO) is a PPO plan offered by Blue Cross and Blue Shield of Alabama available for the 2026 plan year to people living in Birmingham/Mobile. This plan received an overall rating of 3.5 out of 5 stars in 2026.

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.

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:

Drug Coverage

The Blue Advantage Complete (PPO) plan features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $370.00. After meeting this deductible, you will enter the initial coverage phase where standard retail pharmacy and standard mail orders for a 30-day supply cost a $20.00 copay for Tier 1 preferred generics and a $45.00 copay for Tier 2 standard generics. Higher-tier medications require coinsurance, which is set at 44% for Tier 3 preferred brands and 28% for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will have no copay for covered Medicare Part D drugs. Additionally, individuals who qualify for the Low-Income Subsidy (LIS) can benefit from no Part D premium.

Additional Benefits

The Blue Advantage Complete (PPO) plan provides comprehensive medical coverage with predictable out-of-pocket costs, including a $5 copay for primary care visits and a $35 copay for specialists. Inpatient hospital stays require a $330 daily copay for the first seven days with no copay for subsequent days, while emergency services carry a $130 copay. Outpatient services feature copays ranging from no copay up to $345, and ambulance services require a $350 copay with no coinsurance. For specialized care, the plan offers routine hearing and vision exams with copays of $10 and $35, alongside a $40 copay for Medicare-covered dental services. Durable medical equipment and dialysis services require coinsurance of 23% and 20% respectively with no copays. Additionally, skilled nursing facility stays are covered with a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.