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Platinum Blue Core Plan (Cost)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Platinum Blue Core Plan (Cost). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Platinum Blue Core Plan (Cost) in 2025, please refer to our full plan details page.
Platinum Blue Core Plan (Cost) is a Cost plan offered by Aware Integrated, Inc. available for enrollment in 2025 to people living in 21 County region. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Platinum Blue Core Plan (Cost) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Platinum Blue Core Plan (Cost).
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 Platinum Blue Core Plan (Cost), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6000.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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:
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Drug Coverage
Prescription drugs are not covered by Platinum Blue Core Plan (Cost).
Additional Benefits
The Platinum Blue Core Plan (Cost) offers a range of benefits, including inpatient hospital stays with a $600 copay per admission. Outpatient services have a 20% coinsurance, with a $20 copay for outpatient substance abuse services, and ambulance services have no copay. This plan also covers primary care with a $20 copay, and offers hearing services including routine hearing exams and prescription hearing aids, with a copay between $699 and $999. Vision services include 20% coinsurance for contact lenses. Additionally, this plan provides benefits for dental services, home infusion, dialysis, and medical equipment with varying cost-sharing, along with diagnostic and radiological services, home health services, and skilled nursing facility stays.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with a $600 copay per admission or stay; however, additional days, non-Medicare-covered stays, and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services and observation services, are covered with a 20% coinsurance. Outpatient substance abuse services have a $20 copay for both individual and group sessions. Outpatient blood services are also covered, with a waived deductible of three pints.
Partial Hospitalization See details
Partial Hospitalization is covered under the Platinum Blue Core Plan (Cost), with a $60 copay. There is no coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Platinum Blue Core Plan (Cost). All ambulance services are covered with no copay and a 20% coinsurance for both ground and air ambulance services, 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. Emergency Services have a $125 copay, and Urgently Needed Services have a $55 copay, while Worldwide Emergency Coverage has a $125 copay and Worldwide Emergency Transportation has 20% coinsurance.
Primary Care See details
The Platinum Blue Core Plan covers primary care physician services and chiropractic services with a $20 copay, occupational therapy services with a $40 copay, and physical therapy and speech-language pathology services with a $40 copay. Physician specialist services have a 20% coinsurance, and opioid treatment program services have a 20% coinsurance, while routine chiropractic care, podiatry services, and additional telehealth benefits are not covered. Mental health and psychiatric services have a $20 copay for individual and group sessions.
Preventive Services See details
Preventive services include coverage for Medicare-covered services, annual physical exams, health education, fitness benefits, remote access technologies, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers, additional smoking cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices, and counseling services are not covered.
Hearing Services See details
Hearing services include coverage for routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams are covered for 2 visits every year. Prescription hearing aids have a copay between $699 and $999, and are covered for 2 visits every year, while the other prescription hearing aid types are not covered.
Vision Services See details
Vision Services are covered by the Platinum Blue Core Plan (Cost), though routine eye exams are not covered. For eyewear, there is a 20% coinsurance for contact lenses, but the plan does not cover contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, or upgrades.
Dental Services See details
Dental Services are covered under the Platinum Blue Core Plan (Cost), with a 20% coinsurance for Medicare Dental Services, but Orthodontic Services and other dental services are not covered. Prior authorization is required for Medicare Dental Services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Platinum Blue Core Plan (Cost), with prior authorization required. Medicare Part B Insulin Drugs have a copay between $0 and $35, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis services are covered under the Platinum Blue Core Plan (Cost), with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment is covered under the Platinum Blue Core Plan (Cost), with a coinsurance between 20% and 40% for Durable Medical Equipment (DME), and no copay. Prosthetics/Medical Supplies - Non-Medicare benefit is covered with coinsurance, and Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance. Some services are covered, but Durable Medical Equipment for use outside the home, and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
The Platinum Blue Core Plan (Cost) covers Diagnostic and Radiological Services, but Lab Services are not covered. Diagnostic Procedures/Tests have a $25 copay, while Diagnostic Radiological Services and Therapeutic Radiological Services have a coinsurance of at most 20%, and Outpatient X-Ray Services have a $60 copay.
Home Health Services See details
Home Health Services are covered under the Platinum Blue Core Plan (Cost) with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Platinum Blue Core Plan (Cost). This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Platinum Blue Core Plan (Cost). There is no copay for days 1-20, but there is a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for acupuncture, with a $20 copay and a limit of 12 treatments per year, and Over-the-Counter (OTC) Items, with a maximum benefit coverage amount of $25 every three months. This plan does not cover Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services.
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