A non-government entity
Platinum Blue Choice Plan (Cost)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Platinum Blue Choice 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 Choice Plan (Cost) in 2026, please refer to our full plan details page.
Platinum Blue Choice 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 3.5 out of 5 stars in 2026.
It's important to know that Platinum Blue Choice 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 Choice 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 Choice 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 $3900.00 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:
Sign up for Platinum Blue Choice Plan (Cost)
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
Prescription drugs are not covered by Platinum Blue Choice Plan (Cost).
Additional Benefits
The Platinum Blue Choice Plan (Cost) offers robust medical coverage with predictable out-of-pocket costs. You will pay no copay for primary care visits, preventive services, and routine eye exams, while specialist visits require a $20 copay. For hospital stays, there is a $350 copay per stay with no coinsurance, and emergency room visits feature a $100 copay that is waived if you are admitted. This plan also provides valuable supplemental benefits, including dental care with no copay up to a $1,000 annual limit and hearing aid coverage with copays ranging from $599 to $899. Skilled nursing facility stays have no copay for the first 20 days, and home health services are fully covered with no copay. Additionally, diagnostic services and home infusions are available with no copay, while durable medical equipment generally carries a 20% to 40% coinsurance.
Inpatient Hospital See details
Platinum Blue Choice Plan (Cost) covers inpatient hospital services with a $350 copayment per stay and no coinsurance for Medicare-covered acute and psychiatric admissions. This benefit is partially covered, as unlimited additional days are included for acute care, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Platinum Blue Choice Plan (Cost) covers outpatient services with no coinsurance, offering outpatient hospital services with a $0 to $150 copay and ambulatory surgical center services with a $50 copay. Outpatient blood services have no copay or coinsurance, and while some outpatient substance abuse services are covered with no copay or coinsurance, individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered under the Platinum Blue Choice Plan (Cost) with a $15.00 copay and no coinsurance.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by the Platinum Blue Choice Plan (Cost), featuring a $300 copay and no coinsurance for both ground and air ambulance services. However, transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Platinum Blue Choice Plan (Cost) covers emergency services with a $100 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours, and urgent care for a $15 copay and no coinsurance. Worldwide emergency services and transportation are partially covered with a $100 copay and no coinsurance, while worldwide urgent care is not covered.
Primary Care See details
Platinum Blue Choice Plan (Cost) covers primary care visits with no copay and no coinsurance, and specialist visits with a $20 copay and no coinsurance. Therapy services, other healthcare professionals, and opioid treatments require a $15 copay and no coinsurance, while podiatry and telehealth are not covered. Some chiropractic services are covered with a $15 copay and no coinsurance, and some psychiatric and mental health services are covered with no copay and no coinsurance, but routine chiropractic, other chiropractic services, and individual or group therapy sessions are not covered.
Preventive Services See details
Platinum Blue Choice Plan (Cost) offers preventive services, including annual physicals, kidney disease education, and diabetes self-management training, with no copay and no coinsurance. Additional preventive benefits are partially covered; however, the plan does not cover in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, home safety devices, or counseling.
Hearing Services See details
Hearing services are covered under the Platinum Blue Choice Plan (Cost), featuring no copay or coinsurance for routine exams and fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $599 to $899 for up to two aids per year, though inner ear, outer ear, over the ear, and over-the-counter hearing aids are not covered.
Vision Services See details
Vision services are partially covered by the Platinum Blue Choice Plan (Cost), offering one routine eye exam annually with no copay, no coinsurance, and no deductible, while other eye exam services are not covered. Eyewear is also partially covered with no copay and a $125 annual maximum, but contact lenses carry a 20% coinsurance and upgrades are excluded.
Dental Services See details
Platinum Blue Choice Plan (Cost) provides partial coverage for dental services, featuring a $1,000 annual maximum with no copay and no coinsurance for covered services including exams, cleanings, x-rays, fluoride, periodontics, and adjunctive general services. Medicare-covered dental services require a $15 copay and no coinsurance, but restorative services, endodontics, prosthodontics, implants, oral surgery, orthodontics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Platinum Blue Choice Plan (Cost) with no copay, though prior authorization is required. Medicare Part B insulin drugs have a $0 to $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a coinsurance of 0% to 20%.
Dialysis Services See details
The Platinum Blue Choice Plan (Cost) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by the Platinum Blue Choice Plan (Cost) with no copays, though diabetic equipment is only partially covered because diabetic supplies are not covered. Covered durable medical equipment requires prior authorization and carries a 20% to 40% coinsurance, while prosthetic devices, medical supplies, and diabetic therapeutic shoes incur a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Platinum Blue Choice Plan (Cost) with no copay and no coinsurance. While some services are covered, diagnostic procedures and tests, lab services, diagnostic and therapeutic radiological services, and outpatient X-ray services are not covered.
Home Health Services See details
Home Health Services are covered by the Platinum Blue Choice Plan (Cost) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no copay and no coinsurance under the Platinum Blue Choice Plan (Cost), but only some services are covered in practice. Specifically, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Platinum Blue Choice Plan (Cost) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. This benefit requires a prior three-day inpatient hospital stay, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Platinum Blue Choice Plan (Cost) offers acupuncture with a $15 copay and no coinsurance for up to 12 treatments per year, alongside additional telehealth services featuring a $0 to $20 copay and no coinsurance. The plan also covers over-the-counter items up to $50 every three months with no copay and no coinsurance, though meal benefits are not covered.
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