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Platinum Blue Complete Plan (Cost)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Platinum Blue Complete 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 Complete Plan (Cost) in 2025, please refer to our full plan details page.
Platinum Blue Complete 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 Complete 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 Complete 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 Complete 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 $2700.00 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 Complete Plan (Cost).
Additional Benefits
The Platinum Blue Complete Plan (Cost) offers a range of benefits with varying cost structures. Inpatient hospital stays have a $100 copay per admission, while many outpatient services, including emergency, primary care, and preventive services, come with no copay. Vision, hearing, and dental services are included with limitations, such as a $2,000 annual dental maximum and specific hearing aid coverage. The plan also covers home health, dialysis, and medical equipment with different cost-sharing arrangements, and offers additional benefits like acupuncture and OTC items, subject to limitations.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, there is a $100 copay per admission or stay. Additional Days for Inpatient Hospital-Acute are covered with no copay, while other services such as Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, and Outpatient Blood Services, are covered by the Platinum Blue Complete Plan (Cost). Outpatient Substance Abuse Services are partially covered; individual and group sessions for outpatient substance abuse are not covered.
Partial Hospitalization See details
Partial Hospitalization benefits are covered under the Platinum Blue Complete Plan (Cost). There is no copay or coinsurance for this benefit.
Ambulance and Transportation Services See details
The Platinum Blue Complete Plan (Cost) covers all ambulance services with no copay or coinsurance. However, ground and air ambulance services are not covered, along with transportation services to health-related locations.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered with no copay and no coinsurance, while Worldwide Urgent Coverage is not covered. Worldwide Emergency Coverage and Worldwide Emergency Transportation are also covered with no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Opioid Treatment Program Services are covered with no copay and no coinsurance. Chiropractic Services, Physician Specialist Services, Other Health Care Professional, and Psychiatric Services are covered, but require prior authorization. Individual and group sessions for Mental Health Specialty Services and Psychiatric Services, Routine Chiropractic Care, Podiatry Services, and Additional Telehealth Benefits are not covered.
Preventive Services See details
The Platinum Blue Complete Plan (Cost) covers preventive services including Medicare-covered services, annual physical exams, health education, and fitness benefits, with no copay or coinsurance. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered.
Hearing Services See details
Hearing services are covered by the Platinum Blue Complete Plan, including hearing exams with no deductible. Routine hearing exams are covered for two visits every year. Fitting/evaluation for hearing aids is covered. Prescription hearing aids are covered with a copay between $499 and $799, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
The Platinum Blue Complete Plan covers vision services, including routine eye exams once per year, and eyewear with a 20% coinsurance for contact lenses, and a combined maximum plan benefit of $150 per year. This plan also covers contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames, while upgrades are not covered.
Dental Services See details
The Platinum Blue Complete Plan (Cost) covers dental services, with a maximum benefit of $2,000 per year. The plan covers oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and adjunctive general services. Restorative Services, Endodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Platinum Blue Complete Plan (Cost), with prior authorization required. For Medicare Part B Insulin Drugs, there is a copay of $0-$35. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered with this plan.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies - Non-Medicare benefit has no copay or coinsurance, but Prosthetic Devices and Medical Supplies are not covered. Diabetic Equipment has no copay or coinsurance, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. There is no copay for the covered services.
Home Health Services See details
Home Health Services are covered by the Platinum Blue Complete Plan (Cost) with no copay and no coinsurance, though 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 Complete Plan (Cost). Specifically, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Platinum Blue Complete Plan (Cost) with no copay for days 1-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Platinum Blue Complete Plan covers acupuncture, with a limit of 12 treatments per year, but requires prior authorization. This plan also provides Over-the-Counter (OTC) Items, with a maximum benefit coverage amount of $50.00 every three months, and offers Nicotine Replacement Therapy (NRT) and Naloxone coverage as Part C OTC benefits. However, meal benefits, and other services like Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services are not covered.
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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.
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