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Medicare Advantage with drug coverage · PPO · Plan ID H0104-012

Blue Advantage Complete (PPO)

Offered by Blue Cross and Blue Shield of Alabama (BlueCross BlueShield of Alabama) · available in 60 counties in AL

Monthly premium$39.50health + drug coverage
Yearly out-of-pocket max$6,000in network
Drug deductible$620Enhanced Alternative
Star Rating★★★★ 4 out of 52027 CMS rating

Extra benefits listed in the CMS file

DentalPreventive and comprehensive dental
Visionroutine eye exam; eyewear
Hearingroutine hearing exam; hearing aids

Allowances and limits come from the plan's filing with CMS and are simplified here. Some benefits are only for members with certain chronic conditions. The plan's Evidence of Coverage is the final word.

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