Plan ID: H8364-002

What You Need to Know:

  • Bright Advantage Choice Plus (PPO) is a Medicare Advantage Health Maintenance Organization Local PPO plan.
  • It must provide all of the same hospital and medical benefits as Medicare Part A and Part B, however, costs may be different.
  • It has additional benefits not included in Medicare Part A and Part B, including prescription drug coverage.
  • The plan's monthly premium is $69, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is .
  • The plan includes an out-of-pocket maximum of $3,450 per year (in-network).
  • Bright Advantage Choice Plus (PPO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is .
  • This plan's Part D Initial Coverage Limit is $53.

$69

Monthly Premium

Medicare Plan Features
Monthly Premium: $69.00
Part C Premium: $15.60
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$69.00 $15.60 $53.40 $0 $53.40 $445.0 0.0
Gap Coverage: No
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local PPO
Similar Plan: H8364-002
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: No additional gap coverage, only the Donut Hole Discount
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $3,450
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Jefferson, Alabama: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
less than 10 members New plan - No summary rating as of yet. New plan - not yet rated. New plan - not yet rated.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,407 drugs
Number of Members Enrolled in this Plan in Jefferson, Alabama: less than 10 members
Number of Drugs Per Tier: NULL
Preferred Pharmacy Cost Sharing During Initial Coverage Phase: NULL
Special Needs Plan SNP Eligibility Requirement: NULL
Monthly Premium Split as Follows:
Part C Premium Part D Base Premium Part D Supplemental Premium Total Premium
$15.60 $53.40 $0.00 $69.00
Monthly Premium with Extra Help Low Income Subsidy:
LIS100 Subsidy Total Monthly Premium with LIS Parts CD LIS25 Subsidy Monthly PartD Premium with LIS LIS25 Subsidy Total Monthly Premium with LIS Parts CD LIS50 Monthly PartD Premium with LIS LIS50 Subsidy Total Monthly Premium with LIS Parts CD LIS75 Monthly PartD Premium with LIS LIS75 Subsidy Total Monthly Premium with LIS Parts CD
$38.80 $45.80 $61.40 $38.30 $53.90 $30.70 $46.30
Formulary Drug Details:
Tier 1 # of Drugs per Tier Tier 1 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 2 # of Drugs per Tier Tier 2 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 3 # of Drugs per Tier Tier 3 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 4 # of Drugs per Tier Tier 4 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 5 # of Drugs per Tier Tier 6 Preferred Pharmacy Cost Sharing (initial coverage phase)
394 $0.00 884 25% 556 25% 693 25% 688 25%

Other Medicare Advantage Plans in Jefferson, Alabama

Plan Name Type Premium MOOP Rx Deduct. Rating
Blue Advantage Complete (PPO) (2023)Local PPO$5,100$150
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Blue Advantage Premier (PPO) (2023)Local PPO$3,400$0
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VIVA Medicare Select (HMO) (2023)Local HMO *$5,900$-
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VIVA Medicare Premier (HMO) (2023)Local HMO$5,500$0
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VIVA Medicare Me (HMO) (2023)Local HMO$6,400$0
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VIVA Medicare Plus (HMO) (2023)Local HMO$6,700$150
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VIVA Medicare Prime (HMO) (2023)Local HMO$5,900$0
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AARP Medicare Advantage Walgreens (HMO) (2023)Local HMO$4,500$55
5
AARP Medicare Advantage Patriot (HMO) (2023)Local HMO *$5,000$-
5
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
AARP Medicare Advantage Plan 3 (HMO) (2023)Local HMO$5,000$55
5
Ascension Complete St Vincent's Reward (HMO) (2023)Local HMO$7,550$390
New plan - not yet rated.
Ascension Complete St Vincent's Secure (HMO) (2023)Local HMO$5,000$0
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Cigna Fundamental Medicare (HMO) (2023)Local HMO *$4,900$-
4
Cigna Preferred AL Medicare (HMO) (2023)Local HMO$7,100$200
4
Cigna Preferred Plus Medicare (HMO) (2023)Local HMO$4,100$0
4
Cigna Preferred Medicare (HMO) (2023)Local HMO$4,900$0
4
HumanaChoice H5216-179 (PPO) (2023)Local PPO$6,700$360
4
HumanaChoice H5216-214 (PPO) (2023)Local PPO$6,700$150
4
Humana Honor (PPO) (2023)Local PPO *$3,400$-
4
Aetna Medicare Freedom Plan (PPO) (2023)Local PPO$6,400$200
5
Aetna Medicare Eagle Plan (PPO) (2023)Local PPO *$6,400$-
5
Humana Gold Plus H5619-088 (HMO) (2023)Local HMO$6,300$0
4
Cigna True Choice Medicare (PPO) (2023)Local PPO$5,100$0
New plan - not yet rated.
Bright Advantage (HMO) (2023)Local HMO$4,900$445
New plan - not yet rated.
Bright Advantage Plus (HMO) (2023)Local HMO$3,450$445
New plan - not yet rated.
HumanaChoice R7315-001 (Regional PPO) (2023)Regional PPO *$3,400$-
4
HumanaChoice R7315-002 (Regional PPO) (2023)Regional PPO$6,700$400
4
Medicare Advantage Plans by Bright Health
Bright Advantage (HMO) (2023)Local HMO$4,900$445
New plan - not yet rated.
Bright Advantage Plus (HMO) (2023)Local HMO$3,450$445
New plan - not yet rated.

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