Blue Choice® Platinum Overview

Compare and Enroll

 

Here are some of the common benefits of this plan and what you would pay for in-network services.

 

Calendar Year Deductible: $100 per person or $200 maximum for the entire family
 
Out-of-Pocket Maximum: $4,000 per person or $8,000 for the entire family
(Once you reach the maximum, you will pay nothing for eligible, in-network expenses for the rest of the year.)
 
    YOU PAY WE PAY
PHYSICIAN VISITS
Primary Care Physician and Specialist
$20 copay 100% after the copay
ADULT VISION
Yearly eye exam and refraction
$0 100% up to $75
OUTPATIENT SURGERY $150 facility copay 100% after the copay
EMERGENCY ROOM
For a medical emergency
$150 hospital copay
$20 doctor copay
100% after the copay
INPATIENT HOSPITAL CARE $150 copay/day
(days 1-5)
100% after the copay
MATERNITY CARE
Physician Benefits
$0 100%
MENTAL HEALTH
Office Visit or Consultation
$20 copay 100% after the copay
PRESCRIPTION DRUGS
Standard Prescription Drug List
Tier 1: $10
Tier 2: $30
Tier 3: $60
Tier 4: $60
100% after the copay
OCCUPATIONAL, PHYSICAL AND
SPEECH THERAPY
Up to 30 visits per year
20% after you meet the
calendar year deductible
80% after you meet the calendar year deductible
DIAGNOSTIC LAB $0 100%
ROUTINE IMMUNIZATIONS
AND PREVENTIVE SERVICES
These are listed at
AlabamaBlue.com/PreventiveServices
$0 100%
PEDIATRIC
DENTAL &
VISION
Routine Dental Cleaning:
Yearly Eye Exam:
$0
20% after you meet the
calendar year deductible
100%
80% after you meet the calendar year deductible

 

 

*Benefits listed apply to in-network services. 

  Watch the In-Network and Out-of-Network video to learn more 

 

To determine your premium, click on Shop for Plans or call us at 1-855-890-7416.
 
 Find out what you will need to enroll