Bright Health Medicare Advantage plan details in Anderson and Greenville

Selecting a Bright Advantage plan in Anderson and Greenville gives our members access to our unique Care Partner model with Southeastern Health Partners, with no referrals needed for in-network visits. Oh, and added benefits like dental, vision, and a free gym membership.

Bright Advantage (HMO)

Monthly Plan Premium

$0*

Your Selected Plan Add-ons

$0*

Total Monthly Premium

$0*

Please enter your zip to enroll

Plan Details

Monthly Premium

$0

Annual Out-Of-Pocket Maximum (not including Rx)

$5,900

Annual Medical Deductible

$0

Annual Prescription Drug (Rx) Deductible

$0

Does Plan Have Out-of-Network (OON) Benefits?

No

Primary Care Office Visits

$0 copay

Specialist Office Visits

$35 copay

Annual Routine Physical

$0 copay

Preventive Care

$0 copay

Inpatient Hospitalization

$290/day for days 1-7

$0/day for days 8+

Outpatient Surgery (ASC)

$190 copay

Outpatient Surgery (Outpatient Hospital Facility)

$290 copay

Emergency Room

$90 copay

Urgent Care

$35 copay

Ambulance (Ground)

$200 copay

Ambulance (Air)

$260 copay

Lab Services

$0 copay

Outpatient X-rays

$0 copay

Diagnostic Radiology Service (e.g., Ultrasound and other services)

$35 copay

Advanced Diagnostic Imaging (e.g., CT, MRI, and PET scans)

$200 copay

Bright Extra Benefits

Hearing Services

Routine Hearing Exam

$0 copay

Hearing Aid Allowance

$750 hearing aid allowance every year

Dental Services

Annual Dental Benefit Maximum

$1,500 annual benefit maximum

X-rays

$0 copay

Oral Exams

$0 copay

Cleaning (prophylaxis)

$0 copay

Fluoride Treatment

$0 copay

Want more coverage? Upgrade to comprehensive dental benefits

Coinsurance varies depending on the services you receive

$17/month

Vision Services

Routine Eye Exam

$0 copay

Materials Allowance

$130 vision materials allowance every two years

Included Extra Benefits

Over-The-Counter (OTC) Debit Card

$25 OTC credit every month - (Up to $300 annual benefit) Learn More 

Transportation

24 one-way trips to plan-approved locations every year

Fitness/Gym Membership

Bright Health Silver & Fit program includes an annual fitness center membership or home fitness kits at no copay/cost share to the member.

Prescription Drug Coverage Details

Pharmacy Network

Preferred

Annual Prescription Drug (Rx) Deductible

$0

Costs For Initial Coverage Period

Tier

Retail pricing (30-day supply)

Mail order pricing (90-day supply)

Tier 1: Preferred Generic

Retail pricing (30 or 90 day supply)

$0 copay

Mail order pricing (90 day supply)

$0 copay

Tier 2: Generic

Retail pricing (30 or 90 day supply)

$8 copay

Mail order pricing (90 day supply)

$16 copay

Tier 3: Preferred Brand

Retail pricing (30 or 90 day supply)

$39 copay

Mail order pricing (90 day supply)

$78 copay

Tier 4: Non-Preferred Drug

Retail pricing (30 or 90 day supply)

$92 copay

Mail order pricing (90 day supply)

$184 copay

Tier 5: Specialty Tier

Retail pricing (30 or 90 day supply)

33% coinsurance

Mail order pricing (90 day supply)

N/A

Tier 6: Select Care Drugs

Retail pricing (30 or 90 day supply)

$0 copay

Mail order pricing (90 day supply)

$0 copay

Coverage Gap

After your total drug costs (including what our plan has paid and what you have paid) reach $4,020, you will pay no more than 25% coinsurance for generic drugs or 25% coinsurance for brand name drugs, for any drug tier during the coverage gap.

Catastrophic Coverage

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $6,350, you pay the greater of:

  • 5% coinsurance, or
  • $3.60 copay for generic (including brand drugs treated as generic) and a $8.95 copay for all other drugs.

If you get full “Extra Help” you may pay as little as a $0 copay for your prescription drugs during this stage.

Additional Plan Resources

Evidence of Coverage (EOC)

Enrollment Form

Summary of Benefits

*If you qualify for Extra Help, you may be eligible for discounted monthly premiums. Learn more about Bright Health plans with Extra Help

Still have questions?
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Disclaimer

† Savings with a Bright Health Medicare Advantage plan compared to Original Medicare or a Medicare Supplement plan.

Last Updated: Tues Oct 1 2019

Y0127_Bright_Health

Bright Health plans are HMOs and PPOs with a Medicare contract. Bright Health’s New York D-SNP plan is an HMO with a Medicare contract and a Coordination of Benefits Agreement with New York State Department of Health. Our plans are issued through Bright Health Insurance Company or one of its affiliates. Bright Health Insurance Company is a Colorado Life and Health company that issues indemnity products, including EPOs offered through Medicare Advantage. An EPO is an exclusive provider organization plan that may be written on an HMO license in some states and on a Life and Health license in some states, including Colorado. Enrollment in our plans depends on contract renewal.

This information is not a complete description of benefits. Call 844-667-5502 | TTY:711 for more information.

The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

You must continue to pay your Medicare Part B premium.

Every year, Medicare evaluates plans based on a 5-star rating system.

Medicare beneficiaries may also enroll in Bright Health Medicare Advantage plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov 

Bright Health Medicare Advantage plans are plans with a network of doctors, hospitals, pharmacies, and other providers. Out-of-network/noncontracted providers are under no obligation to treat Bright Health members, except in emergency situations.

Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. You must generally use network pharmacies to fill your prescriptions for covered Part D drugs.

Other providers are available in our network. Most network providers participate through our Care Partner.

Bright Advantage Special Care (HMO SNP) has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) through 2021 based on a review of Bright Advantage Special Care (HMO SNP) Model of Care.

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