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Alabama Bright Advantage Plus (HMO) - 2018

To see a full list of benefits, including any limitations, please see the Evidence of coverage (PDF) or Summary of benefits (PDF) in the Additional plan resources section below.

Plan details

Monthly premium$42

Annual maximum out-of-pocket info$3,800

Primary care visit $0

Specialist visit $20

Emergency care$75

Urgent care$40

Hospitalization

Days 1-5$185/day
Day 6 and beyond$0

Would you like to find out if your providers are in-network?

Prescription coverage details

Annual prescription drug deductible$0

Initial Coverage Stage

Retail pricing (30 day/90 day supply)

Tier 1: Preferred Generic
$0 / $0 copay
Tier 2: Generic
$15 / $45 copay
Tier 3: Preferred Brand
$45 / $135 copay
Tier 4: Non-Preferred Drug
$95 / $285 copay
Tier 5: Specialty Tier
33% coinsurance

Mail order pricing (90 day supply )

Tier 1: Preferred Generic
$0 copay
Tier 2: Generic
$0 copay
Tier 3: Preferred Brand
$125 copay
Tier 4: Non-Preferred Drug
$285 copay
Tier 5: Specialty Tier
33% coinsurance

Coverage Gap

After your total yearly drug cost (including what our plan has paid and what you have paid) reaches $3,750, you will enter the coverage gap (also called the "donut hole"). This means that there's a temporary change in what you will pay for your drugs. Not everyone will enter the coverage gap. If you enter the coverage gap, you'll pay 35% of the plan's cost for covered brand name drugs and 44% of the plan's cost for covered generic drugs until your costs total $5,000, which is the end of 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 $5,000, you will pay the greater of:

  • 5% of the cost, or
  • a $3.35 copay for a generic drug or a drug that’s treated like a generic and a $8.35 copay for all other drugs

Your medication costs

Bright Extra Benefits

Preventive vision coverage

Copay for one exam every 12 months

$0

Want more coverage?

$4/month
Upgrade to Optional enhanced vision coverage
• $130 towards eyeglass frames or contact lenses. • Includes coverage for basic lenses and lens enhancements.


Preventive dental coverage

Copay for one cleaning & one exam every 12 months

$0

Copay for Bitewing X-rays every 12 months

$0

Want more coverage?

$20/month
Upgrade to Optional enhanced dental coverage
• You pay only $100 out-of-pocket before your benefits kick in • $1500 benefit maximum per year • 30-50% coinsurance for basic and major services


Preventive and enhanced hearing coverage

Copay for annual hearing aid fitting and evaluation

$0

Hearing aid allowance every 3 years

$2,000

Fitness program

No fees for membership at a participating Silver&Fit® facility

Additional plan resources
Comprehensive formularyEnglish
Provider directoryEnglish
Pharmacy directoryEnglish
Summary of benefitsEnglish
Evidence of coverageEnglish
Enrollment formEnglish
LIS premium summary chartEnglish
Prior authorization criteriaEnglish
Step therapy criteriaEnglish
Dental directoryEnglish
Vision directoryEnglish
Hearing directoryEnglish
Fitness centersView 
Bright Extra Benefits (Optional) Enrollment FormEnglish

Bright Advantage Plus monthly premium      $42