Clear Spring Health BrightPath Advantage (PPO) 2026 Plan Details for Upson County, Georgia Residents
Clear Spring Health BrightPath Advantage (PPO) 2026 Plan Details for Upson County, Georgia Residents
Choosing the right Medicare Advantage plan in Upson County is crucial for your healthcare needs in 2026. With Clear Spring Health BrightPath Advantage (PPO) as one of the options, you can compare it side-by-side with other available plans to find the best fit for you. Whether you prefer enrolling online or seeking advice from a licensed agent, we’ve made the process simple and straightforward.
According to CMS enrollment data, there are approximately 29 members enrolled in this plan, 0 in Upson County.
Clear Spring Health BrightPath Advantage Overview
| Plan ID H9589-003-0 Overview | |
|---|---|
| Health Plan ID: | H9589-003-0 |
| Medicare Advantage Plan Type: | PPO |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $6751.00 (In-Network) |
| Part B Give Back: | Not offered |
| Part D Drug Plan Benefit: | Enhanced, $400.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Upson County, GA |
| Insured By: | Clear Spring Health |
Why Choose Clear Spring Health BrightPath Advantage?
This Medicare Advantage MAPD PPO plan combines hospital, medical, and prescription drug coverage with the flexibility to see providers in or out of the plan’s network. With a monthly premium of $0.00, Clear Spring Health BrightPath Advantage includes all the core benefits of Medicare Part A and Part B, plus built-in drug coverage to help manage your prescriptions. The annual Part D deductible is $400.00.
Primary care visits have a $0 copay | Out-of-network: 45% coinsurance, while seeing a specialist comes with a $0-$25 copay | Out-of-network: 45% coinsurance. Urgent care services carry a $40 copay, and ground ambulance transportation is $275 copay | Out-of-network: 20% coinsurance. These costs apply toward the plan’s annual maximum out-of-pocket (MOOP) limit of $6751.00 — and once that’s reached, all in-network services are fully covered for the rest of the year.
This plan is registered with CMS under ID H9589-003-0. Below, you’ll find a summary of cost sharing for key services. Still have questions? Check the FAQ section for more details.
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Out-of-Pocket Expenses
Clear Spring Health BrightPath Advantage includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H9589-003-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Specialist: | In-network: $0-$25 copay | Out-of-network: 45% coinsurance |
Medicare Advantage plans often include preventive and wellness benefits designed to help members stay healthy, identify risks early, and maintain an active lifestyle.
| Service | Enrollee Cost (in-network) |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over the counter drug benefits: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Health transportation (non-emergency): | Not covered |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $115 copay |
| Wordwide emergency care: | Not covered |
| Urgent care: | $40 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $295 per day for days 1-7 | $0 per day for days 8-90 | $800 Lifetime Reserve Days for days 1-60 | $0 per stay | Out-of-network: | $395 per day for days 1-7 | $0 per day for days 8-90 | $0 per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $160 per day for days 21-100 | Out-of-network: | $195 per day for days 1-35 | $0 per day for days 36-100 | $0 per stay |
| Ground ambulance: | In-network: $275 copay | Out-of-network: 20% coinsurance |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | In-network: $40 copay | Out-of-network: 20% coinsurance |
| Outpatient group therapy: | In-network: $40 copay | Out-of-network: 20% coinsurance |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $295 per day for days 1-7 | $0 per day for days 8-90 | $800 Lifetime Reserve Days for days 1-60 | $0 per stay | Out-of-network: | $395 per day for days 1-7 | $0 per day for days 8-90 | $0 per stay |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $40 copay | Out-of-network: 45% coinsurance |
| Occupational therapy: | In-network: $0 copay | Out-of-network: 45% coinsurance |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Durable medical equipment: | In-network: 20% coinsurance | Out-of-network: 40% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 45% coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | In-network: $0-$100 copay | Out-of-network: 20% coinsurance |
| Lab services: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Outpatient x-rays: | In-network: $0-$100 copay | Out-of-network: 40% coinsurance |
| Diagnostic tests and procedures: | In-network: $0 copay | Out-of-network: 20% coinsurance |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
This section details the dental services covered under your plan including Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Dental x-rays: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Cleaning: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Periodontics: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Endodontics: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Restorative services: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: $0 copay | Out-of-network: 45% coinsurance |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Fitting/evaluation: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Prescription hearing aids: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| OTC hearing aids: | Not covered |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Contact lenses: | Not covered |
| Eyeglass frames only: | Not covered |
| Eyeglass lenses only: | Not covered |
| Eyeglasses (frames & lenses): | In-network: $0 copay | Out-of-network: 45% coinsurance |
| Upgrades: | Not covered |
Medicare Advantage plans may include extra benefits and special needs services designed to support members with chronic conditions, mobility limitations, or other complex health needs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Adult day health services: | Not covered |
| Home based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| 'Wigs for chemotherapy hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
Certain preventive services are covered 100% by Clear Spring Health BrightPath Advantage as a Part B benefit.
Part D Prescription Drug Costs & Benefits
Clear Spring Health BrightPath Advantage includes an enhanced benefit Medicare Part D plan (PDP), which offers greater coverage than basic plans. An enhanced benefit plan has a higher actuarial value, meaning it covers a larger percentage of your healthcare costs.
Part D Plan Premium
The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.
| Basic Part D Premium: | $-2.20 |
|---|---|
| Supplemental Part D Premium: | $2.20 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $25.42 |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $400.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Clear Spring Health starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Clear Spring Health BrightPath Advantage may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $5.00 copay | Coming soon |
| Preferred Brand | 20% coinsurance | Coming soon |
| Non-Preferred Drug | 30% coinsurance | Coming soon |
| Specialty Tier | 28% coinsurance | Coming soon |
| Select Care Drugs | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Rating Overview
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Not enough data available |
| Managing Chronic (Long Term) Conditions | Not enough data available |
| Member Experience with Health Plan | Not enough data available |
| Complaints and Changes in Plans Performance | Not enough data available |
| Health Plan Customer Service | Not enough data available |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | Not enough data available |
| Member Experience with the Drug Plan | Not enough data available |
| Drug Safety and Accuracy of Drug Pricing |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Eligibility Requirements for Clear Spring Health BrightPath Advantage
To enroll in Clear Spring Health BrightPath Advantage, you must meet the following criteria:
- Be eligible for Medicare Part A and Part B.
- Reside in the plan’s service area.
If you meet these requirements, you are eligible to enroll in Clear Spring Health BrightPath Advantage and benefit from its comprehensive coverage options.
When Should You Enroll in Clear Spring Health BrightPath Advantage?
To ensure you don’t miss your chance to enroll in Clear Spring Health BrightPath Advantage, be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to get assistance from a licensed insurance agent.
How to Enroll in Clear Spring Health BrightPath Advantage
Enrolling in Clear Spring Health BrightPath Advantage is easy. Choose the option that works best for you:
- Online through MedicareEnrollment.com: Visit the enrollment page and complete your enrollment through their Secure Online Enrollment Form.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent can assist you with the enrollment process and provide answers to any questions.
- Through Medicare.gov: Go to Medicare.gov, log in or create an account, and follow the instructions to join Clear Spring Health BrightPath Advantage through the official Medicare website.
- Directly with Clear Spring Health BrightPath Advantage: You can also enroll directly with the plan. The necessary contact details are provided below in the "Contact" section.
Remember to enroll during the correct enrollment period to ensure your coverage starts on time.
Here are some of the most frequently asked questions people have about plan ID H9589-003-0:
Is there a premium for this plan in 2026?
The 2026 premium is $0.00 each month, and you must continue to pay your Part B premium.
What’s the MOOP for Clear Spring Health BrightPath Advantage in 2026?
Your costs top out at $6751.00 (for in-network services) in 2026; after that the plan pays 100% of covered services.
Is there a Part D deductible with this plan?
You’ll pay the first $400.00 in drug costs before coinsurance kicks in.
What’s the CMS star score for Clear Spring Health BrightPath Advantage?
CMS rates it ★0.0 out of 5 stars for 2026.
Is Clear Spring Health BrightPath Advantage popular?
CMS reports 29 members in the latest file.
Contact Clear Spring Health
| Contact Type | Details |
|---|---|
| Website: | Clear Spring Health Plan Page |
| New Members: | 1-877-248-6622 |
| Existing Members: | 1-877-364-4566 |
| Plan Address: | P.O. BOX 3040 | Spring Hill, FL 34611 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 14, 2025
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed October 13, 2025
Learn more about how we use CMS data.
- Clear Spring Health, http://www.clearspringhealthcare.com — Last accessed October 13, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Your coverage options" — Last accessed 25 May, 2025
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content managed by David Bynon, Medicare Analyst.
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