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Blue adVantage Liberty (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue adVantage Liberty (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Blue adVantage Liberty (PPO) in 2026, please refer to our full plan details page.
Blue adVantage Liberty (PPO) is a PPO plan offered by Louisiana Health Service & Indemnity Company available for enrollment in 2025 to people living in State of Louisiana. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Blue adVantage Liberty (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Blue adVantage Liberty (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Blue adVantage Liberty (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan has a $1000.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $300.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $11300.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $11300.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Blue adVantage Liberty (PPO) prescription drug plan features an annual drug deductible of $300. Under this plan, you will enjoy no copay for Tier 1 preferred generic drugs when filled through preferred pharmacies or preferred mail order. Tier 2 generic medications cost as low as a $12 copay for a one-month supply at preferred pharmacies, compared to an $18 copay at standard pharmacies. For Tier 3 preferred brand drugs, you will pay a $45 copay for a one-month supply at preferred locations and a $47 copay at standard locations. Tier 4 non-preferred drugs require a 50% coinsurance across all pharmacies, while Tier 5 specialty drugs carry a 29% coinsurance for a one-month supply.
Additional Benefits
The Blue adVantage Liberty (PPO) plan offers robust coverage with no copayments or coinsurance for essential services like primary care visits, preventive screenings, home health care, and routine dental, vision, and hearing exams. Members also benefit from a $2,200 annual dental allowance and a $200 yearly eyewear allowance with no copay, alongside covered over-the-counter items. For specialized or emergency care, members can expect predictable copays, including $50 for specialist visits and $110 for emergency room services. Inpatient hospital stays require a copay for only the first seven days, while durable medical equipment and dialysis services generally carry a 20% coinsurance with no copay.
Inpatient Hospital See details
Blue adVantage Liberty (PPO) partially covers inpatient hospital services with no coinsurance, requiring prior authorization and a $320 copayment for days 1 to 7 (no copay for days 8 to 90) for acute stays, and a $290 copayment for days 1 to 7 (no copay for days 8 to 90) for psychiatric stays. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Blue adVantage Liberty (PPO) covers outpatient hospital services with no coinsurance and a copay ranging from no copay to $300, and observation services with no coinsurance and a $320 daily copay. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under the Blue adVantage Liberty (PPO) plan with a $60.00 copay and no coinsurance, and prior authorization is required.
Ambulance and Transportation Services See details
Blue adVantage Liberty (PPO) covers ground and air ambulance services with a $300 copay and no coinsurance, and this copayment is not waived if you are admitted to the hospital. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Blue adVantage Liberty (PPO) covers emergency services with a $110 copay and no coinsurance, which is waived if you are admitted to the hospital within 72 hours, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency services are partially covered with a $110 copay and no coinsurance, but worldwide urgent coverage and worldwide emergency transportation are not covered.
Primary Care See details
Blue adVantage Liberty (PPO) offers primary care doctor visits and telehealth services with no copay and no coinsurance, while specialist visits require a $50 copay and no coinsurance. Covered physical, occupational, mental health, psychiatric, and opioid treatment services have copays ranging from $35 to $40 with no coinsurance, though chiropractic and podiatry services are not covered.
Preventive Services See details
Blue adVantage Liberty (PPO) covers preventive services, including annual physical exams, kidney disease education, and select screenings, with no copay and no coinsurance. While home-based palliative care and memory fitness are covered, several additional services—such as health education, weight management, in-home safety assessments, nutritional therapy, and personal emergency response systems—are not covered.
Hearing Services See details
Hearing services are covered by Blue adVantage Liberty (PPO) with no copay and no coinsurance for routine exams, OTC hearing aids, and prescription hearing aids. Prescription hearing aids are partially covered up to an $800 maximum limit every three years, but inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Blue adVantage Liberty (PPO) covers vision services with no coinsurance, offering one routine eye exam annually with no copay and eyewear up to a $200 yearly limit with no copay. General eye exams require a $50 copay and prior authorization, while other eye exam services are not covered.
Dental Services See details
Blue adVantage Liberty (PPO) covers dental services with no copay and no coinsurance up to a combined annual maximum of $2,200 for both in-network and out-of-network care. While most preventive and comprehensive services are fully covered, other preventive services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Blue adVantage Liberty (PPO) with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs carry a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered by Blue adVantage Liberty (PPO) with no copay and a 20% coinsurance.
Medical Equipment See details
Blue adVantage Liberty (PPO) partially covers medical equipment, offering durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic equipment is covered with no copay and no coinsurance, but diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Blue adVantage Liberty (PPO) with prior authorization required. Diagnostic procedures and tests have no coinsurance and a copay of $0 to $30, lab services and outpatient X-rays have no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Blue adVantage Liberty (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Blue adVantage Liberty (PPO) provides cardiac rehabilitation services with no coinsurance and prior authorization required, but in practice, some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) services are not covered and require copayments of $15 to $20.
Skilled Nursing Facility (SNF) See details
Blue adVantage Liberty (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and a prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $200 daily copay for days 21 through 100, with no coverage provided for additional days beyond the Medicare-covered limit.
Other Services See details
Blue adVantage Liberty (PPO) offers partial coverage for other services, providing over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, nicotine replacement therapy, and naloxone are not covered under this plan.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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