A non-government entity
Healthy Blue Dual Advantage (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Healthy Blue Dual Advantage (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Healthy Blue Dual Advantage (HMO D-SNP) in 2026, please refer to our full plan details page.
Healthy Blue Dual Advantage (HMO D-SNP) is a HMO D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select parishes in Louisiana. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Healthy Blue Dual Advantage (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Healthy Blue Dual Advantage (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Healthy Blue Dual Advantage (HMO D-SNP).
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 Healthy Blue Dual Advantage (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $15.00. 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 does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 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 Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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:
Sign up for Healthy Blue Dual Advantage (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Healthy Blue Dual Advantage (HMO D-SNP) plan features an annual drug deductible of $615. Under this prescription drug coverage, you will pay no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs filled at standard pharmacies or through standard mail order. This zero-dollar cost sharing applies to one-month, two-month, and three-month supplies of these essential medications. For other medication tiers, you will generally pay a 25% coinsurance through standard pharmacies and standard mail order. This 25% coinsurance applies to Tier 2 generic, Tier 3 preferred brand, and Tier 4 non-preferred drugs for all supply lengths, as well as Tier 5 specialty drugs for a one-month supply. This structure helps you easily plan your healthcare budget based on your specific prescription needs.
Additional Benefits
The Healthy Blue Dual Advantage (HMO D-SNP) plan offers robust medical coverage with many essential services requiring no copay. Inpatient hospital stays, home health services, and skilled nursing facility care are covered with no copay and no coinsurance, though prior authorization is typically required. For outpatient services, primary care, specialist visits, and diagnostic testing, members will generally pay no copay and a 20 percent coinsurance. This plan also features valuable supplemental benefits, including preventive and comprehensive dental services up to a 4,000 dollar annual limit with no copay and no coinsurance. Members can also take advantage of a 140 dollar monthly over-the-counter benefit, up to 125 one-way transportation trips per year with no copay, and generous vision and hearing coverage. Emergency room visits require a 115 dollar copay, while urgently needed care is available with a 20 dollar copay.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Healthy Blue Dual Advantage (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Healthy Blue Dual Advantage (HMO D-SNP) covers outpatient services with no copays, though a 20% coinsurance and prior authorization are required for outpatient hospital, observation, ambulatory surgical center, and outpatient substance abuse services. Outpatient blood services are fully covered with no copay, no coinsurance, and a waived deductible for the first three pints.
Partial Hospitalization See details
Healthy Blue Dual Advantage (HMO D-SNP) covers partial hospitalization services with a $60.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Healthy Blue Dual Advantage (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered with no copay or coinsurance for up to 125 one-way trips per year to plan-approved health-related locations, though transportation to any health-related location is not covered.
Emergency Services See details
Healthy Blue Dual Advantage (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $20 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance, up to a maximum benefit limit of $100,000.
Primary Care See details
Healthy Blue Dual Advantage (HMO D-SNP) covers primary care, specialist visits, mental health, and therapy services with no copay and 20% coinsurance, though prior authorization is generally required. Telehealth benefits are available with no copay and no coinsurance, while chiropractic care is partially covered, offering up to 12 routine visits per year but excluding all other chiropractic services.
Preventive Services See details
Healthy Blue Dual Advantage (HMO D-SNP) covers preventive services, offering annual physical exams and kidney disease education with no copay and no coinsurance, while other services like glaucoma screenings and diabetes self-management require a 20% coinsurance and no copay. Additional preventive benefits are partially covered, providing memory fitness, remote access, PERS, and home safety devices (up to $500 annually) with no copay and no coinsurance. However, health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, and counseling are not covered.
Hearing Services See details
Healthy Blue Dual Advantage (HMO D-SNP) covers hearing services with no deductible, featuring routine exams with a 20% coinsurance and no copay, and hearing aid fittings with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $3,000 annually, though inner ear, outer ear, and over the ear types are not covered. OTC hearing aids are also covered with no copay or coinsurance up to a $300 yearly limit.
Vision Services See details
Vision services are partially covered by Healthy Blue Dual Advantage (HMO D-SNP), offering one routine eye exam per year with no copay and 20% coinsurance, while other eye exams and eyewear upgrades are not covered. Covered eyewear has no deductible and a $500 annual limit, featuring eyeglasses and frames with no copay and no coinsurance, and contact lenses with no copay and 20% coinsurance.
Dental Services See details
Healthy Blue Dual Advantage (HMO D-SNP) partially covers dental services with no copay and a 20% coinsurance for Medicare-covered dental, and no copay or coinsurance for preventive and most comprehensive services up to a $4,000 annual limit. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Healthy Blue Dual Advantage (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Healthy Blue Dual Advantage (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Healthy Blue Dual Advantage (HMO D-SNP) covers durable medical equipment (DME) with no copay and 0% to 20% coinsurance, and prosthetics and medical supplies with no copay and 20% coinsurance. Diabetic equipment, including supplies and therapeutic shoes, is covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Healthy Blue Dual Advantage (HMO D-SNP) covers diagnostic and radiological services, including lab tests, therapeutic radiology, and outpatient X-rays, with no copay and a 20% coinsurance. Prior authorization is required for all of these covered diagnostic and radiological services.
Home Health Services See details
Home health services are covered by Healthy Blue Dual Advantage (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Healthy Blue Dual Advantage (HMO D-SNP) offers Cardiac Rehabilitation Services with no copay and prior authorization, but some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Healthy Blue Dual Advantage (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. Admission does not require a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Healthy Blue Dual Advantage (HMO D-SNP) partially covers other services with no copay and no coinsurance, offering a $140 monthly over-the-counter benefit, chronic illness meals, and community resource support. Acupuncture is not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved