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Medicare HMO Blue SaverRx (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Medicare HMO Blue SaverRx (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Medicare HMO Blue SaverRx (HMO-POS) in 2026, please refer to our full plan details page.
Medicare HMO Blue SaverRx (HMO-POS) is a HMO-POS plan offered by Blue Cross and Blue Shield of Massachusetts, Inc. available for enrollment in 2025 to people living in Massachusetts except Berkshire Dukes and Nantucket. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Medicare HMO Blue SaverRx (HMO-POS) 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 Medicare HMO Blue SaverRx (HMO-POS).
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 Medicare HMO Blue SaverRx (HMO-POS), 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 does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $9200.00 (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 $9200.00 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 Medicare HMO Blue SaverRx (HMO-POS) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. For Tier 1 preferred generic drugs, you will pay no copay when using a preferred pharmacy or standard mail order. Tier 2 generic drugs are also highly affordable, starting at a $5 copay for a one-month supply at preferred pharmacies and through standard mail order. For brand-name and higher-tier medications, the plan utilizes coinsurance instead of flat copays. Tier 3 preferred brand drugs require a 20% coinsurance, while Tier 4 non-preferred drugs carry a 40% coinsurance across all pharmacy types. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply, regardless of whether you use a preferred pharmacy, standard pharmacy, or standard mail order.
Additional Benefits
The Medicare HMO Blue SaverRx (HMO-POS) plan offers comprehensive healthcare coverage with predictable out-of-pocket costs, featuring no coinsurance for most primary medical services. Members enjoy no copay for primary care visits, annual physicals, and home health services, while specialist visits require a copay of up to $50. Emergency room visits carry a $115 copay that is waived if admitted, while inpatient hospital stays require a daily copay of $388 for the first seven days. Routine hearing exams and preventive dental care are covered with no copay, while routine eye exams range from no copay to a $50 copay. Preventive dental services have no copay up to a $500 annual limit, and eyewear is covered with no copay up to a $200 limit every two years. Additionally, the plan covers diabetic equipment and chronic illness meal benefits with no copay, alongside a $50 over-the-counter item allowance every three months.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Medicare HMO Blue SaverRx (HMO-POS) with no coinsurance, requiring a daily copay of $388 for days 1 to 7 of acute stays and $415 for days 1 to 5 of psychiatric stays, with no copay for additional days. Prior authorization is required, and non-Medicare-covered stays and acute care upgrades are not covered.
Outpatient Services See details
Medicare HMO Blue SaverRx (HMO-POS) covers outpatient services with no coinsurance, featuring a $350 copay for outpatient hospital services, a $325 copay per stay for observation services, and a $250 copay for ambulatory surgical center services. Outpatient substance abuse services require a $30 copay with no coinsurance, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization services are covered under the Medicare HMO Blue SaverRx (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Medicare HMO Blue SaverRx (HMO-POS) covers ground and air ambulance services with a $375 copay and no coinsurance, though prior authorization is required and the copay is waived upon hospital admission. Although some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Medicare HMO Blue SaverRx (HMO-POS) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay to a $40 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with a $115 copay and no coinsurance.
Primary Care See details
Medicare HMO Blue SaverRx (HMO-POS) covers primary care and opioid treatment with no copay and no coinsurance, while specialists, telehealth, and therapies require copays up to $50 and no coinsurance. Mental health and psychiatric services have copays up to $30 with no coinsurance, podiatry is not covered, and some chiropractic services are covered but routine and other chiropractic services are not.
Preventive Services See details
Medicare HMO Blue SaverRx (HMO-POS) provides partially covered preventive services with no copay and no coinsurance for covered benefits like annual physical exams, kidney disease education, and fitness programs. However, several sub-services are not covered, including in-home safety assessments, medical nutrition therapy, personal emergency response systems, and alternative therapies.
Hearing Services See details
Medicare HMO Blue SaverRx (HMO-POS) offers partially covered hearing services with no deductible, including routine hearing exams and fittings with no copay and no coinsurance. Up to two prescription hearing aids are covered annually with no coinsurance and a copay between $699.00 and $999.00, though OTC hearing aids, as well as inner ear, outer ear, and over the ear prescription models, are not covered.
Vision Services See details
Vision services are partially covered by Medicare HMO Blue SaverRx (HMO-POS) with no deductibles, as other eye exam services and eyewear upgrades are not covered. Covered routine eye exams have a $0 to $50 copay and no coinsurance once per year, and covered eyewear has no copay and no coinsurance up to a $200 maximum limit every two years.
Dental Services See details
Dental services are partially covered by Medicare HMO Blue SaverRx (HMO-POS), offering Medicare-covered dental for a $50 copay and no coinsurance, alongside diagnostic and preventive care with no copay and no coinsurance up to a $500 annual limit. Comprehensive services like restorative care and implants are covered with no copay and a 50% coinsurance, though fluoride treatments, other preventive dental services, and orthodontics are not covered.
Home Infusion bundled Services See details
Medicare HMO Blue SaverRx (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs require no copay and no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Medicare HMO Blue SaverRx (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medicare HMO Blue SaverRx (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic equipment is partially covered with no copay and no coinsurance, although diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered under Medicare HMO Blue SaverRx (HMO-POS) with no coinsurance, though prior authorization is required. Some diagnostic services are covered with no copay, but diagnostic procedures, tests, and lab services are not covered. Covered radiological services feature no coinsurance but require copays, which are $10 for outpatient X-rays, a minimum of $60 for therapeutic radiological services, and a minimum of $350 for diagnostic radiological services.
Home Health Services See details
Home Health Services are covered by Medicare HMO Blue SaverRx (HMO-POS) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services under Medicare HMO Blue SaverRx (HMO-POS) feature no coinsurance, but only some services are covered in practice. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and carry copayments ranging from $15 to $30.
Skilled Nursing Facility (SNF) See details
Medicare HMO Blue SaverRx (HMO-POS) partially covers skilled nursing facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Medicare HMO Blue SaverRx (HMO-POS) partially covers other services, offering over-the-counter items up to $50 every three months and meal benefits for chronic illnesses with no copay and no coinsurance. Acupuncture and other supplemental services under this category are not covered.
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