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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 2025, 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 3.5 out of 5 stars in 2025.
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 $6200.00 (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 $6200.00 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 has an enhanced alternative drug benefit with no deductible. During the initial coverage phase, you will pay different copays or coinsurance amounts depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $2 copay at a preferred pharmacy, while standard generic drugs have 20% coinsurance at both preferred and standard pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Medicare HMO Blue SaverRx (HMO-POS) plan offers a range of benefits with varying cost-sharing. Hospital stays have copays, with outpatient services, emergency care, and specialist visits also subject to copays. The plan includes coverage for preventive services, hearing, vision, and dental, but with specific copays, coinsurance, and annual maximums. Additional benefits include coverage for home health services with no copay, along with coverage for medical equipment, home infusion, and dialysis services with coinsurance. The plan also offers coverage for over-the-counter items and meal benefits, but excludes services like cardiac rehabilitation, and many other specialized services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered. For Inpatient Hospital-Acute, you pay a $385 copay for days 1-7, and no copay for days 8-90. Inpatient Hospital Psychiatric has a $300 copay for days 1-5, and no copay for days 6-90. Additional days for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are covered. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services with the Medicare HMO Blue SaverRx (HMO-POS) plan includes coverage for all outpatient hospital services, with a $300 copay, and observation services, with a $325 copay. Ambulatory Surgical Center (ASC) Services have a $250 copay, and outpatient substance abuse services have a $30 copay for both individual and group sessions. Outpatient blood services are also covered, with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Medicare HMO Blue SaverRx (HMO-POS) plan. Ground and Air Ambulance Services have a $375 copay, and there is no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay, Urgently Needed Services have a copay between $0 and $55, and Worldwide Emergency Services have a $90 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Medicare HMO Blue SaverRx (HMO-POS) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $20 copay, physician specialist services with a copay between $0 and $40, mental health and psychiatric services with varying copays, physical therapy and speech-language pathology services with a $20 copay, and additional telehealth benefits with a copay between $0 and $40. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Medicare HMO Blue SaverRx (HMO-POS) plan covers preventive services, including annual physical exams and additional preventive services, with no copay. The plan also covers wigs for hair loss related to chemotherapy, with a maximum benefit of $500 per year, and weight management programs, with a maximum benefit of $150 per year.
Hearing Services See details
Hearing exams are covered with no copay, with Routine Hearing Exams covered once per year. Fitting/Evaluation for Hearing Aid is also covered. Prescription hearing aids are partially covered, with the plan covering Prescription Hearing Aids (all types) with a copay between $699 and $999 for 2 visits per year, but not covering Prescription Hearing Aids - Inner Ear, Outer Ear, or Over the Ear. OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a copay of $0-$40, and routine eye exams once per year. Eyewear is covered with a combined maximum benefit of $200 every two years, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are also covered. Upgrades are not covered.
Dental Services See details
Dental Services offers coverage for Medicare and other dental services, with a $1,200 maximum benefit per year. Medicare Dental Services have a $40 copay, and Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, and Prophylaxis (Cleaning) are covered. Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, and Oral and Maxillofacial Surgery have a 50% coinsurance. Fluoride Treatment and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Medicare HMO Blue SaverRx (HMO-POS) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment is covered by the Medicare HMO Blue SaverRx (HMO-POS) plan, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Medicare HMO Blue SaverRx (HMO-POS) plan, but some services are not covered. Diagnostic Procedures/Tests and Lab Services are not covered, while Diagnostic Radiological Services have a copay of at most $310, Therapeutic Radiological Services have a copay of at most $60, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the Medicare HMO Blue SaverRx (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Medicare HMO Blue SaverRx (HMO-POS) plan. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $200. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services for the Medicare HMO Blue SaverRx (HMO-POS) plan covers over-the-counter items with a maximum benefit of $60 every three months, and also covers meal benefits for a chronic illness. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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