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Blue Medicare Medical Only (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue Medicare Medical Only (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Blue Medicare Medical Only (HMO-POS) in 2026, please refer to our full plan details page.
Blue Medicare Medical Only (HMO-POS) is a HMO-POS plan offered by CuraCor Solutions Corp. available for enrollment in 2025 to people living in Select North Carolina Counties. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Blue Medicare Medical Only (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Blue Medicare Medical Only (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 Blue Medicare Medical Only (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. Additionally, this plan comes with a Part B Premium reduction of $35.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3900.00 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:
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Drug Coverage
Prescription drugs are not covered by Blue Medicare Medical Only (HMO-POS).
Additional Benefits
The Blue Medicare Medical Only (HMO-POS) plan offers comprehensive medical coverage with no deductibles and many services featuring no copays. Primary care visits, routine eye exams, preventive dental care, and home health services require no copay or coinsurance. For other essential services, members will pay predictable copays, such as $25 for specialist visits, $150 for emergency room visits, and a $295 daily copay for the first few days of inpatient hospital stays. Diagnostic lab tests and X-rays are available with no copay, while durable medical equipment and dialysis services require a 20% coinsurance. The plan also includes valuable extra benefits with no copays, including up to 12 one-way transportation trips per year, a $100 quarterly over-the-counter item allowance, and dental coverage up to a $2,000 annual limit. Hearing aids are also covered with copays ranging from $499 to $999 and no coinsurance.
Inpatient Hospital See details
Blue Medicare Medical Only (HMO-POS) covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute care stays require a $295 daily copay for days 1 to 6 and no copay for additional days, while psychiatric stays require a $295 daily copay for days 1 to 5 and no copay for days 6 to 90. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Blue Medicare Medical Only (HMO-POS) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center, observation, and blood services. Outpatient hospital services have a copay of $0 to $275, while outpatient substance abuse sessions carry a $25 copay with no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Blue Medicare Medical Only (HMO-POS) with a $40.00 copay and no coinsurance. Prior authorization is required to access these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Blue Medicare Medical Only (HMO-POS), featuring a $250 copay and no coinsurance for ground and air ambulance services. Transportation services are partially covered with no copay or coinsurance for up to 12 one-way trips per year to any health-related location, though plan-approved health-related location transportation is not covered.
Emergency Services See details
Blue Medicare Medical Only (HMO-POS) covers emergency room visits with a $150 copay (waived if admitted within 48 hours) and urgently needed services with a $65 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance up to a $100,000 limit, requiring copays of $150, $65, and $250 respectively.
Primary Care See details
Primary Care benefits under Blue Medicare Medical Only (HMO-POS) are partially covered, offering primary care physician visits with no copay and no coinsurance. Specialist visits, mental health, and physical therapy services require a $25 copay and no coinsurance, while podiatry and routine chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered under Blue Medicare Medical Only (HMO-POS) with no copay and no coinsurance for covered options such as annual physicals, kidney disease education, and fitness benefits. However, several services are not covered, including 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, enhanced disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by Blue Medicare Medical Only (HMO-POS), featuring a $25 copay and no coinsurance for Medicare-covered exams, alongside routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are covered with no coinsurance and a copay ranging from $499 to $999 for up to two aids per year, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Blue Medicare Medical Only (HMO-POS) covers vision services with no deductibles, offering routine eye exams and eyeglasses with no copay and no coinsurance, up to a $300 annual maximum. Contact lens exams require a $25 copay with no coinsurance, while contact lenses have a 20% coinsurance and no copay.
Dental Services See details
Dental services under Blue Medicare Medical Only (HMO-POS) are partially covered up to a $2,000 yearly maximum, offering no copay and no coinsurance for covered preventive and comprehensive services, while Medicare-covered dental requires a $25 copay and no coinsurance. Sub-services that are not covered under this plan include other diagnostic services, other preventive services, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Blue Medicare Medical Only (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization and step therapy. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Blue Medicare Medical Only (HMO-POS) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Blue Medicare Medical Only (HMO-POS) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copays and a 20% coinsurance, except for diabetic supplies which range from no coinsurance to 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Blue Medicare Medical Only (HMO-POS), with prior authorization required. Diagnostic tests have no coinsurance and a $0 to $25 copay, lab and X-ray services require no copay, and radiological services carry a minimum 20% coinsurance and no copay.
Home Health Services See details
Home health services are covered under the Blue Medicare Medical Only (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are partially covered under Blue Medicare Medical Only (HMO-POS) with no copays and no coinsurance. While some additional rehabilitation services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Blue Medicare Medical Only (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100 per stay, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Blue Medicare Medical Only (HMO-POS) provides coverage for select other services with no copay and no coinsurance, including a meal benefit for chronic illnesses and a $100 quarterly over-the-counter (OTC) item allowance. A referral is required for the meal benefit, while acupuncture is not covered under this plan.
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