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Blue Medicare Enhanced (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue Medicare Enhanced (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 Enhanced (HMO-POS) in 2026, please refer to our full plan details page.
Blue Medicare Enhanced (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 Enhanced (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 Blue Medicare Enhanced (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 Enhanced (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $30.00. 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 $100.00 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 $4200.00 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
The Blue Medicare Enhanced (HMO-POS) plan features a low $100 annual drug deductible and offers significant savings on generic prescriptions. You will pay no copay for Tier 1 preferred generics and Tier 6 select care drugs when using preferred retail pharmacies or preferred mail order services. For Tier 2 generic drugs, you can also enjoy no copay through preferred mail order, or pay copays as low as $4 at preferred pharmacies. For brand-name and specialty medications, costs are structured as coinsurance regardless of which pharmacy you choose. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 31% coinsurance. Utilizing preferred network pharmacies and mail-order options helps maximize your savings on this plan.
Additional Benefits
The Blue Medicare Enhanced (HMO-POS) plan offers robust medical coverage featuring no copay for primary care visits and a low $20 copay for specialists. If you require hospital care, inpatient acute stays have a $350 copay for the first six days with no copay thereafter, while emergency room visits cost $150 and urgent care visits require a $65 copay. Additionally, diagnostic lab tests, preventive care, and home health services are all available with no copay or coinsurance. This plan also includes valuable supplemental benefits such as dental and vision care, featuring no copay for routine exams along with annual coverage limits of $2,000 for dental services and $300 for vision hardware. Hearing coverage includes no copay for routine exams and fixed copays between $499 and $999 for prescription hearing aids. Members also benefit from a $41 quarterly over-the-counter allowance and 12 one-way transportation trips per year to health-related locations with no copay.
Inpatient Hospital See details
Blue Medicare Enhanced (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring prior authorization and a $350 copay per stay for days 1 to 6 of acute stays and days 1 to 5 of psychiatric stays, with no copay for subsequent days. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered under this plan.
Outpatient Services See details
Outpatient services are covered by Blue Medicare Enhanced (HMO-POS) with no coinsurance, featuring a $0 to $335 copay for outpatient hospital services and a $335 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $20 copay and no coinsurance.
Partial Hospitalization See details
Blue Medicare Enhanced (HMO-POS) covers partial hospitalization services with a $60.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Blue Medicare Enhanced (HMO-POS) covers ground and air ambulance services with a $250 copay and no coinsurance per service. Additionally, the plan provides transportation services to any health-related location with no copay and no coinsurance, limited to 12 one-way trips per year.
Emergency Services See details
Blue Medicare Enhanced (HMO-POS) covers emergency services with a $150 copay (waived if admitted to the hospital within 48 hours) and urgently needed services with a $65 copay, both with no coinsurance and cost-sharing that does not count toward the plan deductible. Worldwide emergency, urgent, and transportation services are also covered up to a $100,000 maximum benefit with no coinsurance and copays of $150, $65, and $250, respectively.
Primary Care See details
Blue Medicare Enhanced (HMO-POS) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $20 copay and no coinsurance. Physical, occupational, and speech therapies require a $10 copay and no coinsurance, while podiatry is not covered, and chiropractic services only cover some services since routine and other chiropractic care are not covered. Mental health, psychiatric, telehealth, and opioid treatment services are covered with no coinsurance and copays ranging from $0 to $20.
Preventive Services See details
Blue Medicare Enhanced (HMO-POS) provides partially covered preventive services with no copay and no coinsurance for covered care, such as annual physical exams, diabetes self-management training, and fitness benefits. Services not covered under this benefit include 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 benefits, palliative care, enhanced disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Blue Medicare Enhanced (HMO-POS) hearing services are partially covered, offering Medicare-covered exams for a $20 copay and no coinsurance, plus one annual routine exam and unlimited fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to two per year with a $499 to $999 copay and no coinsurance, but OTC hearing aids as well as inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Blue Medicare Enhanced (HMO-POS) covers vision services with no deductible and a $300 annual maximum benefit. Routine eye exams and eyeglasses are provided with no copay and no coinsurance, while contact lenses require a 20% coinsurance with no copay, and contact lens exams require a $20 copay with no coinsurance.
Dental Services See details
Blue Medicare Enhanced (HMO-POS) dental services are partially covered, offering a $20 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered services up to a $2,000 annual maximum. Excluded services include other diagnostic, other preventive, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Blue Medicare Enhanced (HMO-POS) with no copay, though prior authorization and step therapy apply. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Blue Medicare Enhanced (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by Blue Medicare Enhanced (HMO-POS) with no copays, though prior authorization is required for these services. Members are responsible for a 20% coinsurance on durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes, while diabetic supplies range from no coinsurance up to a 20% coinsurance.
Diagnostic and Radiological Services See details
Blue Medicare Enhanced (HMO-POS) covers diagnostic and radiological services with prior authorization required, offering lab services with no copay and no coinsurance, and diagnostic tests for a $0 to $25 copay and no coinsurance. Radiological and outpatient X-ray services require a minimum 20% coinsurance and a minimum copay of $0.
Home Health Services See details
Home health services are covered under the Blue Medicare Enhanced (HMO-POS) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Blue Medicare Enhanced (HMO-POS) with no copay and no coinsurance, though in practice only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Blue Medicare Enhanced (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and 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
Other services are partially covered by Blue Medicare Enhanced (HMO-POS) with no copay and no coinsurance, including a meal benefit and a $41 quarterly allowance for over-the-counter items. Acupuncture is not covered under this benefit.
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