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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 $40.00. 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 an annual drug deductible of $100. For prescription costs, Tier 1 preferred generics and Tier 6 select care drugs have no copay when filled through a preferred pharmacy or preferred mail order. Tier 2 generics also offer no copay through preferred mail order, while preferred pharmacies charge a low copay starting at $4 for a one-month supply. For brand-name and specialty medications, the plan transitions to coinsurance, with Tier 3 preferred brands requiring a 25% coinsurance across all pharmacy types. Tier 4 non-preferred drugs and Tier 5 specialty drugs both require a 31% coinsurance. Utilizing standard pharmacies or standard mail order for any tier generally increases your out-of-pocket expenses compared to preferred network options.
Additional Benefits
The Blue Medicare Enhanced (HMO-POS) plan offers comprehensive coverage featuring no copay for primary care visits, routine eye exams, and eyeglasses. Inpatient hospital stays require a $350 daily copay for the first six days with no copay thereafter, while emergency room visits carry a $150 copay that is waived if you are admitted. Outpatient services, lab tests, and home health services are also highly accessible, with many of these options requiring no copay or coinsurance. Specialist visits and Medicare-covered dental care require a low $20 copay, and other covered dental services are available with no copay up to a $2,000 annual maximum. Additionally, members benefit from no copay for routine hearing exams, up to 12 free one-way transportation trips per year, and a quarterly allowance for over-the-counter items. Most covered services under this plan feature no coinsurance, helping to keep out-of-pocket costs predictable.
Inpatient Hospital See details
Blue Medicare Enhanced (HMO-POS) covers inpatient acute hospital stays with no coinsurance and a $350 daily copay for days 1-6, followed by no copay for unlimited additional days. Inpatient psychiatric care is covered with no coinsurance and a $350 daily copay for days 1-5, then no copay for days 6-90, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Blue Medicare Enhanced (HMO-POS) covers outpatient services with no coinsurance, including outpatient hospital copays from $0 to $335 and observation services at $335 per stay. Ambulatory surgical center and outpatient blood services require no copay and no coinsurance, while outpatient substance abuse sessions have a $20 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered under the Blue Medicare Enhanced (HMO-POS) plan with a $60.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Blue Medicare Enhanced (HMO-POS) covers ambulance services with a $250 copay and no coinsurance for ground and air transport, which requires prior authorization. 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 transport to plan-approved health-related locations is not covered.
Emergency Services See details
Blue Medicare Enhanced (HMO-POS) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 48 hours. Urgently needed services require a $65 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to $100,000 with no coinsurance and copays ranging from $65 to $250.
Primary Care See details
Blue Medicare Enhanced (HMO-POS) offers primary care physician services with no copay and no coinsurance, while specialists, mental health, and psychiatric services require a $20 copay and no coinsurance. Physical, occupational, and speech therapies have a $10 copay and no coinsurance, whereas podiatry is not covered. For chiropractic care, some services are covered with a $20 copay and no coinsurance, but routine and other chiropractic services are not covered.
Preventive Services See details
Blue Medicare Enhanced (HMO-POS) features partially covered preventive services with no copay and no coinsurance for covered options like annual physicals, fitness benefits, and select screenings. Sub-services that are not covered include health education, in-home safety assessments, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
Hearing services are covered under Blue Medicare Enhanced (HMO-POS) with no coinsurance, featuring a $20 copay for Medicare-covered exams and no copay for routine annual exams and fitting evaluations. Prescription hearing aids are partially covered with copays ranging from $499 to $999 and no coinsurance, though OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription models are not covered.
Vision Services See details
Blue Medicare Enhanced (HMO-POS) covers vision services with no deductible, offering routine eye exams and eyeglasses with no copay and no coinsurance. Contact lens exams require a $20 copay with no coinsurance, and contact lenses are covered with no copay and a 20% coinsurance.
Dental Services See details
Blue Medicare Enhanced (HMO-POS) provides partially covered dental services with a $20 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered services up to a $2,000 annual maximum. Sub-services that are not covered under this plan include other diagnostic dental, other preventive dental, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Blue Medicare Enhanced (HMO-POS) covers Home Infusion bundled Services with no copay, though prior authorization is required. Medicare Part B insulin drugs feature a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Blue Medicare Enhanced (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Blue Medicare Enhanced (HMO-POS) covers medical equipment, prosthetics, and diabetic supplies with no copay, though prior authorization is required. A 20% coinsurance applies to durable medical equipment, prosthetics, medical supplies, and diabetic shoes, while diabetic supplies range from no coinsurance to 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 and outpatient X-rays with no copay. Diagnostic procedures and tests have a $0 to $25 copay with no coinsurance, while diagnostic and therapeutic radiological services require a minimum 20% coinsurance and a minimum $0 copay.
Home Health Services See details
Home Health Services are covered by Blue Medicare Enhanced (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no copay and no coinsurance under Blue Medicare Enhanced (HMO-POS), although standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Blue Medicare Enhanced (HMO-POS) covers skilled nursing facility services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a three-day prior hospital stay is not necessary, and additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
Other services are partially covered under the Blue Medicare Enhanced (HMO-POS) plan, which offers over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, while acupuncture is not covered. The OTC benefit provides up to $41 of coverage every three months, and the meal benefit requires a referral.
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