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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 $47.00. 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 medications. Members pay no copay for Tier 1 preferred generics and Tier 6 select care drugs when using preferred pharmacies or preferred mail order services. Tier 2 generic drugs are also highly affordable, costing as little as a $4 copay at preferred pharmacies or no copay through preferred mail order. For brand-name and specialty medications, costs transition to coinsurance. Tier 3 preferred brand drugs require a 25% coinsurance across all pharmacy types, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 31% coinsurance. Standard pharmacies and standard mail-order options are also available, though they generally carry higher copays for lower-tier medications.
Additional Benefits
The Blue Medicare Enhanced (HMO-POS) plan offers comprehensive medical coverage with no copay or coinsurance for primary care doctor visits, while specialist visits require a $20 copay. Inpatient hospital stays require a $350 daily copay for the first few days followed by no copay, while emergency care carries a $150 copay. Outpatient hospital services feature copays ranging from no copay up to $335, with no coinsurance required. Routine dental and vision services are highly accessible, featuring no copays or coinsurance for most preventive care alongside a $2,000 annual dental limit. The plan also provides up to 12 one-way health-related transportation trips per year with no copay, while ambulance services require a $250 copay. Essential medical equipment and dialysis services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by Blue Medicare Enhanced (HMO-POS) with no coinsurance, requiring a $350 daily copay for days 1-6 of acute stays and days 1-5 of psychiatric stays, with no copay for remaining covered days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Blue Medicare Enhanced (HMO-POS) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services which also have no copay. Outpatient hospital services require a copay between $0 and $335 (with a $335 copay per stay for observation services), while outpatient substance abuse sessions require a $20 copay.
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 this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Blue Medicare Enhanced (HMO-POS), featuring a $250 copay and no coinsurance for both ground and air ambulance services. The plan also includes up to 12 one-way transportation trips per year to any health-related location with no copay and no coinsurance.
Emergency Services See details
Blue Medicare Enhanced (HMO-POS) covers emergency services with a $150 copay (waived if admitted within 48 hours) and urgent care with a $65 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $100,000 maximum with no coinsurance and copays of $150, $65, and $250 respectively.
Primary Care See details
Primary Care benefits under Blue Medicare Enhanced (HMO-POS) feature no copay and no coinsurance for primary care physician visits, while specialist visits require a $20 copay and no coinsurance. Physical, occupational, and speech therapies are covered with a $10 copay and no coinsurance, whereas chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services under Blue Medicare Enhanced (HMO-POS) are covered with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. While select supplemental benefits like fitness programs and in-home support are covered, other services—such as health education, nutritional therapy, alternative therapies, and home safety modifications—are not covered.
Hearing Services See details
Hearing services are covered under Blue Medicare Enhanced (HMO-POS) with no coinsurance or deductibles, featuring a $20 copay for Medicare-covered exams and no copay for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered with a $499 to $999 copay for up to two aids per year, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services under Blue Medicare Enhanced (HMO-POS) are covered 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, while contact lenses have no copay but require a 20% coinsurance, up to a $300 annual maximum.
Dental Services See details
Blue Medicare Enhanced (HMO-POS) provides partially covered dental services, featuring a $20 copay and no coinsurance for Medicare-covered dental care, and no copay or coinsurance for most preventive and comprehensive services up to a $2,000 annual limit. Other diagnostic, other preventive, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics are not covered.
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 are covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance of 0% to 20%.
Dialysis Services See details
Blue Medicare Enhanced (HMO-POS) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Blue Medicare Enhanced (HMO-POS) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with no copays and prior authorization required. Members pay a 20% coinsurance for DME, prosthetics, medical supplies, and diabetic shoes, while diabetic supplies carry no coinsurance to 20% coinsurance and are limited to specific manufacturers.
Diagnostic and Radiological Services See details
Blue Medicare Enhanced (HMO-POS) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic lab services and outpatient X-rays have no copay, diagnostic procedures carry a copay of $0 to $25 with no coinsurance, and radiological services require a 20% coinsurance with no copay.
Home Health Services See details
Home health services are covered under the Blue Medicare Enhanced (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Blue Medicare Enhanced (HMO-POS) with no copay and no coinsurance, although only some services are covered in practice. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered by the plan.
Skilled Nursing Facility (SNF) See details
Blue Medicare Enhanced (HMO-POS) covers skilled nursing facility services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a daily copay of $218 for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Blue Medicare Enhanced (HMO-POS) offers partial coverage for other services, featuring over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, though a referral is required for the meals. Acupuncture is not covered under this plan, and the OTC benefit is limited to a maximum of $20 every three months.
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