A non-government entity
Blue Cross Medicare Advantage Basic Plus (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue Cross Medicare Advantage Basic Plus (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Blue Cross Medicare Advantage Basic Plus (HMO-POS) in 2026, please refer to our full plan details page.
Blue Cross Medicare Advantage Basic Plus (HMO-POS) is a HMO-POS plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in Chicago Metro Area HMO POS. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Blue Cross Medicare Advantage Basic Plus (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 Cross Medicare Advantage Basic Plus (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 Cross Medicare Advantage Basic Plus (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 a $450.00 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 $6750.00 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:
Sign up for Blue Cross Medicare Advantage Basic Plus (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Blue Cross Medicare Advantage Basic Plus (HMO-POS) plan features an annual drug deductible of $450. Tier 1 preferred generic drugs offer no copay at preferred pharmacies and preferred mail order, while standard pharmacies charge copays starting at $5. Tier 2 generic drugs are also highly affordable, with copays ranging from $1 at preferred pharmacies to $18 for a three-month supply at standard pharmacies. For brand-name and specialty medications, costs are calculated using coinsurance. Tier 3 preferred brand drugs require an 18% coinsurance at preferred locations and 22% at standard locations, while Tier 4 non-preferred drugs range from 39% to 43% coinsurance. Tier 5 specialty drugs require a flat 27% coinsurance for a one-month supply regardless of your pharmacy choice.
Additional Benefits
The Blue Cross Medicare Advantage Basic Plus (HMO-POS) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, telehealth, home health services, and preventive care. For inpatient hospital stays, members pay no coinsurance alongside a $300 daily copay for the first eight days of acute care, after which there is no copay. Emergency room visits carry a $125 copay, while specialist visits require a $44 copay with no coinsurance. This plan also provides valuable supplemental benefits, including routine dental, vision, and hearing exams with no copay and no coinsurance. Prescription hearing aids, eyewear, and comprehensive dental services are partially covered with specific copays or coinsurance, and members receive up to a $65 quarterly allowance for over-the-counter items with no copay. Durable medical equipment and dialysis services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) partially covers inpatient hospital services with no coinsurance, featuring a $300 daily copay for acute care days 1 through 8 (with no copay for days 9 and beyond) and a $215 daily copay for psychiatric care days 1 through 7 (with no copay for days 8 through 90). However, hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $275 copay and observation services with a $275 copay per stay. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while individual and group outpatient substance abuse sessions require a $75 copay with no coinsurance.
Partial Hospitalization See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers partial hospitalization services with a $55 copay and no coinsurance. Prior authorization and a referral are required to receive this covered benefit.
Ambulance and Transportation Services See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers ambulance services with a $250 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport, with prior authorization required for both. Transportation services to plan-approved or any other health-related locations are not covered under this plan.
Emergency Services See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers emergency services with a $125 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent care are partially covered with a $125 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers primary care and telehealth visits with no copay and no coinsurance, while specialist visits require a $44 copay and no coinsurance. Covered services such as physical, occupational, mental health, and psychiatric therapies feature copays ranging from $30 to $40 and no coinsurance, though chiropractic and podiatry services are not covered.
Preventive Services See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers preventive services, including annual physical exams, kidney disease education, and select screenings, with no copay and no coinsurance. While fitness benefits and remote access technologies are also covered at no cost, other supplemental preventive services—such as health education, in-home safety assessments, and nutritional benefits—are not covered.
Hearing Services See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers hearing services with no coinsurance, offering Medicare-covered exams for a $5 copay, alongside routine exams and fitting evaluations with no copay. Prescription hearing aids are partially covered with a $699 to $999 copay and no coinsurance 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
Blue Cross Medicare Advantage Basic Plus (HMO-POS) provides partially covered vision services, offering one routine eye exam per year with no copay and no coinsurance. Eyewear is covered with a $35 copay and no coinsurance up to a $100 annual limit, but other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by Blue Cross Medicare Advantage Basic Plus (HMO-POS), featuring a $35 copay and no coinsurance for Medicare-covered care, and no copay or coinsurance for preventive cleanings, exams, and x-rays. Comprehensive services are covered up to a $750 annual limit with no copay and 0% to 50% coinsurance, though fluoride, implants, orthodontics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a referral are required to access these covered services.
Medical Equipment See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers medical equipment, prosthetics, and diabetic supplies with no copay and a 20% coinsurance, though diabetic supplies 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
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers diagnostic and radiological services, with prior authorization and referrals required. Diagnostic tests and procedures have no coinsurance and a copay of up to $50, lab services and outpatient X-rays feature no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Blue Cross Medicare Advantage Basic Plus (HMO-POS) plan with no copay and no coinsurance. Members must obtain prior authorization and a referral to access this benefit.
Cardiac Rehabilitation Services See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers some Cardiac Rehabilitation Services with no coinsurance, but in practice, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. Prior authorization and referrals are required for these services.
Skilled Nursing Facility (SNF) See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and a referral. There is no copay for days 1 to 20 and days 40 to 100, a $218 daily copay for days 21 to 39, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Blue Cross Medicare Advantage Basic Plus (HMO-POS) partially covers other services, providing over-the-counter (OTC) items with no copay and no coinsurance up to a maximum benefit of $65 every three months. Acupuncture, meal benefits, and other additional services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved