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Security Blue HMO-POS Basic (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Security Blue HMO-POS Basic (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Security Blue HMO-POS Basic (HMO-POS) in 2026, please refer to our full plan details page.
Security Blue HMO-POS Basic (HMO-POS) is a HMO-POS plan offered by Highmark Health available for enrollment in 2025 to people living in Western PA. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Security Blue HMO-POS Basic (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 Security Blue HMO-POS Basic (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 Security Blue HMO-POS Basic (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 $23.00. 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 combined Maximum Out-Of-Pocket cost of $8950.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $8950.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Security Blue HMO-POS Basic (HMO-POS)
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Drug Coverage
Prescription drugs are not covered by Security Blue HMO-POS Basic (HMO-POS).
Additional Benefits
The Security Blue HMO-POS Basic (HMO-POS) plan offers comprehensive medical coverage featuring no copay for primary care visits, home health services, and annual physical exams. Specialist visits, mental health services, and routine dental, vision, and hearing exams are highly accessible with a standard $30 copay and no coinsurance. Inpatient hospital admissions require a $340 copay with no coinsurance, while emergency room visits carry a $130 copay that is waived if you are admitted. This plan also provides valuable supplemental benefits, including up to 24 one-way transportation trips to plan-approved locations per year and up to $425 for covered eyewear with no copay. For specialized care, skilled nursing facility stays have no copay for the first 20 days, while medical equipment and dialysis services generally require a 20% coinsurance. Diagnostic services are highly affordable, offering lab services with no copay and outpatient X-rays for a $25 copay.
Inpatient Hospital See details
Security Blue HMO-POS Basic (HMO-POS) partially covers inpatient hospital services with a $340 copay per admission and no coinsurance, subject to prior authorization. While unlimited additional acute care days are covered, non-Medicare-covered stays, room upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Security Blue HMO-POS Basic (HMO-POS) covers outpatient services with no coinsurance, featuring a $200 copay per day for outpatient hospital and observation services and a $100 copay for ambulatory surgical center services. Outpatient substance abuse services require a $30 copay per individual or group session with no coinsurance, while outpatient blood services have no copay or coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Security Blue HMO-POS Basic (HMO-POS) with no copay and no coinsurance.
Ambulance and Transportation Services See details
Security Blue HMO-POS Basic (HMO-POS) covers ambulance services with a $270 copay and no coinsurance for both ground and air transport. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by Security Blue HMO-POS Basic (HMO-POS) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within three days. Urgently needed services require a $50 copay with no coinsurance, while worldwide coverage is offered with no coinsurance and copays of $130 for emergency care, $50 for urgent care, and $270 for emergency transportation.
Primary Care See details
Security Blue HMO-POS Basic (HMO-POS) offers primary care physician services with no copay and no coinsurance, while specialist, therapy, and mental health services require a $30 copay and no coinsurance. Chiropractic services are partially covered, featuring a $15 copay and no coinsurance for routine care, though other chiropractic services are not covered. Additional telehealth services are also available with a $0 to $50 copay and no coinsurance.
Preventive Services See details
Security Blue HMO-POS Basic (HMO-POS) features partially covered preventive services, including annual physical exams and kidney disease education with no copay and no coinsurance. While remote access technologies carry a $0 to $30 copay (with no coinsurance) and home safety devices require a 20% coinsurance (with no copay), multiple options like health education, personal emergency response systems, and nutritional therapy are not covered.
Hearing Services See details
Security Blue HMO-POS Basic (HMO-POS) covers annual routine hearing exams with a $30 copay and no coinsurance, and partially covers prescription hearing aids with a $599 to $899 copay and no coinsurance. Fitting and evaluation services, over-the-counter hearing aids, and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
Security Blue HMO-POS Basic (HMO-POS) provides partial coverage for vision services, featuring one routine eye exam per year for a $30 copay and no coinsurance with no deductible, though other eye exam services are not covered. Covered eyewear, including contacts, lenses, frames, and upgrades, has no copay, no coinsurance, and no deductible, up to a $425 maximum annual benefit.
Dental Services See details
Dental services are partially covered by Security Blue HMO-POS Basic (HMO-POS), featuring Medicare-covered dental services for a $30 copay and no coinsurance, and other covered services for a $15 copay and no coinsurance. While exams, cleanings, x-rays, and adjunctive general services (which have no copay) are covered with no coinsurance, this plan does not cover fluoride, restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, or orthodontics.
Home Infusion bundled Services See details
Security Blue HMO-POS Basic (HMO-POS) covers home infusion bundled services with no copay, subject to prior authorization. Medicare Part B chemotherapy, insulin, and other drugs require a coinsurance ranging from no coinsurance to 20%, with insulin drugs also carrying a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the Security Blue HMO-POS Basic (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered under the Security Blue HMO-POS Basic (HMO-POS) plan with no copays, though prior authorization is required. Covered items—including durable medical equipment, prosthetics, medical supplies, and diabetic equipment—generally require a 20% coinsurance, while diabetic supplies range from no coinsurance up to 20% coinsurance.
Diagnostic and Radiological Services See details
Security Blue HMO-POS Basic (HMO-POS) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Members pay no copay for lab services, up to a $20 copay for diagnostic tests, a $25 copay for outpatient X-rays, and minimum copays of $60 for therapeutic and $100 for diagnostic radiological services.
Home Health Services See details
Security Blue HMO-POS Basic (HMO-POS) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Security Blue HMO-POS Basic (HMO-POS) covers some services under Cardiac Rehabilitation Services with no copay and no coinsurance, though Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Security Blue HMO-POS Basic (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, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Security Blue HMO-POS Basic (HMO-POS) partially covers other services, which includes a meal benefit for chronic illnesses with no copay and no coinsurance. Other services such as acupuncture and over-the-counter (OTC) items are not covered.
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