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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 2025, 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 5 out of 5 stars in 2025.
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.
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.
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 a range of benefits, including coverage for inpatient and outpatient services, with varying copays. You'll have a $340 copay per admission for inpatient hospital stays, and outpatient services have copays ranging from $30 to $200 depending on the service. Emergency services and ambulance services are covered, and the plan also includes coverage for primary care, hearing, vision, and dental services, each with its own set of copays and limitations. This plan also provides coverage for home health services with no copay, skilled nursing facilities with a $0 copay for the first 20 days, and various diagnostic and radiological services with copays. The plan covers medical equipment and home infusion services, and offers a meal benefit for chronic illnesses. However, note that certain services like cardiac rehabilitation, acupuncture, and specific types of dental and vision services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization. The copay for a Medicare-covered stay is $340 per admission or stay, and additional days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a $200 copay, observation services with a $200 copay, ambulatory surgical center (ASC) services with a $100 copay, outpatient substance abuse services with a $30 copay for individual and group sessions, and outpatient blood services. The plan also waives the three-pint deductible for blood services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Security Blue HMO-POS Basic (HMO-POS) plan.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services, each with a $125 copay. Transportation services to a plan-approved health-related location are covered for up to 24 one-way trips per year, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Security Blue HMO-POS Basic plan. Emergency Services have a $125 copay and no coinsurance, Urgently Needed Services have a $50 copay and no coinsurance, and Worldwide Emergency Coverage and Transportation have a $125 copay, while Worldwide Urgent Coverage has a $50 copay, with no coinsurance for any of these services.
Primary Care See details
The Security Blue HMO-POS Basic (HMO-POS) plan covers primary care physician services, chiropractic services with a $15 copay, occupational therapy services with a $30 copay, and specialist physician services with a $30 copay. The plan also covers mental health services with a $30 copay, podiatry services with a $30 copay, other health care professionals, psychiatric services with a $30 copay, physical therapy and speech-language pathology services with a $30 copay, additional telehealth benefits with a $0-$50 copay, and opioid treatment program services with a $30 copay.
Preventive Services See details
Preventive services are covered, including Medicare-covered preventive services, annual physical exams, and other preventive services. Remote Access Technologies have a copay of $0-$30, and Home and Bathroom Safety Devices and Modifications have a 20% coinsurance. Some services, such as Health Education and Counseling Services are not covered.
Hearing Services See details
Hearing services include routine hearing exams with a $30 copay for one visit per year, and prescription hearing aids with a copay between $599 and $899 for two hearing aids per year. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, prescription hearing aids - over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a $30 copay, and eyewear with a combined maximum benefit of $425 per year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental Services are covered, including Medicare and other dental services, with a $30 copay for Medicare dental services and a $15 copay for other dental services. Additional covered services include oral exams, dental x-rays, prophylaxis (cleaning), and adjunctive general services. Fluoride treatment, restorative services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, you will pay a $35 copay and 0-20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Security Blue HMO-POS Basic (HMO-POS) plan. There is a 20% coinsurance for this benefit.
Medical Equipment See details
Medical equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires authorization, while Prosthetic Devices and Medical Supplies have a 20% coinsurance. Diabetic Supplies have a coinsurance between 0% and 20%, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $20, lab services with no copay, diagnostic radiological services with a copay of at least $100, therapeutic radiological services with a copay of at least $60, and outpatient X-ray services with a $25 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the Security Blue HMO-POS Basic (HMO-POS) plan with no copay and no coinsurance, but prior authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Security Blue HMO-POS Basic (HMO-POS) plan. This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by Security Blue HMO-POS Basic (HMO-POS), with a $0 copay for days 1-20 and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other services are not covered, including acupuncture, over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services. The plan does provide a meal benefit for a chronic illness.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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