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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 with varying costs. Inpatient hospital stays have a $340 copay per admission, while outpatient services have copays ranging from $30 to $200. Primary care visits have copays between $15 and $30, and emergency services cost $125. Preventive services, including annual exams, are covered with no copay. The plan also covers hearing exams for $30, and vision services with a $30 copay for routine eye exams. Dental services have copays of $15-$30, and ambulance services have a $125 copay. Additional benefits include coverage for home health services with no copay, and skilled nursing facilities with a $0 copay for the first 20 days.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered with a copay of $340 per admission or stay. Additional days for inpatient hospital-acute are covered with no copay, while non-Medicare-covered stays and upgrades for inpatient hospital-acute, as well as additional days and non-Medicare-covered stays for inpatient hospital-psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the Security Blue HMO-POS Basic (HMO-POS) plan. Outpatient Hospital Services and Observation Services have a $200 copay, while Ambulatory Surgical Center (ASC) Services have a $100 copay. Outpatient Substance Abuse Individual and Group Sessions have a copay between $30 and $30, and Outpatient Blood Services are also covered.
Partial Hospitalization See details
Partial Hospitalization benefits are covered by the Security Blue HMO-POS Basic (HMO-POS) plan. No additional cost information is available for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground and air ambulance services have a $125 copay, but no coinsurance. Transportation Services to a plan-approved health-related location are covered for up to 24 one-way trips per year, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Security Blue HMO-POS Basic (HMO-POS) plan. Emergency Services have a $125 copay with no coinsurance, Urgently Needed Services have a $50 copay with no coinsurance, Worldwide Emergency Coverage has a $125 copay with no coinsurance, Worldwide Urgent Coverage has a $50 copay with no coinsurance, and Worldwide Emergency Transportation has a $125 copay with no coinsurance.
Primary Care See details
Primary Care benefits cover services such as primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services have a $15 copay, occupational therapy services have a $30 copay, physician specialist services have a $30 copay, mental health specialty services, podiatry services, psychiatric services, and opioid treatment program services have a $30 copay, physical therapy and speech-language pathology services have a $30 copay, and additional telehealth benefits have a $0-$50 copay.
Preventive Services See details
The Security Blue HMO-POS Basic (HMO-POS) plan covers preventive services, including annual physical exams, with no copay or coinsurance. Additional preventive services, such as remote access technologies, are covered, but some services like health education and counseling services are not covered. Home and bathroom safety devices have a 20% coinsurance.
Hearing Services See details
Hearing exams are covered with a $30 copay, and routine hearing exams are covered with a limit of one exam per year. Prescription hearing aids are covered, with a copay between $599 and $899 for all types of prescription hearing aids, but fitting/evaluation for hearing aids, inner ear prescription hearing aids, outer ear prescription hearing aids, over the ear prescription hearing aids, and OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for routine eye exams with a $30 copay. Eyewear is covered with a combined maximum benefit of $425 per year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental services are covered, with a $30 copay for Medicare dental services and a $15 copay for other dental services. Oral exams, dental x-rays, prophylaxis (cleaning), and adjunctive general services are covered, while fluoride treatments, 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, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Security Blue HMO-POS Basic (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered, including durable medical equipment (DME) with 20% coinsurance and authorization required, prosthetic devices with 20% coinsurance, medical supplies with 20% coinsurance, and diabetic equipment. Diabetic supplies have between 0% and 20% coinsurance, and diabetic therapeutic shoes/inserts have 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 under the Security Blue HMO-POS Basic (HMO-POS) plan. Diagnostic Procedures/Tests have a copay between $0 and $20, Lab Services have no copay, Diagnostic Radiological Services have a minimum copay of $100, Therapeutic Radiological Services have a minimum copay of $60, and Outpatient X-Ray Services have a $25 copay.
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 additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Security Blue HMO-POS Basic (HMO-POS) plan. Specifically, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Security Blue HMO-POS Basic (HMO-POS) plan, with a $0 copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include a meal benefit for a chronic illness, while acupuncture, over-the-counter items, Dual Eligible SNPs, 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 are not covered. There is no cost information provided for the meal benefit.
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