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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.
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 comprehensive medical coverage with predictable costs, including no copay for primary care physician visits, preventive screenings, and home health services. For specialist visits, routine dental care, and routine vision exams, members will pay a $30 copay with no coinsurance. Inpatient hospital stays require a $340 copay per admission, while emergency room visits carry a $130 copay, which is waived upon admission. This plan also features no copay for covered eyewear up to a $425 annual maximum, while routine dental cleanings and exams require a $15 copay. Diagnostic lab services and partial hospitalization are available with no copay, whereas durable medical equipment and dialysis services require a 20% coinsurance. Prescription hearing aids are covered up to twice per year with copays ranging from $599 to $899 and no coinsurance.
Inpatient Hospital See details
Inpatient hospital care under Security Blue HMO-POS Basic (HMO-POS) is partially covered, requiring a $340 copayment per admission and no coinsurance for Medicare-covered acute and psychiatric stays. Prior authorization is required, and certain services such as non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Security Blue HMO-POS Basic (HMO-POS) covers outpatient hospital and daily observation services with a $200 copay and no coinsurance, and ambulatory surgical center services with a $100 copay and no coinsurance. Outpatient substance abuse services require a $30 copay per session with no coinsurance, while outpatient blood services are covered with no copay, coinsurance, or deductible.
Partial Hospitalization See details
Security Blue HMO-POS Basic (HMO-POS) covers partial hospitalization with no copay and no coinsurance.
Ambulance and Transportation Services See details
Ambulance and Transportation Services under Security Blue HMO-POS Basic (HMO-POS) are covered, with Medicare-covered ground and air ambulance services requiring a $280 copay and no coinsurance. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
Security Blue HMO-POS Basic (HMO-POS) covers emergency services 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 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays of $130, $50, and $280 respectively.
Primary Care See details
Security Blue HMO-POS Basic (HMO-POS) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, mental health, and podiatry services require a $30 copay and no coinsurance. Chiropractic care is partially covered, offering routine visits for a $15 copay and no coinsurance, while other chiropractic services are not covered. Telehealth benefits are also available with copays ranging from $0 to $50 and no coinsurance.
Preventive Services See details
Preventive services are partially covered by Security Blue HMO-POS Basic (HMO-POS), featuring annual physical exams, kidney disease education, and screenings with no copay and no coinsurance. Remote access technologies require a $0 to $30 copay and no coinsurance, and home safety devices have a 20% coinsurance and no copay, but services like health education, personal emergency response systems, and nutritional counseling are not covered.
Hearing Services See details
Hearing services through Security Blue HMO-POS Basic (HMO-POS) are partially covered, offering one routine hearing exam annually for a $30 copay and no coinsurance, though fitting evaluations and OTC hearing aids are not covered. Prescription hearing aids are covered up to twice per year with copays ranging from $599 to $899 and no coinsurance, but inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Security Blue HMO-POS Basic (HMO-POS) partially covers vision services, offering one routine eye exam per year for a $30 copay and no coinsurance, while other eye exam services are not covered. Covered eyewear, including contacts, lenses, frames, and upgrades, has no copay or coinsurance up to a $425 annual maximum.
Dental Services See details
Security Blue HMO-POS Basic (HMO-POS) provides partial dental coverage, featuring a $30 copay and no coinsurance for Medicare-covered dental, and a $15 copay with no coinsurance for other dental services like exams, cleanings, and x-rays. Adjunctive general services are covered with no copay and no coinsurance, but fluoride, restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
Security Blue HMO-POS Basic (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, 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
Security Blue HMO-POS Basic (HMO-POS) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Security Blue HMO-POS Basic (HMO-POS) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and generally a 20% coinsurance, though diabetic supplies range from no coinsurance to 20% coinsurance. Prior authorization is required for these covered items, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Security Blue HMO-POS Basic (HMO-POS) with no coinsurance, although prior authorization is required. Diagnostic procedures and tests have a copay of $0 to $20, lab services have no copay, and radiological services require copays of $25 for X-rays, a minimum of $60 for therapeutic radiology, and a minimum of $100 for diagnostic radiology.
Home Health Services See details
Home Health Services are covered by Security Blue HMO-POS Basic (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Security Blue HMO-POS Basic (HMO-POS) does not cover Cardiac Rehabilitation Services. This includes cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services, which are all excluded from coverage.
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 limit are not covered.
Other Services See details
Security Blue HMO-POS Basic (HMO-POS) partially covers other services, offering a chronic illness meal benefit with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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