Security Blue HMO-POS ValueRx (HMO-POS)

Security Blue HMO-POS ValueRx (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 ValueRx (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 Security Blue HMO-POS ValueRx (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.

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:

Drug Coverage

The Security Blue HMO-POS ValueRx (HMO-POS) Medicare plan offers prescription drug coverage with a $0 drug deductible, meaning your benefits begin immediately. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at a preferred pharmacy, or a 3-month supply through preferred mail order. Tier 2 generic medications cost as low as a $13 copay for a 1-month supply at preferred pharmacies, while standard pharmacies and mail-order options have slightly higher copays. Tier 3 preferred brand drugs require a $45 copay for a 1-month supply at preferred pharmacies, with preferred mail order offering a 3-month supply for $115. Higher-tier medications are subject to coinsurance rather than flat copays, with Tier 4 non-preferred drugs requiring a 35% coinsurance across all pharmacy options. Tier 5 specialty drugs have a 33% coinsurance for a 1-month supply at both preferred and standard pharmacies as well as mail order.

Additional Benefits

The Security Blue HMO-POS ValueRx (HMO-POS) plan offers affordable essential care with no copay for primary care visits, preventive services, and home health care. For specialized care, specialist visits require a $35 copay, while outpatient hospital services carry a $200 copay and emergency room visits require a $130 copay. If you require inpatient hospital stays, you will pay a $220 daily copay for days one through five, with no copay for days six through 90. This plan also includes valuable supplemental benefits, such as select dental services for a $15 copay and routine vision exams for a $35 copay, which includes up to a $425 annual allowance for eyewear. Routine hearing exams carry a $35 copay, and up to two prescription hearing aids are covered annually with copays ranging from $599.00 to $899.00. Additionally, members can access up to 24 one-way transportation trips per year to plan-approved locations with no copay, while durable medical equipment and dialysis services require a 20% coinsurance.