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Security Blue HMO-POS Deluxe (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Security Blue HMO-POS Deluxe (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 Deluxe (HMO-POS) in 2025, please refer to our full plan details page.
Security Blue HMO-POS Deluxe (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 Deluxe (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 Deluxe (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 Deluxe (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $200.00. 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.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
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:
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Drug Coverage
The Security Blue HMO-POS Deluxe (HMO-POS) plan has an enhanced alternative drug benefit with no deductible. During the initial coverage phase, you'll pay a copay for your prescriptions, which varies based on the drug tier and pharmacy. For example, you will pay a $13.00 copay at a standard pharmacy for a preferred generic drug. Once your total drug costs reach $2,000.00, you enter the catastrophic coverage phase where you will pay nothing for your covered drugs. If you qualify for the low-income subsidy, your monthly premium will be reduced.
Additional Benefits
The Security Blue HMO-POS Deluxe (HMO-POS) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying copays. It also covers ambulance and transportation services, with a limit of 24 one-way trips per year, and emergency services. Preventive services and home health services are covered with no copay. This plan provides coverage for hearing, vision, and dental services, with copays for exams and specific costs for hearing aids and eyewear. It also covers home infusion, dialysis, medical equipment, and diagnostic services, with coinsurance or copays applying to these services. However, some services like cardiac rehabilitation and many "other services" are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with a $210 copay per stay, though non-Medicare-covered stays, additional days for Inpatient Hospital Psychiatric, and upgrades for Inpatient Hospital-Acute are not covered. Additional days for Inpatient Hospital-Acute have no copay.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, outpatient substance abuse services, and outpatient blood services, are covered by the Security Blue HMO-POS Deluxe plan. Outpatient hospital and observation services have a $150 copay, while ambulatory surgical center services have a $75 copay. Individual and group sessions for outpatient substance abuse have a copay between $25 and $25.
Partial Hospitalization See details
Partial Hospitalization benefits are covered by the Security Blue HMO-POS Deluxe (HMO-POS) plan.
Ambulance and Transportation Services See details
The Security Blue HMO-POS Deluxe (HMO-POS) plan covers ambulance services with a $150 copay for both ground and air ambulance services, and transportation services to plan-approved health-related locations, for up to 24 one-way trips per year, with no coinsurance. 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. Emergency Services has a $125 copay, Urgently Needed Services has a $5 copay, Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a $5 copay, and Worldwide Emergency Transportation has a $150 copay.
Primary Care See details
The Security Blue HMO-POS Deluxe (HMO-POS) plan covers primary care physician services, chiropractic services (with a $15 copay), occupational therapy services (with a $20 copay), physician specialist services (with a $25 copay), and mental health specialty services, podiatry services, other health care professional services, psychiatric services and opioid treatment program services (each with a $25 copay). Physical therapy and speech-language pathology services have a $25 copay, and additional telehealth benefits have a copay between $0 and $25.
Preventive Services See details
The Security Blue HMO-POS Deluxe (HMO-POS) plan covers preventive services, including Medicare-covered services, annual physical exams, and other preventive services. Additional preventive services have no copay, but some services have a 20% coinsurance, and some services such as Health Education, Counseling Services, and others are not covered.
Hearing Services See details
Hearing Services include coverage for routine hearing exams with a $25 copay, and prescription hearing aids, with a copay between $399 and $699 for all types of hearing aids. Fitting/evaluation for hearing aids, prescription hearing aids for the inner ear, outer ear, and over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a $25 copay, and eyewear with a combined maximum benefit of $425 every year, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. Routine eye exams are covered once per year.
Dental Services See details
Dental services include coverage for Medicare Dental Services and Other Dental Services, with a $25 copay and a $15 copay, respectively. Additionally, Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), and Adjunctive General Services are covered, with specific limitations on the number of visits and periodicity, but 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 and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Security Blue HMO-POS Deluxe (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, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have a coinsurance between 0-20%, 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, with a copay required for all diagnostic services and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $10, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at least $75, Therapeutic Radiological Services have a copay of at least $60, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the Security Blue HMO-POS Deluxe (HMO-POS) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Security Blue HMO-POS Deluxe (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) services are covered by the Security Blue HMO-POS Deluxe (HMO-POS) plan, but require prior authorization. You will have no 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 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. However, the plan does cover a meal benefit for a chronic illness.
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