A non-government entity
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 2026, 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 4.5 out of 5 stars in 2026.
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 $179.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $19.00. You must continue to pay paying your reduced 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:
Sign up for Security Blue HMO-POS Deluxe (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Security Blue HMO-POS Deluxe (HMO-POS) plan offers a $0 drug deductible, meaning your prescription coverage begins immediately with no upfront deductible costs. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies and standard mail order. Tier 2 generic drugs cost a $13 copay for a 1-month supply and a $39 copay for a 3-month supply at standard pharmacies, with a reduced $32.50 copay for a 3-month mail-order supply. Higher-tier medications under this plan have increased cost-sharing requirements. Tier 3 preferred brand drugs require a $42 copay for a 1-month supply, while Tier 4 non-preferred drugs carry a $100 copay for a 1-month supply at standard pharmacies. Finally, Tier 5 specialty drugs require a 33% coinsurance for a 1-month supply at standard pharmacies or through standard mail order.
Additional Benefits
The Security Blue HMO-POS Deluxe (HMO-POS) plan offers comprehensive medical coverage with no copay for primary care doctor visits, preventive screenings, and home health services. For specialized care and hospital services, members pay predictable flat fees, including a fifteen to twenty-five dollar copay for specialist visits and a two hundred ten dollar copay per inpatient hospital stay. Outpatient hospital services feature a one hundred fifty dollar copay, while emergency care is covered with a one hundred thirty dollar copay with no coinsurance. This plan also includes valuable dental, vision, and hearing benefits to support your daily well-being. Routine dental exams and annual eye exams are available for low copays, and members receive up to a four hundred twenty-five dollar annual allowance for eyewear with no copay. Additionally, durable medical equipment and dialysis services are covered with a twenty percent coinsurance and no copay.
Inpatient Hospital See details
Security Blue HMO-POS Deluxe (HMO-POS) covers inpatient acute and psychiatric hospital stays with a $210 copayment per stay and no coinsurance, subject to prior authorization. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Security Blue HMO-POS Deluxe (HMO-POS) outpatient services are covered with no coinsurance, featuring a $150 copay for outpatient hospital and observation services, and a $75 copay for ambulatory surgical center services. Additionally, outpatient substance abuse services require a $25 copay per session with no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Security Blue HMO-POS Deluxe (HMO-POS) covers partial hospitalization services with no copay and no coinsurance.
Ambulance and Transportation Services See details
Security Blue HMO-POS Deluxe (HMO-POS) covers ambulance services with a $260 copay and no coinsurance for both ground and air transport. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Security Blue HMO-POS Deluxe (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 have a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays of $130, $50, and $260 respectively.
Primary Care See details
Security Blue HMO-POS Deluxe (HMO-POS) primary care benefits feature no copay and no coinsurance for primary care physician visits, while specialist, therapy, and mental health services require copays ranging from $15 to $25 with no coinsurance. Chiropractic services are partially covered under this plan, offering routine care for a $15 copay and no coinsurance while other chiropractic services are not covered.
Preventive Services See details
Security Blue HMO-POS Deluxe (HMO-POS) preventive services are partially covered, offering annual physicals, kidney disease education, and other preventive screenings with no copay and no coinsurance. Home safety devices require a 20% coinsurance with no copay, while remote access technologies feature a $0 to $25 copay with no coinsurance. Excluded services include health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, telemonitoring, and counseling.
Hearing Services See details
Security Blue HMO-POS Deluxe (HMO-POS) provides partially covered hearing services, featuring one routine hearing exam annually for a $25 copay and no coinsurance, and up to two prescription hearing aids per year with a copay between $399.00 and $699.00 and no coinsurance. Fitting and evaluation exams, OTC hearing aids, and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Security Blue HMO-POS Deluxe (HMO-POS) provides partially covered vision services, featuring routine eye exams for a $25 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, offering up to a $425 combined annual maximum for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Security Blue HMO-POS Deluxe (HMO-POS) offers partially covered dental services, featuring a $25 copay for Medicare-covered dental and a $15 copay for exams, cleanings, and X-rays, both with no coinsurance. 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
Home Infusion bundled Services are covered by Security Blue HMO-POS Deluxe (HMO-POS) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs require coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs have a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by Security Blue HMO-POS Deluxe (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by Security Blue HMO-POS Deluxe (HMO-POS) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and diabetic therapeutic shoes. Diabetic supplies are also covered with no copay and coinsurance ranging from no coinsurance up to 20%, with prior authorization required for all medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Security Blue HMO-POS Deluxe (HMO-POS) with no coinsurance, though prior authorization is required. Members pay no copay for lab services, a $0 to $10 copay for diagnostic procedures, and copays starting at $15 for X-rays, $60 for therapeutic radiology, and $75 for diagnostic radiology.
Home Health Services See details
Security Blue HMO-POS Deluxe (HMO-POS) covers home health services with no copay and no coinsurance, although prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered under the Security Blue HMO-POS Deluxe (HMO-POS) plan. This includes cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services, none of which are covered by the plan.
Skilled Nursing Facility (SNF) See details
Security Blue HMO-POS Deluxe (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-covered limit are not covered.
Other Services See details
Security Blue HMO-POS Deluxe (HMO-POS) partially covers other services, offering a limited-duration meal benefit for chronic illness with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and dual eligible SNP services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved