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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 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 $138.00. 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:
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Drug Coverage
The Security Blue HMO-POS Deluxe (HMO-POS) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. Tier 1 preferred generic drugs are available with no copay for a 1-month or 3-month supply at standard pharmacies and through standard mail order. For Tier 2 generic drugs, you will pay a $13 copay for a 1-month supply at standard pharmacies, or a $32.50 copay for a 3-month supply via standard mail order. Tier 3 preferred brand drugs carry a $42 copay for a 1-month supply, while Tier 4 non-preferred drugs require a $100 copay for a 1-month supply at standard pharmacies. Ordering a 3-month supply of these medications through standard mail order costs $105 for Tier 3 and $250 for Tier 4. Tier 5 specialty drugs require a 33% coinsurance for a 1-month supply at standard pharmacies and through standard mail order.
Additional Benefits
The Security Blue HMO-POS Deluxe (HMO-POS) plan offers comprehensive medical coverage with affordable cost-sharing, including no copays for primary care visits, preventive services, and home health care. For inpatient hospital stays, members pay a $210 copay per admission with no coinsurance, while outpatient hospital services require a $150 copay. Emergency room visits carry a $130 copay, which is waived if admitted within three days, and urgent care is available for a $50 copay. Specialist visits and routine dental and vision exams are highly accessible, requiring low copays ranging from $15 to $25 with no coinsurance. The plan also covers up to 24 one-way transportation trips and partial hospitalization with no copay, though durable medical equipment and dialysis services require a 20% coinsurance. Additionally, prescription hearing aids are covered with copays between $399 and $699, and members receive a $425 annual allowance for eyewear with no copay.
Inpatient Hospital See details
Security Blue HMO-POS Deluxe (HMO-POS) covers inpatient acute and psychiatric hospital stays with a $210 copay per admission and no coinsurance, though prior authorization is required. While unlimited additional days are covered for acute care, additional days for psychiatric stays, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Security Blue HMO-POS Deluxe (HMO-POS) covers outpatient hospital and daily observation services with a $150 copay and no coinsurance, and ambulatory surgical center services with a $75 copay and no coinsurance. Outpatient substance abuse services require a $25 copay per individual or group session with no coinsurance, while outpatient blood services are provided with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Security Blue HMO-POS Deluxe (HMO-POS) with no copay and no coinsurance.
Ambulance and Transportation Services See details
Security Blue HMO-POS Deluxe (HMO-POS) covers ambulance services with a $265 copay and no coinsurance for both ground and air transport. Transportation services are partially covered with no copay or coinsurance for up to 24 one-way trips per year to plan-approved locations, though trips to any health-related location are not covered.
Emergency Services See details
Security Blue HMO-POS Deluxe (HMO-POS) covers emergency services with a $130 copay (waived if admitted to the hospital within three days) and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency services are also covered with no coinsurance, featuring a $130 copay for emergency care, a $50 copay for urgent care, and a $265 copay for emergency transportation.
Primary Care See details
Security Blue HMO-POS Deluxe (HMO-POS) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, and psychiatric services require copays ranging from $15 to $25 and no coinsurance. Chiropractic services are partially covered, with routine care requiring a $15 copay and no coinsurance, while other chiropractic services are not covered. Additional telehealth benefits are also available with a $0 to $50 copay and no coinsurance.
Preventive Services See details
Security Blue HMO-POS Deluxe (HMO-POS) covers annual physical exams, kidney disease education, and other preventive screenings with no copay and no coinsurance. Additional preventive benefits are partially covered, offering remote access technologies with a $0 to $25 copay and home safety devices with a 20% coinsurance, while services like health education, weight management, and in-home safety assessments are not covered.
Hearing Services See details
Security Blue HMO-POS Deluxe (HMO-POS) provides partial coverage for hearing services, including one routine hearing exam per year for a $25 copay and no coinsurance, while fitting evaluations and OTC hearing aids are not covered. Up to two prescription hearing aids per year are covered with a copay ranging from $399 to $699 and no coinsurance, though inner ear, outer ear, and over the ear models are excluded.
Vision Services See details
Security Blue HMO-POS Deluxe (HMO-POS) partially covers eye exams, offering one routine exam per year for a $25 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance, providing a combined maximum benefit of $425 per year for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Security Blue HMO-POS Deluxe (HMO-POS), which provides Medicare dental services for a $25 copay and no coinsurance, and other dental services for a $15 copay and no coinsurance. While routine exams, cleanings, x-rays, and adjunctive general services are covered with no coinsurance, several services including fluoride, restorative, endodontics, periodontics, and implants are not covered.
Home Infusion bundled Services See details
Security Blue HMO-POS Deluxe (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and radiation, require a 0% to 20% coinsurance with no copay, while Medicare Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Security Blue HMO-POS Deluxe (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Security Blue HMO-POS Deluxe (HMO-POS) covers medical equipment with no copays, requiring prior authorization for all categories. Durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes carry a 20% coinsurance, while diabetic supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Security Blue HMO-POS Deluxe (HMO-POS) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Members pay no copay for lab services, up to a $10 copay for diagnostic procedures, a $15 copay for X-rays, and minimum copays of $75 for diagnostic radiology and $60 for therapeutic radiology.
Home Health Services See details
Security Blue HMO-POS Deluxe (HMO-POS) covers home health services with no copay and no coinsurance. Prior authorization is required to receive 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 no coverage for standard cardiac, intensive cardiac, pulmonary, or SET for PAD rehabilitation services.
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, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Security Blue HMO-POS Deluxe (HMO-POS), which offers a chronic illness meal benefit with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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