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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 $178.00. 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. There is no deductible for prescription drugs. During the initial coverage phase, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Security Blue HMO-POS Deluxe (HMO-POS) plan provides comprehensive coverage, including inpatient and outpatient hospital services, with varying copays for different services. Emergency and urgent care services have copays, and ambulance services are covered. The plan also includes coverage for primary care, preventive, hearing, vision, and dental services, each with specific copays. This plan offers additional benefits such as home health services with no copay, and skilled nursing facility care with a copay after 20 days. It also covers medical equipment, diagnostic and radiological services, and offers transportation services. However, certain services like cardiac rehabilitation and specific dental procedures are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, each with a copay of $210 per admission or stay. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, and outpatient substance abuse services, each with a $150 copay. Ambulatory Surgical Center (ASC) Services have a $75 copay, while individual and group sessions for outpatient substance abuse have a copay between $25 and $25. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Security Blue HMO-POS Deluxe (HMO-POS) plan. There is no copay or coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $150 copay for both ground and air ambulance services. Transportation Services to a plan-approved health-related location are covered for up to 24 one-way trips per year, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, and Worldwide Urgent Coverage have a copay of $125, $5, $125, and $5, respectively, and no coinsurance; Worldwide Emergency Transportation has a $150 copay with no coinsurance.
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), mental health specialty services (with a $25 copay for individual and group sessions), podiatry services (with a $25 copay), other health care professional visits (with a copay between $0 and $25), psychiatric services (with a $25 copay for individual and group sessions), physical therapy and speech-language pathology services (with a $25 copay), additional telehealth benefits (with a copay between $0 and $25), and opioid treatment program services (with a $25 copay).
Preventive Services See details
The Security Blue HMO-POS Deluxe (HMO-POS) plan covers preventive services, including Medicare-covered services and annual physical exams. Additional preventive services are covered, and some services like Health Education, Counseling Services, and others are not covered. Remote Access Technologies have a copay between $0 and $25, and Home and Bathroom Safety Devices and Modifications have 20% coinsurance.
Hearing Services See details
Hearing Services includes routine hearing exams with a $25 copay, and prescription hearing aids with a copay between $399 and $699 for all types. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, Prescription Hearing Aids - Over the Ear, and OTC Hearing Aids are not covered.
Vision Services See details
Vision Services include eye exams with a $25 copay. Eyewear is covered with a combined maximum of $425 every year, while contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental Services are covered, with a $25 copay for Medicare dental services and a $15 copay for other dental services. Specific services such as 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%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Security Blue HMO-POS Deluxe (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance, Prosthetics/Medical Supplies with a 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have a 0-20% coinsurance, 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 include coverage for Diagnostic Procedures/Tests with a copay between $0 and $10, Lab Services with no copay, Diagnostic Radiological Services with a copay of at most $75, Therapeutic Radiological Services with a copay of at most $60, and Outpatient X-Ray Services with a $15 copay. All services require prior authorization.
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, including 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, but require prior authorization. For days 1-20, there is no copay, but for days 21-100, there is a $214 copay. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services are partially covered by the Security Blue HMO-POS Deluxe (HMO-POS) plan, but 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 are not covered. The plan provides a meal benefit for a chronic illness.
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