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BlueMedicare Independence (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BlueMedicare Independence (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on BlueMedicare Independence (HMO) in 2025, please refer to our full plan details page.
BlueMedicare Independence (HMO) is a HMO plan offered by USAble Mutual Insurance Company available for enrollment in 2025 to people living in Select Counties in Arkansas. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that BlueMedicare Independence (HMO) 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 BlueMedicare Independence (HMO).
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 BlueMedicare Independence (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.90. 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 a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $4000.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 BlueMedicare Independence (HMO) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay for your prescriptions based on the drug tier and the pharmacy you use. For example, in the initial coverage phase, you will pay $18 for a 30-day supply of a Tier 1 drug at a standard pharmacy, or 20% coinsurance for a Tier 2 drug at a standard pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your prescriptions.
Additional Benefits
The BlueMedicare Independence (HMO) plan offers a range of benefits with varying costs. Hospital stays have a $300 copay for days 1-5, with no copay for days 6-90, and outpatient services have a $300 copay. The plan also includes coverage for primary care, preventive services, and home health services with no copay. Additional benefits include coverage for hearing, vision, and dental services with copays ranging from $0 to $25, and hearing aids are covered up to $1,000 every three years. The plan also covers ambulance services, emergency services, and skilled nursing facility stays, with some services requiring copays or coinsurance. However, it is important to note that some services, like cardiac rehabilitation and additional hours of care, are not covered.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric, are covered by the BlueMedicare Independence (HMO) plan. For days 1-5, the copay is $300, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient Services includes coverage for outpatient hospital services with a $300 copay, observation services with a $300 copay, and ambulatory surgical center services with a $250 copay. Outpatient substance abuse services have a $30 copay for individual and group sessions, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the BlueMedicare Independence (HMO) plan, but requires prior authorization. The copay for this benefit is $85.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground ambulance services with a $325 copay, air ambulance services with 20% coinsurance, and transportation services to a plan-approved health-related location with no copay, limited to 60 one-way trips per year. 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 under the BlueMedicare Independence (HMO) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a $30 copay, with no coinsurance for either service. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a 20% coinsurance, while Worldwide Emergency Transportation is not covered.
Primary Care See details
The BlueMedicare Independence (HMO) plan covers primary care physician services with no copay, and chiropractic services with a $15 copay. Occupational therapy services have a $35 copay, while physician specialist services have a $25 copay. Mental health specialty services, individual and group sessions for psychiatric services, podiatry services, and other health care professional services have varying copays. Physical therapy and speech-language pathology services have a $35 copay, and additional telehealth benefits have no copay. Opioid treatment program services have a $40 copay.
Preventive Services See details
The BlueMedicare Independence (HMO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services such as Medicare-covered Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
The BlueMedicare Independence (HMO) plan covers hearing exams with a $25 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to $1,000 every three years with no copay, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The BlueMedicare Independence (HMO) plan covers vision services, including eye exams with a copay between $0 and $25. Eyewear, including contact lenses, eyeglasses (lenses and frames), and upgrades, are covered with no copay, but eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
The BlueMedicare Independence (HMO) plan covers Medicare Dental Services with a $25 copay, and other dental services with a $3,000 maximum benefit per year. Oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatments have no copay, with limitations on the number of visits or x-rays, and the fluoride treatment being unlimited. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), and oral and maxillofacial surgery have a 20% coinsurance, while maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, 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 under the BlueMedicare Independence (HMO) plan, with a coinsurance of 20%.
Medical Equipment See details
Medical equipment is covered by the BlueMedicare Independence (HMO) plan. Durable Medical Equipment (DME) has a 20% coinsurance and requires prior authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies and Diabetic Equipment are also covered, with a 20% coinsurance for Medicare-covered Prosthetic Devices and Medical Supplies, and no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 20%, with a minimum of 0%. Diagnostic Radiological Services have a copay of at most $300, with a minimum of $25, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the BlueMedicare Independence (HMO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the BlueMedicare Independence (HMO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the BlueMedicare Independence (HMO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefits with no copay. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several additional services are not covered.
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