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Blue adVantage Classic (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue adVantage Classic (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Blue adVantage Classic (HMO-POS) in 2025, please refer to our full plan details page.
Blue adVantage Classic (HMO-POS) is a HMO-POS plan offered by Louisiana Health Service & Indemnity Company available for enrollment in 2025 to people living in State of Louisiana. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Blue adVantage Classic (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 Blue adVantage Classic (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 Blue adVantage Classic (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.50. 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 Maximum Out-Of-Pocket cost of $4500.00 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 Blue adVantage Classic (HMO-POS) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay for generic drugs, and coinsurance for brand-name and non-preferred drugs. The copay for preferred generic drugs is $12.00, and the coinsurance for preferred brand drugs is 50%. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs. This plan may reduce your premium if you qualify for the low-income subsidy.
Additional Benefits
The Blue adVantage Classic (HMO-POS) plan offers a wide range of benefits, including coverage for inpatient and outpatient hospital services with varying copays. You'll find no copays for preventive, hearing, and vision services, as well as dental services and home health. The plan also covers ambulance services, emergency services, and primary care services. Other benefits include coverage for home infusion, dialysis, medical equipment, and diagnostic services with copays or coinsurance, depending on the service.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered. For Inpatient Hospital-Acute, you pay a $245 copay for days 1-10, and no copay for days 11-90; additional days, non-Medicare-covered stays, and upgrades are not covered. For Inpatient Hospital Psychiatric, you pay a $225 copay for days 1-8, and no copay for days 9-90; additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $350, Observation Services with a $245 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $0 and $40 for individual and group sessions, and Outpatient Blood Services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Blue adVantage Classic (HMO-POS) plan, but requires prior authorization. You will pay a $60 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Blue adVantage Classic (HMO-POS) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $250 copay, and air ambulance services have a $260 copay, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered under the Blue adVantage Classic (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, while Urgently Needed Services have a $40 copay; there is no coinsurance for any of these services. Worldwide Urgent Coverage and Worldwide Emergency Transportation are not covered.
Primary Care See details
Primary Care benefits include no copay for Primary Care Physician Services, a $20 copay for Chiropractic Services, and a $0-$35 copay for Occupational Therapy Services. Physician Specialist Services have a copay of $15-$30, while Mental Health Specialty Services have a copay that ranges from $0-$40 depending on the service. Other Health Care Professional services have a 20% coinsurance and a copay from $0-$30. Psychiatric Services and Opioid Treatment Program Services have a copay of $0-$40, while Physical Therapy and Speech-Language Pathology Services have a copay from $0-$35. Additional Telehealth Benefits have a copay from $0-$40. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services are covered by the Blue adVantage Classic (HMO-POS) plan, including Medicare-covered services, annual physical exams, and additional preventive services. Some additional preventive services like Health Education, In-Home Safety Assessments, Personal Emergency Response Systems, and others are not covered.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Routine hearing exams and fitting/evaluation for hearing aids have no copay, and prescription hearing aids have a plan-specified amount of $800 per year.
Vision Services See details
Vision services include eye exams with a copay of $15-$30, and eyewear with no copay. Routine eye exams, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are covered with no copay, with some limitations.
Dental Services See details
Dental services include coverage for Medicare dental services with no copay. Other dental services are covered, up to a maximum of $2200 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), implant services, and oral and maxillofacial surgery are covered with no copay. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. Medicare Part B Insulin Drugs have a $35 copay. Other Medicare Part B drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Blue adVantage Classic (HMO-POS) plan. This plan has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and no copay, Prosthetics/Medical Supplies with 20% coinsurance and no copay, and Diabetic Equipment. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for diagnostic procedures/tests with a copay between $0 and $30, lab services with no copay, diagnostic radiological services with a copay up to $250, therapeutic radiological services with a coinsurance of at least 20%, and outpatient X-ray services with a coinsurance of at least 0%. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the Blue adVantage Classic (HMO-POS) plan with no copay or coinsurance, though authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Blue adVantage Classic (HMO-POS) plan. Prior authorization is required for covered services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Blue adVantage Classic (HMO-POS) plan, requiring prior authorization. There is no copay for days 1-20, and a $165 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Blue adVantage Classic (HMO-POS) plan covers Over-the-Counter (OTC) Items but does not cover Acupuncture, Meal Benefit, or Dual Eligible SNPs with Highly Integrated Services. Additionally, the plan does not cover 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.
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