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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 2026, 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 4 out of 5 stars in 2026.
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.
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 $300.00 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 $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) Medicare prescription drug plan features an annual drug deductible of $300. Under this plan, you will pay no copay for Tier 1 preferred generic drugs when using a preferred pharmacy or preferred mail-order service, while standard pharmacies charge an $8 copay for a one-month supply. Tier 2 generic medications cost a $12 copay at preferred pharmacies and a $16 copay at standard pharmacies for a one-month supply. For Tier 3 preferred brand drugs, the copay is $45 at preferred pharmacies and $47 at standard pharmacies for a one-month fill. Higher-tier prescriptions require coinsurance rather than flat copays, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs requiring a 29% coinsurance for a one-month supply. These structured costs help you estimate your out-of-pocket expenses when choosing between preferred and standard pharmacy options.
Additional Benefits
The Blue adVantage Classic (HMO-POS) plan offers robust medical coverage with no copay and no coinsurance for primary care visits, preventive screenings, and home health services. Specialist consultations, urgent care, and emergency room visits are covered with flat copayments and no coinsurance. Inpatient hospital stays require daily copays for the first several days with no coinsurance, while outpatient services range from no copay to variable copays depending on the procedure. Supplemental benefits include dental, vision, and hearing care, which offer routine exams, eyewear, and select services with no copay or coinsurance up to specified plan maximums. Standard diagnostic lab work and over-the-counter items also feature no copay, though services like dialysis and durable medical equipment require a twenty percent coinsurance. Overall, this plan minimizes out-of-pocket surprise costs by eliminating coinsurance for most routine, preventive, and specialty care.
Inpatient Hospital See details
Blue adVantage Classic (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $245 daily copay for days 1 to 10 of acute stays and a $225 daily copay for days 1 to 8 of psychiatric stays, with no copay for subsequent days up to day 90. Prior authorization is required, and additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient services are covered under the Blue adVantage Classic (HMO-POS) plan with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require prior authorization with a copay of $0 to $350, while observation services cost a $245 copay per day and outpatient substance abuse sessions have a $20 to $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered under the Blue adVantage Classic (HMO-POS) plan with a $60.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Blue adVantage Classic (HMO-POS), offering ground ambulance with a $250 copay and air ambulance with a $260 copay, both with no coinsurance. For transportation, some services are covered but transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by Blue adVantage Classic (HMO-POS) for a $125 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 72 hours. Urgently needed services are covered with a $40 copay and no coinsurance, while worldwide emergency services are partially covered with a $125 copay and no coinsurance, excluding worldwide urgent coverage and worldwide emergency transportation.
Primary Care See details
Blue adVantage Classic (HMO-POS) covers primary care physician services with no copay and no coinsurance, while specialists, therapies, and mental health services require copays from $15 to $40 and no coinsurance. Other healthcare professionals require a 20% coinsurance with a $0 to $30 copay, whereas podiatry is not covered, and for chiropractic services, some services are covered but routine and other chiropractic care are not.
Preventive Services See details
Blue adVantage Classic (HMO-POS) offers preventive services, including annual physical exams, kidney disease education, and select screenings, with no copay and no coinsurance. Additional preventive benefits are only partially covered; services such as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, home safety modifications, and counseling are not covered.
Hearing Services See details
Blue adVantage Classic (HMO-POS) covers routine hearing exams and OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to an $800 maximum every three years, though inner ear, outer ear, and over-the-ear types are not covered.
Vision Services See details
Vision services are partially covered by Blue adVantage Classic (HMO-POS), featuring routine eye exams with no copay or coinsurance, though other eye exam services are not covered and general eye exams require a $20 to $30 copay with no coinsurance. Eyewear is covered with no copay or coinsurance up to a $200 annual maximum for contact lenses, eyeglasses, and upgrades.
Dental Services See details
Blue adVantage Classic (HMO-POS) offers partially covered dental services with no copay and no coinsurance up to a $2,200 yearly maximum. While most preventive, diagnostic, and comprehensive services are included, other preventive services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Blue adVantage Classic (HMO-POS) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this benefit, Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and 0% to 20% coinsurance.
Dialysis Services See details
Blue adVantage Classic (HMO-POS) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Blue adVantage Classic (HMO-POS) covers durable medical equipment and prosthetics or medical supplies with no copay and 20% coinsurance. Diabetic equipment is partially covered with no copay and no coinsurance, but diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Blue adVantage Classic (HMO-POS) covers diagnostic services with no coinsurance, requiring no copay for lab work and a $0 to $30 copay for diagnostic tests. Covered radiological services require prior authorization and feature no coinsurance for outpatient X-rays, a minimum 20% coinsurance plus a copay for therapeutic radiology, and a $0 minimum copay with coinsurance for diagnostic radiology.
Home Health Services See details
Home health services are covered by Blue adVantage Classic (HMO-POS) with no copay and no coinsurance. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Blue adVantage Classic (HMO-POS) with no coinsurance, though prior authorization is required and only some services are covered. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Blue adVantage Classic (HMO-POS) with no coinsurance, requiring prior authorization and a three-day prior inpatient hospital stay. There is no copay for days 1 through 20, followed by a $200 daily copay for days 21 through 100, with no coverage for additional days beyond the Medicare-covered limit.
Other Services See details
Blue adVantage Classic (HMO-POS) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, nicotine replacement therapy, and naloxone are not covered under this benefit.
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