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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. For Tier 1 preferred generic drugs, members pay no copay when using preferred pharmacies or preferred mail-order services, while standard pharmacies and mail order charge an $8 copay for a one-month supply. Tier 2 generic drugs cost a $12 copay at preferred locations and a $16 copay at standard locations for a one-month fill. For Tier 3 preferred brand drugs, the one-month copay is $45 at preferred pharmacies and $47 at standard pharmacies. Tier 4 non-preferred drugs require a 50% coinsurance across all pharmacy and mail-order options. Finally, Tier 5 specialty drugs incur a 29% coinsurance for a one-month supply at both preferred and standard pharmacies.
Additional Benefits
The Blue adVantage Classic (HMO-POS) plan offers comprehensive medical coverage featuring no copay for primary care visits, preventive services, and home health care. Specialist visits require a $30 copay, while inpatient hospital stays incur a daily copay of $245 for the first ten days with no coinsurance. Emergency care is available with a $125 copay, which is waived if you are admitted, and ambulance services require a flat copay with no coinsurance. This plan also includes strong dental, vision, and hearing benefits, highlighted by no copays for covered dental care up to $2,200 annually and routine eye and hearing exams. Covered eyewear and prescription hearing aids are also available up to specified allowance limits with no copay. Additionally, durable medical equipment and dialysis services require no copay and a 20% coinsurance, while diabetic equipment is covered with no copay or coinsurance.
Inpatient Hospital See details
Blue adVantage Classic (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a daily copay of $245 for days 1-10 of acute stays and $225 for days 1-8 of psychiatric stays, followed by no copay for the remaining covered days. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Blue adVantage Classic (HMO-POS) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay ranging from $0 to $350, observation services have a $245 daily copay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Blue adVantage Classic (HMO-POS) covers partial hospitalization services with a $60.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services are covered by Blue adVantage Classic (HMO-POS) with a $250 copay for ground transport and a $260 copay for air transport, with no coinsurance for either service. Transportation services are not covered under this plan.
Emergency Services See details
Blue adVantage Classic (HMO-POS) covers emergency services with a $125 copay and no coinsurance, which is waived if admitted to the hospital within 72 hours, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency services are partially covered with a $125 copay and no coinsurance for emergency care, while worldwide urgent care and worldwide emergency transportation are not covered.
Primary Care See details
Blue adVantage Classic (HMO-POS) offers primary care physician services with no copay and no coinsurance, while specialist visits require a $30 copay and no coinsurance. Physical, occupational, and speech therapy services are covered with a $35 copay and no coinsurance, but podiatry and routine chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Blue adVantage Classic (HMO-POS) with no copay and no coinsurance for covered options like annual exams, kidney disease education, and home-based palliative care. Excluded services include health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Hearing services are covered by Blue adVantage Classic (HMO-POS) with no copay and no coinsurance for routine exams, fitting evaluations, and OTC hearing aids. Prescription hearing aids are partially covered with no copay or coinsurance up to an $800 maximum every three years, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Blue adVantage Classic (HMO-POS) partially covers vision services with no coinsurance or deductibles, offering one routine eye exam per year with no copay and other covered eye exams for a $30 copay, while other eye exam services are not covered. Covered eyewear, including contacts, frames, and lenses, features no copay and no coinsurance up to a $200 annual maximum benefit.
Dental Services See details
Dental services are partially covered by Blue adVantage Classic (HMO-POS) with no copay and no coinsurance up to a maximum annual benefit of $2,200. Covered care includes preventive and comprehensive services like cleanings, exams, and implants, though 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, although prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Blue adVantage Classic (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Blue adVantage Classic (HMO-POS) covers durable medical equipment and prosthetics with no copay and a 20% coinsurance. Diabetic equipment is also covered with no copay and no coinsurance, though diabetic supplies and therapeutic shoes or inserts are not covered under this plan.
Diagnostic and Radiological Services See details
Blue adVantage Classic (HMO-POS) covers diagnostic and radiological services with prior authorization, offering lab services and outpatient X-rays with no copays or coinsurance. Diagnostic tests and procedures have no coinsurance and a $0 to $30 copay, while diagnostic radiological services have no copay (coinsurance applies) and therapeutic radiological services require both a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Blue adVantage Classic (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Blue adVantage Classic (HMO-POS) with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for peripheral artery disease ($10 copay) are not covered in practice.
Skilled Nursing Facility (SNF) See details
Blue adVantage Classic (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and a prior three-day 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.
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, while acupuncture and meal benefits are not covered.
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