A non-government entity
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:
Sign up for Blue adVantage Classic (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Blue adVantage Classic (HMO-POS) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for generic drugs, and coinsurance for brand-name and non-preferred drugs, which varies 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 covered drugs. If you qualify for the low-income subsidy, your Part D costs will be $0.
Additional Benefits
The Blue adVantage Classic (HMO-POS) plan offers a variety of benefits with varying costs. For inpatient hospital stays, you'll pay a copay, and outpatient services have copays depending on the service. Emergency services and primary care visits have copays, and the plan also covers preventive, hearing, vision, and dental services, often with no copay. Additional benefits include ambulance services with copays, and coverage for home infusion, dialysis, and medical equipment with coinsurance. The plan also covers diagnostic and radiological services, and skilled nursing facility stays. Some services, such as cardiac rehabilitation, and certain other services, are not covered.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you pay a $205 copay for days 1-10, and no copay for days 11-90; Inpatient Hospital Psychiatric has a $225 copay for days 1-8, and no copay for days 9-90. Additional days, non-Medicare stays, and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay between $0 and $275, observation services with a $205 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services, including individual and group sessions, have a $40 copay, and outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Blue adVantage Classic (HMO-POS) plan, but requires prior authorization. There is a $60 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Blue adVantage Classic (HMO-POS) plan. Ground Ambulance Services have a $250 copay, while Air Ambulance Services have a $260 copay, and there is no coinsurance for either service. 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 by the Blue adVantage Classic (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay and no coinsurance, while Urgently Needed Services have a $40 copay and no coinsurance. Worldwide Urgent Coverage and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Blue adVantage Classic (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $35 copay, and physician specialist services with a $25 copay. Mental health specialty services, including individual and group sessions, have a $40 copay. Other health care professional services have a copay between $0 and $25, with a 20% coinsurance. Physical therapy and speech-language pathology services have a $35 copay, and additional telehealth benefits have a copay between $0 and $40. Opioid treatment program services have a $40 copay. Podiatry services are not covered.
Preventive Services See details
The Blue adVantage Classic (HMO-POS) plan covers preventive services including Medicare-covered services and annual physical exams. Other services like Health Education, In-Home Safety Assessment, and several others are not covered.
Hearing Services See details
Hearing Services includes hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. The plan also covers prescription hearing aids with a maximum plan benefit coverage of $800 per year, and OTC hearing aids with no copay.
Vision Services See details
Vision services include eye exams with a $25 copay, and routine eye exams with no copay. Eyewear is covered with no copay, and includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades; there is a combined maximum of $400 per year for all eyewear.
Dental Services See details
Dental services are covered, including 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 with no copay. Maxillofacial prosthetics and orthodontics are not covered, and there is a $2,200 annual maximum benefit.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered under the Blue adVantage Classic (HMO-POS) plan. The plan has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical equipment is covered by the Blue adVantage Classic (HMO-POS) plan. Durable Medical Equipment (DME) has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Equipment is covered but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $30, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $250, while Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of up to 20%.
Home Health Services See details
Home Health Services are covered by the Blue adVantage Classic (HMO-POS) plan with no copay and no coinsurance, but 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. 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 Blue adVantage Classic (HMO-POS) plan, but require 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 stays for SNF are not covered.
Other Services See details
Other Services benefits are partially covered. Acupuncture, Meal Benefit, 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. Over-the-Counter (OTC) Items are covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved