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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) plan has a 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. For Tier 2 generic medications, copays start at $12 for a one-month supply at preferred locations and rise to $16 at standard locations. For Tier 3 preferred brand drugs, you will pay a $45 copay for a one-month supply at preferred pharmacies and $47 at standard pharmacies. Higher-tier prescriptions require coinsurance instead of copays, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs requiring 29% coinsurance. Utilizing preferred pharmacies and preferred mail-order services helps maximize your savings on this plan.
Additional Benefits
The Blue adVantage Classic (HMO-POS) plan offers comprehensive medical coverage with predictable cost-sharing, featuring no copay and no coinsurance for primary care visits and routine preventive services. Specialist visits require a $25 copay, while emergency room visits incur a $125 copay, both with no coinsurance. For hospital care, inpatient acute stays require a $205 daily copay for days 1 to 10 with no coinsurance, while outpatient services range from no copay up to a $275 copay. This plan also includes supportive supplemental benefits, providing routine dental, vision, and hearing care with no copay and no coinsurance, including up to a $2,200 annual maximum for dental services. Skilled nursing facility care features no copay for the first 20 days followed by a $200 daily copay, while home health services require no copay and no coinsurance. Additionally, durable medical equipment and dialysis services are available with no copay and a 20% coinsurance.
Inpatient Hospital See details
Blue adVantage Classic (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $205 daily copay for days 1 to 10 of acute stays (no copay for days 11 to 90) and a $225 daily copay for days 1 to 8 of psychiatric stays (no copay for days 9 to 90). Prior authorization is required, and the benefit is partially covered as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Blue adVantage Classic (HMO-POS) covers outpatient hospital services with no coinsurance and copays ranging from $0 to $275, alongside a $205 daily copay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions incur a $40 copay and no coinsurance.
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 access this benefit.
Ambulance and Transportation Services See details
Blue adVantage Classic (HMO-POS) covers ground ambulance services with a $250 copay and air ambulance services with a $260 copay, with no coinsurance required and no copayment waiver if admitted to the hospital. Transportation services to plan-approved or health-related locations are not covered.
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, offering emergency coverage with a $125 copay and no coinsurance, while worldwide urgent care and emergency transportation are not covered.
Primary Care See details
Blue adVantage Classic (HMO-POS) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $25 copay and no coinsurance. Physical therapy, occupational therapy, and mental health services require copays of $35 to $40 with no coinsurance, while 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 all covered benefits, which include annual physical exams, kidney disease education, glaucoma screenings, diabetes self-management training, and memory fitness. However, the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional or dietary benefits, in-home support services, caregiver support, additional smoking and tobacco cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home and bathroom safety modifications, and counseling services.
Hearing Services See details
Blue adVantage Classic (HMO-POS) covers routine hearing exams, fittings, and OTC hearing aids with no deductible, no copay, and no coinsurance. For prescription hearing aids, some services are covered up to an $800 maximum every three years with no deductible, copay, or coinsurance, but inner ear, outer ear, and over the ear hearing aids 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 and no coinsurance, though other eye exam services are not covered. Medicare-covered eye exams require a $25 copay and no coinsurance, while eyewear is covered with no copay or coinsurance up to a $200 annual maximum.
Dental Services See details
Blue adVantage Classic (HMO-POS) partially covers dental services with no copay and no coinsurance up to a maximum annual benefit of $2,200. While preventive and comprehensive services like cleanings, exams, and implants are included, other preventive services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Blue adVantage Classic (HMO-POS) with no copay, though prior authorization is required. Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs range from no coinsurance 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 20% coinsurance, while diabetic equipment is covered with no copay or coinsurance. However, this benefit is only partially covered as diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Blue adVantage Classic (HMO-POS) covers diagnostic and radiological services with prior authorization, offering lab services, diagnostic radiology, and X-rays with no copays and no coinsurance. Outpatient diagnostic procedures and tests require a copay of up to $30 with no coinsurance, while therapeutic radiological services require 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, specific programs including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
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 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, though additional days beyond the Medicare-covered limit are not covered.
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. However, acupuncture, meal benefits, and nicotine replacement therapy are not covered.
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