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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 $5900.00 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 plan features an annual drug deductible of $300. For prescription coverage, Tier 1 preferred generic drugs have no copay when filled at a preferred pharmacy or through preferred mail order, while standard pharmacies charge an $8 copay for a one-month supply. Tier 2 generic drugs are also affordable, costing a $12 copay for a one-month supply at preferred locations. Tier 3 preferred brand drugs require a $45 copay for a one-month supply at preferred pharmacies, compared to $47 at standard pharmacies. For higher-tier medications, Tier 4 non-preferred drugs carry a 50% coinsurance, while Tier 5 specialty drugs require a 29% coinsurance for a one-month supply. Choosing preferred pharmacies and mail-order services with this plan is an effective way to minimize your out-of-pocket prescription costs.
Additional Benefits
The Blue adVantage Classic (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. For specialist visits, urgent care, and outpatient services, copays range from no copay up to $250, while inpatient hospital stays require daily copays for the first ten days with no coinsurance. Emergency services are available with a $125 copay, which is waived if you are admitted to the hospital. This plan also features robust supplemental benefits, including dental, routine vision, and hearing services with no copay or coinsurance, subject to specific annual and multi-year allowance limits. Diagnostic lab work and X-rays are covered with no copay, while durable medical equipment and dialysis services require a 20% coinsurance. Additionally, members can access over-the-counter items and select prescription hearing aids with no copay or coinsurance.
Inpatient Hospital See details
Blue adVantage Classic (HMO-POS) covers inpatient acute and psychiatric hospital services with no coinsurance, requiring a $195 daily copay for days 1 to 10 of acute care and a $155 daily copay for days 1 to 10 of psychiatric care, followed by no copay for days 11 to 90. This benefit is partially covered, as 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, including outpatient hospital services with a $0 to $250 copay and observation services with a $195 daily copay. Ambulatory surgical center and blood services are fully covered with no copay and no coinsurance, while outpatient substance abuse individual and group sessions require a $40 copay.
Partial Hospitalization See details
Blue adVantage Classic (HMO-POS) covers partial hospitalization services with a $60 copay and no coinsurance. Prior authorization is required to receive 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 for either service. Some transportation services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Blue adVantage Classic (HMO-POS) covers emergency services with a $125 copay—which is waived if admitted to the hospital within 72 hours—and no coinsurance, while urgently needed services require a $40 copay with no coinsurance. Worldwide emergency services are partially covered with a $125 copay and no coinsurance, but worldwide urgent coverage and worldwide 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 $40 copay and no coinsurance. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, other health care professionals require a $0 to $40 copay and 20% coinsurance, while podiatry and routine chiropractic services are not covered.
Preventive Services See details
Blue adVantage Classic (HMO-POS) covers preventive services, including annual physical exams, kidney disease education, and select screenings, with no copay and no coinsurance. Additional preventive services are partially covered with no copay and no coinsurance, but do not include 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 modifications, and counseling.
Hearing Services See details
Blue adVantage Classic (HMO-POS) covers routine hearing exams and over-the-counter 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 limit 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, as other eye exam services are not covered. Routine eye exams and eyewear (including contacts and eyeglasses) have no copay, subject to a $200 annual eyewear limit, while other covered eye exams require a $40 copay.
Dental Services See details
Blue adVantage Classic (HMO-POS) dental services are partially covered with no copay and no coinsurance up to a maximum benefit of $2,200 per year. Covered services include cleanings, exams, and restorative care, while other preventive dental 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 is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while Medicare Part B chemotherapy and other Part B drugs require 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
Medical equipment benefits are covered by Blue adVantage Classic (HMO-POS) with prior authorization, offering durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance. Diabetic equipment is partially covered with no copay and no coinsurance, though diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Blue adVantage Classic (HMO-POS) diagnostic and radiological services are covered and require prior authorization. Lab services and outpatient X-rays feature no copay and no coinsurance, diagnostic procedures have a copay between $0 and $30 with no coinsurance, and therapeutic radiological services require a 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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Blue adVantage Classic (HMO-POS) covers Cardiac Rehabilitation Services with no coinsurance, though prior authorization is required. While some services are covered, cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for symptomatic 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 three-day inpatient hospital stay before admission. 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 standard Medicare limit are not covered.
Other Services See details
Other Services are partially covered by Blue adVantage Classic (HMO-POS), which provides 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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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.
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