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.
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 no drug deductible. Your prescription medication coverage will start immediately.
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:
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, such as $12.00-$16.00, depending on the pharmacy. For brand name drugs, you'll pay 50% coinsurance, and 33% coinsurance for non-preferred drugs. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs. This plan's premium may be reduced if you qualify for the low-income subsidy.
Additional Benefits
The Blue adVantage Classic (HMO-POS) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a $155 copay for days 1-10, and then no copay for days 11-90. Outpatient services have copays from $0 to $250, and primary care visits are free. Preventive, vision, and dental services are covered, with no copays for many services. Hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and OTC hearing aids have no copay, and prescription hearing aids are covered up to $800 per year. The plan covers a wide array of dental services with no copay, up to a $2,200 annual maximum. Additional benefits include ambulance services, emergency care, and home health services.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered under the Blue adVantage Classic (HMO-POS) plan. For days 1-10, there is a $155 copay, and for days 11-90, there is no copay. Additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services for the Blue adVantage Classic (HMO-POS) plan includes coverage for all outpatient hospital services and observation services, with copays ranging from $0 to $250 and $155, respectively. Ambulatory Surgical Center (ASC) Services have no copay, and outpatient substance abuse services have a $40 copay for both individual and group sessions. 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. You will have a $60 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Blue adVantage Classic (HMO-POS) plan. Ground Ambulance Services have a $250 copay, and Air Ambulance Services have a $260 copay, with no coinsurance for either. 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 under the Blue adVantage Classic (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, while Urgently Needed Services have a $40 copay, and there is no coinsurance for any of these services. 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, and chiropractic services with a $20 copay. Occupational therapy services have a $35 copay, and physician specialist services have a $35 copay. Mental health and psychiatric services have a $40 copay for individual and group sessions. Other health care professional services have a $0-$35 copay with 20% coinsurance. Physical therapy and speech-language pathology services have a $35 copay, and additional telehealth benefits have a $0-$40 copay. Opioid treatment program services have a $40 copay.
Preventive Services See details
Preventive Services are covered, including Medicare-covered services with no copay. Additional services like Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), and others are not covered.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and OTC hearing aids have no copay. Prescription hearing aids are covered up to a maximum of $800 per year, and prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams have a $35 copay, and routine eye exams are covered with no copay. Eyewear benefits are covered with no copay, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Dental Services are covered under the Blue adVantage Classic (HMO-POS) plan, with a $2,200 maximum benefit each year. You will have no copay for Oral Exams (up to 2 per year), Dental X-Rays (1 per year), Other Diagnostic Dental Services (1 per year), Prophylaxis (Cleaning) (2 per year), Fluoride Treatment (2 per year), Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Implant Services, Prosthodontics (fixed), and Oral and Maxillofacial Surgery. Maxillofacial Prosthetics and Orthodontics are not covered, and Orthodontic services are covered under Diagnostic and Preventive Dental.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Blue adVantage Classic (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and no copay, Prosthetics/Medical Supplies with coinsurance and no copay, and Diabetic Equipment with limited manufacturers, but some services like Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. Prior authorization is required for this benefit.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures and tests, are covered by the Blue adVantage Classic (HMO-POS) plan, with copays ranging from $0 to $30. Lab services have no copay, while diagnostic radiological services have a copay of at most $250, and therapeutic radiological services and outpatient X-ray services have coinsurance of at most 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, though authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the specific Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Blue adVantage Classic (HMO-POS) plan, but prior authorization is required. You will pay no copay for days 1-20, and a $165 copay per day for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Blue adVantage Classic (HMO-POS) plan's Other Services benefit covers over-the-counter (OTC) items, but does not cover acupuncture, meal benefits, or dual eligible SNPs with highly integrated services. The plan also does not cover 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, or Self-Directed Personal Assistance Services.
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