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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 a $300 annual drug deductible and offers affordable cost-sharing options during the initial coverage phase. For Tier 1 preferred generic drugs, you will pay no copay when using preferred pharmacies or preferred mail-order services, while standard services cost $8 for a one-month supply. Tier 2 generic medications are available for a $12 copay at preferred locations and a $16 copay at standard locations. For brand-name and specialty medications, Tier 3 preferred brand drugs require a $45 copay at preferred pharmacies and a $47 copay at standard pharmacies. Tier 4 non-preferred drugs are subject to a 50% coinsurance across all pharmacy and mail-order options. Specialty drugs in Tier 5 require 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 with no copays or coinsurance for primary care doctor visits, preventive services, home health care, and routine hearing exams. For hospital care, inpatient stays require a $225 daily copay for the first 10 days with no coinsurance, while specialist visits require a $45 copay. Emergency room services carry a $125 copay, which is waived if you are admitted, and urgent care visits require a $40 copay. This plan also features strong dental and vision benefits, including no copays or coinsurance for dental care up to a $2,200 annual limit and a $200 annual allowance for eyewear. Skilled nursing facility stays require no copay for the first 20 days, and over-the-counter items are also covered with no copay. For medical equipment and dialysis services, members will pay no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Blue adVantage Classic (HMO-POS) with no coinsurance, requiring a $225 daily copay for days 1-10 of acute stays (no copay for days 11-90) and days 1-8 of psychiatric stays (no copay for days 9-90). Prior authorization is required, but additional hospital days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Blue adVantage Classic (HMO-POS) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $225, observation services carry a $225 daily copay, and outpatient substance abuse sessions have a $40 copay, with prior authorization required for most of these benefits.
Partial Hospitalization See details
Blue adVantage Classic (HMO-POS) covers partial hospitalization services 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 ambulance services with no coinsurance, requiring a $250 copay for ground ambulance services and a $260 copay for air ambulance services, while transportation services 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 you are 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, but worldwide urgent coverage 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, and specialist visits with a $45 copay and no coinsurance. Physical, occupational, and speech therapy services require a $35 copay and no coinsurance, while podiatry is not covered and chiropractic services are not covered in practice because routine and other chiropractic services are excluded.
Preventive Services See details
Preventive services are partially covered by Blue adVantage Classic (HMO-POS) with no copay and no coinsurance for covered benefits like annual physical exams, kidney disease education, and glaucoma screenings. While memory fitness and home-based palliative care are covered, several additional services are not, including health education, weight management, personal emergency response systems, and in-home safety assessments.
Hearing Services See details
Blue adVantage Classic (HMO-POS) covers routine hearing exams and OTC 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 every three years, though inner ear, outer ear, and over the ear prescription devices are not covered.
Vision Services See details
Vision services are partially covered under the Blue adVantage Classic (HMO-POS) plan, as other eye exam services are not covered. Routine eye exams have no copay (one per year), other covered eye exams have a $45 copay, and eyewear is covered with no copay up to a $200 annual limit, all with no deductibles or coinsurance.
Dental Services See details
Blue adVantage Classic (HMO-POS) dental services are partially covered with no copay and no coinsurance up to an annual maximum of $2,200. Covered benefits include 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, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, 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
Blue adVantage Classic (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 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
Diagnostic and radiological services are covered by Blue adVantage Classic (HMO-POS) with prior authorization required. Lab services and outpatient X-rays have no copay and no coinsurance, diagnostic tests carry a $0 to $30 copay with no coinsurance, and therapeutic radiological services require both a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Blue adVantage Classic (HMO-POS) 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 coinsurance and require prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Blue adVantage Classic (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, though prior authorization and a three-day inpatient hospital stay are required. 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 beyond the standard Medicare limit.
Other Services See details
Blue adVantage Classic (HMO-POS) provides partial coverage for other services, offering 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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