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 or coinsurance depending on the drug tier and pharmacy you use. For example, preferred generic drugs have a $12 copay at a preferred pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs. If you qualify for the low-income subsidy, your costs may be reduced.
Additional Benefits
The Blue adVantage Classic (HMO-POS) plan offers a wide range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services may have a copay depending on the service. Emergency services and primary care visits have copays, while preventive services and home health services have no copay. The plan also covers hearing, vision, and dental services with specific copays or maximum benefits. Diagnostic, radiological, and dialysis services have coinsurance, and ambulance services have copays. There are also services like partial hospitalization and skilled nursing facilities that have copays, and home infusion services that have a copay and coinsurance.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, you will pay a $225 copay for days 1-10, and no copay for days 11-90. For Inpatient Hospital Psychiatric, you will pay a $225 copay for days 1-8, and no copay for days 9-90. Additional days, non-Medicare-covered stays, and upgrades for both are not covered.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $225, observation services have a $225 copay, ambulatory surgical center services have no copay, and outpatient substance abuse services have a $40 copay for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the Blue adVantage Classic (HMO-POS) plan, but requires prior authorization. The copay for this benefit is $60.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Blue adVantage Classic (HMO-POS) plan. Medicare-covered ground ambulance services have a $250 copay, and air ambulance services have a $260 copay, while 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 have a $125 copay, Urgently Needed Services have a $40 copay, and Worldwide Emergency Coverage has a $125 copay; all three services have no coinsurance. Worldwide Urgent Coverage and Worldwide Emergency Transportation are not covered.
Primary Care See details
Primary Care Physician Services have no copay, while Chiropractic Services have a $20 copay, but routine care is not covered. Occupational Therapy Services have a $35 copay, and Physician Specialist Services have a $45 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 $45, and a 20% coinsurance. Psychiatric Services, including individual and group sessions, have a $40 copay. Physical Therapy and Speech-Language Pathology Services have a $35 copay. Additional Telehealth Benefits have a copay between $0 and $45, and Opioid Treatment Program Services have a $40 copay.
Preventive Services See details
Preventive Services, including Medicare-covered services, Annual Physical Exams, and Kidney Disease Education Services are covered. Additional preventive services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 and OTC hearing aids have no copay, while prescription hearing aids have a maximum benefit of $800 per year.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a $45 copay, while routine eye exams have no copay. Eyewear, including contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades, are covered with no copay and a combined maximum benefit of $400 per year.
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, all with no copay. Maxillofacial Prosthetics and Orthodontics are not covered, and there is a $2,200 annual maximum for other dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 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 are covered by the Blue adVantage Classic (HMO-POS) plan, including Durable Medical Equipment (DME) with 20% coinsurance and no copay, and Prosthetics/Medical Supplies with 20% coinsurance and no copay. However, Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay between $0 and $30, and Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $250, while Therapeutic Radiological Services and Outpatient X-Ray Services have a 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, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services, including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for these 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. For days 1-20, there is no copay, and for days 21-100, the copay is $165 per day; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items, but Acupuncture, Meal Benefit, and Dual Eligible SNPs with Highly Integrated Services are not covered. Additional services such as 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 also not 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