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Blue adVantage Reliance (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue adVantage Reliance (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 Reliance (HMO-POS) in 2026, please refer to our full plan details page.
Blue adVantage Reliance (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 Reliance (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 Reliance (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 Reliance (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.90. 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 $4100.00 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 Reliance (HMO-POS) Medicare plan features a $300 annual drug deductible and offers affordable options for prescription drug coverage. For Tier 1 preferred generics, there is no copay when using preferred pharmacies or preferred mail-order services, while standard locations charge a $5 copay for a one-month supply. Tier 2 generic medications cost a $12 copay for a one-month supply at preferred pharmacies and a $14 copay at standard pharmacies. Tier 3 preferred brand drugs require a $45 copay for a one-month supply at preferred locations and a $47 copay at standard locations. For higher-tier prescriptions, Tier 4 non-preferred drugs carry a 50% coinsurance, and Tier 5 specialty drugs require a 29% coinsurance for a one-month supply across all pharmacy and mail-order options.
Additional Benefits
The Blue adVantage Reliance (HMO-POS) plan offers comprehensive coverage with many everyday healthcare services featuring no copay and no coinsurance. Members benefit from no copays for primary care visits, preventive care, home health services, and routine dental, vision, and hearing exams. The plan also includes valuable allowances, such as up to $1,000 annually for covered dental services and up to $200 annually for eyewear, all with no copays or coinsurance. For specialized medical needs, specialist visits require a copay of $20 to $30, while emergency room visits have a $125 copay and no coinsurance. Inpatient hospital stays and skilled nursing facility admissions are covered with set daily copays and no coinsurance. Additionally, services like dialysis and durable medical equipment require a 20% coinsurance with no copay.
Inpatient Hospital See details
Blue adVantage Reliance (HMO-POS) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute stays require a $205 daily copay for days 1 to 10 and no copay for days 11 to 90, while psychiatric stays require a $225 daily copay for days 1 to 8 and no copay for days 9 to 90; upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Blue adVantage Reliance (HMO-POS) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services which also feature no copays. Outpatient hospital services require a copay of $0 to $250, observation services have a $205 daily copay, and outpatient substance abuse sessions have a copay of $15 to $30, with prior authorization required for most services.
Partial Hospitalization See details
Blue adVantage Reliance (HMO-POS) covers partial hospitalization services with a $60.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Blue adVantage Reliance (HMO-POS) covers ground ambulance services with a $250 copay and air ambulance services with a $260 copay, both with no coinsurance. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Blue adVantage Reliance (HMO-POS) covers emergency services with a $125 copay (waived if admitted to the hospital within 72 hours) and no coinsurance, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency coverage is partially covered with a $125 copay and no coinsurance, though worldwide urgent care and worldwide emergency transportation are not covered.
Primary Care See details
Blue adVantage Reliance (HMO-POS) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $20 to $30 copay and no coinsurance. Chiropractic services are partially covered with a $20 copay and no coinsurance, though routine and other chiropractic services are not covered, while podiatry services are not covered.
Preventive Services See details
Blue adVantage Reliance (HMO-POS) provides preventive services with no copay and no coinsurance, though the benefit is only partially covered. Uncovered sub-services include health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional or dietary benefits, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, home safety devices, and counseling.
Hearing Services See details
Blue adVantage Reliance (HMO-POS) covers routine hearing exams, fitting evaluations, and over-the-counter hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered up to an $800 maximum every three years with no copay and no coinsurance, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Blue adVantage Reliance (HMO-POS) partially covers vision services, offering routine annual eye exams and eyewear with no copay and no coinsurance, up to a $200 annual maximum. Other covered eye exams require prior authorization and have a $20 to $30 copay and no coinsurance, while "other" eye exam services are not covered.
Dental Services See details
Dental services are partially covered by Blue adVantage Reliance (HMO-POS) with no copay and no coinsurance up to a $1,000 annual maximum. Covered care includes exams, cleanings, x-rays, fluoride, restorative services, endodontics, periodontics, prosthodontics, implants, and oral surgery, while other preventive services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Blue adVantage Reliance (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization and step therapy. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Dialysis Services are covered by Blue adVantage Reliance (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
Blue adVantage Reliance (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance, subject to prior authorization. Diabetic equipment is covered with no copay and no coinsurance, but diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Blue adVantage Reliance (HMO-POS) plan, with prior authorization required for all services. Lab services feature no copay or coinsurance, diagnostic tests have a $0 to $30 copay with no coinsurance, and therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Blue adVantage Reliance (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 Reliance (HMO-POS) with no coinsurance, though prior authorization is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Blue adVantage Reliance (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $200 copay for days 21 through 100. Prior authorization and a three-day inpatient hospital stay are required before admission, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Blue adVantage Reliance (HMO-POS), featuring over-the-counter (OTC) items with no copay and no coinsurance, though acupuncture and meal benefits are not covered.
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