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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 has an annual drug deductible of $300. For Tier 1 preferred generics, you pay no copay at preferred pharmacies or through preferred mail order, while standard options 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 mail order, or $14 at standard pharmacies. Tier 3 preferred brand drugs require a $45 copay for a one-month supply at preferred pharmacies and $47 at standard locations. For Tier 4 non-preferred drugs, you will pay 50% coinsurance regardless of the pharmacy type or supply duration. Tier 5 specialty drugs require a 29% coinsurance for a one-month supply at both preferred and standard pharmacies or mail order.
Additional Benefits
The Blue adVantage Reliance (HMO-POS) plan offers comprehensive medical coverage with predictable out-of-pocket costs and no coinsurance for many key services. Members enjoy no copay for primary care physician visits, while specialist visits require a $30 copay and emergency room care has a $125 copay. For inpatient hospital stays, there is a $205 daily copay for the first 10 days and no copay for days 11 through 90. This plan also features robust supplemental benefits, including preventive care, routine vision exams, and dental services with no copay. Dental care is covered up to a $1,000 annual maximum, eyewear includes a $200 annual allowance, and routine hearing exams are fully covered. For specialized needs, home health services require no copay, while durable medical equipment and dialysis services carry a 20% coinsurance.
Inpatient Hospital See details
Blue adVantage Reliance (HMO-POS) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute stays, you will pay a $205 daily copay for days 1 through 10 and no copay for days 11 through 90, while psychiatric stays require a $225 daily copay for days 1 through 8 and no copay for days 9 through 90; additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Blue adVantage Reliance (HMO-POS) covers outpatient hospital services with no coinsurance and copays ranging from $0 to $250, while outpatient observation services carry a $205 daily copay. Ambulatory surgical center and outpatient blood services are covered with no copay or coinsurance, and outpatient substance abuse sessions require a $30 copay with no coinsurance.
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
Ambulance services are covered by Blue adVantage Reliance (HMO-POS) with a $250 copay for ground transport and a $260 copay for air transport, with no coinsurance for either. For transportation services, some services are covered but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Blue adVantage Reliance (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 Reliance (HMO-POS) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $30 copay and no coinsurance. Physical, occupational, and speech therapies have a $35 copay and no coinsurance, mental health and psychiatric sessions require a $30 copay and no coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by Blue adVantage Reliance (HMO-POS) with no copay and no coinsurance for annual physical exams, kidney disease education, and routine screenings. However, additional preventive benefits are only partially covered, as the plan excludes health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs for chemotherapy-related hair loss, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home and bathroom safety devices, and counseling services.
Hearing Services See details
Hearing services are covered by Blue adVantage Reliance (HMO-POS) with no copay and no coinsurance for routine hearing exams, fitting evaluations, and OTC hearing aids. 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 Reliance (HMO-POS) partially covers vision services with no deductible and no coinsurance, as other eye exam services are not covered. Routine eye exams and eyewear are covered with no copay, including a $200 annual maximum for eyewear, while other covered eye exams require a $30 copay.
Dental Services See details
Blue adVantage Reliance (HMO-POS) partially covers dental services with no copay and no coinsurance up to a maximum annual benefit of $1,000. Non-covered services include other preventive dental services, maxillofacial prosthetics, and orthodontics.
Home Infusion bundled Services See details
Blue adVantage Reliance (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Blue adVantage Reliance (HMO-POS) plan 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. For diabetic equipment, some services are covered with no copay and no coinsurance, but diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Blue adVantage Reliance (HMO-POS) with prior authorization, featuring no copay or coinsurance for lab services and a $0 to $30 copay with no coinsurance for diagnostic tests. Outpatient x-rays require no coinsurance, diagnostic radiological services feature no copay but require coinsurance, and therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Blue adVantage Reliance (HMO-POS) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Blue adVantage Reliance (HMO-POS) covers Cardiac Rehabilitation Services with no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation 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 per day for days 21 through 100. Prior authorization and a prior three-day inpatient hospital stay are required for admission, and additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Other services are partially covered by Blue adVantage Reliance (HMO-POS), which features Over-the-Counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, Nicotine Replacement Therapy (NRT), and Naloxone are not covered.
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