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Blue adVantage Dual Plus (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue adVantage Dual Plus (HMO-POS D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Blue adVantage Dual Plus (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
Blue adVantage Dual Plus (HMO-POS D-SNP) is a HMO-POS D-SNP 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 Dual Plus (HMO-POS D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Blue adVantage Dual Plus (HMO-POS D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Blue adVantage Dual Plus (HMO-POS D-SNP).
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 Dual Plus (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $18.20. 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 $615.00 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 $9250.00 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 Dual Plus (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are fully covered with no copay for both standard retail pharmacies and standard mail order services. This ensures that many common, essential medications remain highly affordable for enrolled members. For other drug categories, costs are shared through coinsurance rather than set copays. Members pay a 25% coinsurance for Tier 2 generic, Tier 3 preferred brand, and Tier 5 specialty drugs, while Tier 4 non-preferred drugs require a 27% coinsurance. These standard pharmacy and mail order rates apply to multi-month supplies, except for specialty drugs which are limited to a 1-month supply.
Additional Benefits
The Blue adVantage Dual Plus (HMO-POS D-SNP) offers comprehensive healthcare coverage where many core medical services, including primary care, outpatient care, emergency visits, and medical equipment, require no copay and a 20% coinsurance. Additionally, essential services like home health care, skilled nursing facility stays, and annual physical exams are covered with no copay and no coinsurance. This plan also features robust supplemental benefits, including up to $4,000 in annual dental coverage for most preventive and comprehensive care with no copay and no coinsurance. Members also enjoy no copay and no coinsurance for over-the-counter items, up to 48 one-way transportation trips, and eyeglasses, while routine vision and hearing exams are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Blue adVantage Dual Plus (HMO-POS D-SNP) inpatient hospital services are partially covered, requiring prior authorization and featuring Medicare-defined copays with no coinsurance for acute and psychiatric stays. Additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for most of these outpatient services, and there is no deductible for the first three pints of blood.
Partial Hospitalization See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering up to 48 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers emergency and urgently needed services with no copay and a 20% coinsurance, which does not count toward the plan deductible and features per-visit maximums of $100 (waived if admitted within 72 hours) and $40. Although worldwide emergency services are technically covered, the worldwide emergency, urgent, and transportation sub-services are not covered in practice.
Primary Care See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers primary care, specialist, mental health, therapy, and telehealth services with no copay and 20% coinsurance, with prior authorization required for most of these benefits. Chiropractic and podiatry services are not covered under this plan.
Preventive Services See details
Preventive services are partially covered by Blue adVantage Dual Plus (HMO-POS D-SNP), with annual physical exams, personal emergency response systems, home-based palliative care, and memory fitness offered with no copay and no coinsurance. Kidney disease education and select screenings, such as glaucoma and diabetes self-management, are covered with no copay and a 20% coinsurance. Non-covered services include health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, home and bathroom safety devices, and counseling.
Hearing Services See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers hearing services, including routine hearing exams with no copay and a 20% coinsurance, and OTC hearing aids with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to an $800 maximum benefit every three years, though inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Blue adVantage Dual Plus (HMO-POS D-SNP), as other eye exam services are not covered. Covered routine eye exams and contact lenses require no copay and a 20% coinsurance, while eyeglasses, lenses, frames, and upgrades have no copay and no coinsurance, up to a $200 annual combined maximum.
Dental Services See details
Dental services are partially covered by Blue adVantage Dual Plus (HMO-POS D-SNP), offering up to $4,000 in annual coverage for most preventive and comprehensive care with no copay and no coinsurance. Medicare-covered dental services require no copay and a 20% coinsurance, though other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these covered benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers diagnostic and radiological services with prior authorization, offering lab services with no copay and diagnostic procedures with a copay and 20% minimum coinsurance. Radiological services, including diagnostic, therapeutic, and outpatient X-rays, are covered with no copay and a 20% minimum coinsurance.
Home Health Services See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Blue adVantage Dual Plus (HMO-POS D-SNP) covers some cardiac rehabilitation services with no copay and prior authorization, but standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Blue adVantage Dual Plus (HMO-POS D-SNP) with no copay and no coinsurance for Medicare-covered days, though prior authorization is required. Admission requires a prior three-day inpatient hospital stay, and additional days beyond the standard Medicare benefit are not covered.
Other Services See details
Blue adVantage Dual Plus (HMO-POS D-SNP) provides partial coverage for other services, which includes over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, nicotine replacement therapy, and naloxone are not covered under this plan.
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