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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 2025, 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 3.5 out of 5 stars in 2025.
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 $38.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $2.00. You must continue to pay paying your reduced 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 $590.00 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 $9350.00 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) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for your drugs based on the tier and pharmacy you use, until your total drug costs reach $2,000. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs. If you qualify for the low-income subsidy (LIS), your premium will be $38.00.
Additional Benefits
The Blue adVantage Dual Plus (HMO-POS D-SNP) plan offers a wide range of benefits with varying cost-sharing. Many services, like hearing exams, and fitting/evaluation for hearing aids, have no copay. The plan also includes coverage for dental, vision, and home health services. You will pay a 20% coinsurance for many services, including outpatient, emergency, and primary care services, as well as ambulance, and diagnostic services. The plan also provides additional benefits like an allowance for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but Additional Days, Non-Medicare-covered Stays, and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stays for Inpatient Hospital Psychiatric, are not covered. The copay for these services is not specified.
Outpatient Services See details
Outpatient Services include outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a 20% coinsurance. Ambulatory Surgical Center services and outpatient substance abuse services have a 20% coinsurance. Outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under the Blue adVantage Dual Plus (HMO-POS D-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground and Air Ambulance Services have a 20% coinsurance, and Transportation Services to a plan-approved health-related location covers 84 one-way trips per year. Transportation Services to any health-related location is not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered by the Blue adVantage Dual Plus (HMO-POS D-SNP) plan. Emergency Services have a 20% coinsurance, and Urgently Needed Services also have a 20% coinsurance. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are not covered.
Primary Care See details
The Blue adVantage Dual Plus (HMO-POS D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services with 20% coinsurance. Routine Chiropractic Care is not covered, and podiatry services are not covered.
Preventive Services See details
The Blue adVantage Dual Plus (HMO-POS D-SNP) plan covers preventive services, including Medicare-covered services with no copay, annual physical exams, and other preventive services like glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, all with 20% coinsurance. The plan does not cover health education, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services. The plan also covers Personal Emergency Response System (PERS), Home-Based Palliative Care, Kidney Disease Education Services, and a Fitness Benefit.
Hearing Services See details
The Blue adVantage Dual Plus (HMO-POS D-SNP) plan covers hearing exams with a coinsurance of at most 20% for routine hearing exams, and also covers fitting/evaluation for hearing aids with no copay. The plan also covers prescription hearing aids with no copay and a maximum benefit of $1500 per year, but does not cover hearing aids for the inner, outer, or over-the-ear. Additionally, the plan covers OTC hearing aids with no copay.
Vision Services See details
Vision Services include coverage for eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams have no copay. Eyewear has a 20% coinsurance, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades have no copay, with a combined maximum benefit of $300 per year.
Dental Services See details
The Blue adVantage Dual Plus (HMO-POS D-SNP) plan covers dental services with a 20% coinsurance for Medicare dental services. Other dental services have a maximum plan benefit of $4,000 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), implant services, prosthodontics (fixed), and oral and maxillofacial surgery are covered with no copay, while maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0% to 20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Blue adVantage Dual Plus (HMO-POS D-SNP) plan. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment is covered under the Blue adVantage Dual Plus (HMO-POS D-SNP) plan, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts all have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Blue adVantage Dual Plus (HMO-POS D-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, and Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Blue adVantage Dual Plus (HMO-POS D-SNP) plan with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Blue adVantage Dual Plus (HMO-POS D-SNP) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required, and cost sharing applies.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items with a maximum benefit of $100.00 every month, but does not cover Acupuncture, Meal Benefits, Dual Eligible SNPs with Highly Integrated Services, 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, or Self-Directed Personal Assistance Services.
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