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Blue adVantage Giveback (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue adVantage Giveback (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 Giveback (HMO-POS) in 2026, please refer to our full plan details page.
Blue adVantage Giveback (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 Giveback (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 Giveback (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 Giveback (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. Additionally, this plan comes with a Part B Premium reduction of $70.00. 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 $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 $6500.00 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 Giveback (HMO-POS) plan features a $300 drug deductible, offering structured prescription coverage across five tiers. You will pay no copay for Tier 1 preferred generic drugs when using a preferred pharmacy or preferred mail order service, while standard options charge a $10 copay for a one-month supply. For Tier 2 generic drugs, one-month copays start at $12 at preferred locations and $18 at standard locations. Tier 3 preferred brand drugs require a $45 copay at preferred pharmacies and a $47 copay at standard pharmacies for a one-month supply. Higher-tier prescriptions transition to coinsurance, with Tier 4 non-preferred drugs requiring 50% coinsurance and Tier 5 specialty drugs requiring 29% coinsurance across all pharmacy types. Choosing preferred pharmacies and mail-order options helps maximize your savings under this plan.
Additional Benefits
The Blue adVantage Giveback (HMO-POS) plan offers comprehensive coverage with no copays or coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, you will pay a $295 daily copay for the first seven days and no copay for days eight through 90, with no coinsurance required. Specialist visits and outpatient services are also accessible, requiring a $50 copay for specialists and outpatient copays ranging from $0 to $300. This plan features valuable extra benefits, including dental care with no copay and no coinsurance up to a $1,500 annual limit, and routine vision exams and eyewear with no copay up to a $200 yearly maximum. Hearing exams and over-the-counter items are also covered with no copay or coinsurance. For durable medical equipment and dialysis services, members will pay no copay and a 20% coinsurance.
Inpatient Hospital See details
Blue adVantage Giveback (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $295 daily copay for days 1 through 7 and no copay for days 8 through 90. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Blue adVantage Giveback (HMO-POS) covers outpatient services with no coinsurance, offering outpatient hospital services with a copay of $0 to $300 and observation services with a $295 daily copay. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay.
Partial Hospitalization See details
Blue adVantage Giveback (HMO-POS) covers partial hospitalization services with a $60.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
Blue adVantage Giveback (HMO-POS) covers ground ambulance services with a $250 copay and air ambulance services with a $300 copay, both with no coinsurance. For transportation services, some services are covered, but transportation to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Blue adVantage Giveback (HMO-POS) covers emergency services with a $125 copay and no coinsurance, which is waived if admitted to the hospital within 72 hours, and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency services are partially covered with a $125 copay and no coinsurance for emergency care, but worldwide urgent coverage and worldwide emergency transportation are not covered.
Primary Care See details
Blue adVantage Giveback (HMO-POS) offers primary care services with no copay and no coinsurance, while specialist visits require a $50 copay and no coinsurance. Physical, occupational, and speech therapy cost a $35 copay with no coinsurance, psychiatric and mental health sessions have a $40 copay with no coinsurance, and podiatry is not covered. Some chiropractic services are covered with a $15 copay and no coinsurance, though routine and other chiropractic services are not, and telehealth benefits range from a $0 to $50 copay with no coinsurance.
Preventive Services See details
Blue adVantage Giveback (HMO-POS) covers preventive services, including annual physical exams, kidney disease education, and diabetes self-management training, with no copay and no coinsurance. Additional preventive services are partially covered; home-based palliative care and memory fitness are covered, but several services—including health education, personal emergency response systems, in-home safety assessments, medical nutrition therapy, and weight management—are not covered.
Hearing Services See details
Blue adVantage Giveback (HMO-POS) covers hearing exams and OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to an $800 maximum benefit every three years, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Blue adVantage Giveback (HMO-POS) offers partially covered vision services with no coinsurance, though other eye exam services are not covered. Routine eye exams and eyewear (including lenses, frames, and contacts) feature no copay, while other covered eye exams require a $50 copay and prior authorization, with a combined eyewear maximum benefit of $200 per year.
Dental Services See details
Blue adVantage Giveback (HMO-POS) provides partially covered dental services with no copay and no coinsurance, up to a maximum annual benefit of $1,500. While most diagnostic, preventive, and restorative services are covered, other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Blue adVantage Giveback (HMO-POS) covers Home Infusion bundled Services with no copay, while Medicare Part B insulin is covered with a $35 copay and no coinsurance. Other covered Medicare Part B chemotherapy, radiation, and miscellaneous drugs require a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Blue adVantage Giveback (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Blue adVantage Giveback (HMO-POS) covers medical equipment with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic equipment is partially covered with no copay and no coinsurance, though diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Blue adVantage Giveback (HMO-POS) with prior authorization required. Diagnostic lab services have no copay or coinsurance, diagnostic procedures have a copay of up to $30 with no coinsurance, and radiological services range from no coinsurance for X-rays to a minimum 20% coinsurance for therapeutic treatments.
Home Health Services See details
Home health services are covered under the Blue adVantage Giveback (HMO-POS) plan with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
Blue adVantage Giveback (HMO-POS) covers Cardiac Rehabilitation Services with no copay and no coinsurance, though prior authorization is required. Some services are covered in practice, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Blue adVantage Giveback (HMO-POS) with no coinsurance, though prior authorization and a three-day inpatient hospital stay are required. There is no copay for days 1 through 20, followed by a $200 copay for days 21 through 100, with no coverage for additional days.
Other Services See details
Other Services are partially covered by the Blue adVantage Giveback (HMO-POS) plan, which provides Over-the-Counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, Nicotine Replacement Therapy, and Naloxone are not covered.
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