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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 $57.00. 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 $5500.00 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) Medicare plan features an annual prescription drug deductible of $300. Beneficiaries enjoy no copay for Tier 1 preferred generic drugs when using preferred pharmacies or preferred mail-order services, while standard options charge a $10 copay for a one-month supply. Tier 2 generic drugs are also highly affordable, with one-month copays starting at $12 at preferred locations and $18 at standard locations. For Tier 3 preferred brand drugs, the plan requires a $45 copay at preferred pharmacies and a $47 copay at standard pharmacies for a one-month supply. Higher-tier medications require coinsurance, with Tier 4 non-preferred drugs carrying a 50% coinsurance and Tier 5 specialty drugs carrying a 29% coinsurance for a one-month supply across all pharmacy options.
Additional Benefits
The Blue adVantage Giveback (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, annual physicals, and home health services. For hospital stays, members pay no coinsurance and a $295 daily copay for the first seven days of inpatient care, followed by no copay for days 8 through 90. Specialist visits require a $50 copay, while emergency room services carry a $125 copay that is waived if you are admitted. This plan also includes valuable supplemental benefits, featuring dental care with no copay or coinsurance up to a $1,500 annual limit for exams, cleanings, and implants. Routine hearing and vision exams are covered with no copay, alongside allowances of $800 for prescription hearing aids every three years and $200 yearly for eyewear. Additionally, durable medical equipment is covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Blue adVantage Giveback (HMO-POS) partially covers inpatient acute and psychiatric hospital stays with no coinsurance and a copay of $295 per day for days 1 through 7, followed by 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, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $300 ($295 per day for observation services), and outpatient substance abuse sessions have a $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Blue adVantage Giveback (HMO-POS) with a $60.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Blue adVantage Giveback (HMO-POS) covers ambulance services with no coinsurance, requiring a $250 copay for ground ambulance services and a $300 copay for air ambulance services. While transportation services are technically covered by the plan, trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
Emergency services are covered under the Blue adVantage Giveback (HMO-POS) plan with a $125 copay (waived if admitted within 72 hours) and no coinsurance, while urgently needed services require a $50 copay and no coinsurance. Worldwide emergency coverage is partially covered with a $125 copay and no coinsurance, but worldwide urgent care and worldwide emergency transportation are not covered.
Primary Care See details
Blue adVantage Giveback (HMO-POS) offers primary care physician services with no copay and no coinsurance, while specialist visits require a $50 copay and therapy services have a $35 copay, both with no coinsurance. Mental health, psychiatric, and opioid treatment services carry a $40 copay with no coinsurance, telehealth costs range from a $0 to $50 copay with no coinsurance, and podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive Services are covered by Blue adVantage Giveback (HMO-POS) with no copay and no coinsurance for annual physicals, kidney disease education, and routine screenings. Additional preventive benefits are only partially covered, excluding health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission 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 technologies, home safety modifications, and counseling.
Hearing Services See details
Blue adVantage Giveback (HMO-POS) covers hearing services with no copay and no coinsurance, including annual routine hearing exams and over-the-counter hearing aids. Prescription hearing aids are partially covered with no copay or coinsurance up to an $800 maximum every three years, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Blue adVantage Giveback (HMO-POS), offering routine eye exams with no copay and other covered exams for a $50 copay, with no coinsurance. Eyewear is covered with no copay or coinsurance, providing a combined maximum benefit of $200 per year for contacts, eyeglasses, frames, and upgrades.
Dental Services See details
Blue adVantage Giveback (HMO-POS) dental services are partially covered with no copay and no coinsurance, up to a maximum plan benefit of $1,500 every year. Covered benefits include cleanings, exams, and implants, but 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, though prior authorization and step therapy may be required. Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs carry a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Blue adVantage Giveback (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Blue adVantage Giveback (HMO-POS) covers durable medical equipment and prosthetics with no copay and a 20% coinsurance, subject to prior authorization. Diabetic equipment is partially covered with no copay and no coinsurance, but diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Blue adVantage Giveback (HMO-POS) covers diagnostic and radiological services with prior authorization, featuring no coinsurance for diagnostic services, no copay for lab services, and copays from $0 to $30 for diagnostic procedures and tests. Radiological services require coinsurance for diagnostic and therapeutic services, including a minimum 20% coinsurance and a copay for therapeutic services, while outpatient X-rays carry no coinsurance.
Home Health Services See details
Home Health Services are covered by the Blue adVantage Giveback (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Blue adVantage Giveback (HMO-POS) plan with no coinsurance and required prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered by the plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Blue adVantage Giveback (HMO-POS) with no coinsurance, offering no copay for days 1 to 20 and a $200 daily copay for days 21 to 100. Prior authorization and a three-day inpatient hospital stay are required, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
Other services are partially covered by Blue adVantage Giveback (HMO-POS), which provides 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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