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Blue Cross Medicare Advantage Secure (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue Cross Medicare Advantage Secure (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Blue Cross Medicare Advantage Secure (HMO) in 2025, please refer to our full plan details page.
Blue Cross Medicare Advantage Secure (HMO) is a HMO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in Chicago Metro Area. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Blue Cross Medicare Advantage Secure (HMO) 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 Cross Medicare Advantage Secure (HMO).
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 Cross Medicare Advantage Secure (HMO), 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.
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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3500.00 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:
Sign up for Blue Cross Medicare Advantage Secure (HMO)
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Drug Coverage
The Blue Cross Medicare Advantage Secure (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for your medications, such as $10.00 for preferred generic drugs at a preferred pharmacy and 50% coinsurance for preferred brand drugs. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, where you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your Part D costs are $0.00.
Additional Benefits
The Blue Cross Medicare Advantage Secure (HMO) plan offers comprehensive coverage with various benefits. This plan provides inpatient hospital care with a copay of $250 for days 1-7 and no copay for days 8-90, along with outpatient services and emergency care with varying copays. Additional benefits include no copay for primary care visits, preventive services, and home health services. The plan also covers hearing, vision, and dental services with copays or coinsurance for specific services.
Inpatient Hospital See details
Inpatient Hospital benefits for the Blue Cross Medicare Advantage Secure (HMO) plan include coverage for Inpatient Hospital-Acute with a $250 copay for days 1-7 and no copay for days 8-90, while Inpatient Hospital Psychiatric has a $260 copay for days 1-7 and no copay for days 8-90. Additional Days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a $250 copay, Observation Services with a $200 copay, Ambulatory Surgical Center (ASC) Services with a $100 copay, and Outpatient Substance Abuse Services with a $75 copay for individual and group sessions. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Blue Cross Medicare Advantage Secure (HMO) plan, but requires prior authorization and a doctor's referral. The copay for this benefit is $55.
Ambulance and Transportation Services See details
The Blue Cross Medicare Advantage Secure (HMO) plan covers ambulance and transportation services. Ground ambulance services have a $250 copay, while air ambulance services have 20% coinsurance. Transportation services to a plan-approved health-related location are covered with no copay, up to 12 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by the Blue Cross Medicare Advantage Secure (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay and no coinsurance, while Urgently Needed Services have a $40 copay and no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Blue Cross Medicare Advantage Secure (HMO) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay. Occupational Therapy Services have a $35 copay, while Physician Specialist Services have a $15 copay. Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services each have a minimum copay of $30, $30, and $25 respectively. Physical Therapy and Speech-Language Pathology Services have a $35 copay. Additional Telehealth Benefits are covered with no copay.
Preventive Services See details
The Blue Cross Medicare Advantage Secure (HMO) plan covers preventive services, including an annual physical exam with no copay. Other services include Fitness Benefit, Remote Access Technologies, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with a $35 copay, and routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered, but inner ear, outer ear, and over the ear prescription hearing aids are not covered, and OTC hearing aids are also not covered. Prescription hearing aids (all types) have a copay between $699 and $999.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Eye exams and contact lenses have no copay, while eyewear has a $35 copay; eyeglass frames and eyeglass lenses have no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with a $35 copay, oral exams with no copay, and dental x-rays and prophylaxis (cleaning) with no copay. Additionally, restorative services and adjunctive general services have no coinsurance, endodontics, prosthodontics (removable), maxillofacial prosthetics, and prosthodontics (fixed) have a 20% coinsurance, and oral and maxillofacial surgery and periodontics have a 0-20% coinsurance. Fluoride treatment, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay with a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Blue Cross Medicare Advantage Secure (HMO) plan, but require prior authorization and a doctor's referral. You are responsible for a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance, while Diabetic Supplies have a 0-20% coinsurance and Diabetic Therapeutic Shoes/Inserts 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, including Diagnostic Procedures/Tests with a copay between $0 and $50, and Lab Services with no copay. Therapeutic Radiological Services have a 20% coinsurance, and Outpatient X-Ray Services have no copay. Diagnostic Radiological Services have a maximum copay of $200.
Home Health Services See details
Home Health Services are covered by the Blue Cross Medicare Advantage Secure (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization and referral are required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services including 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. A doctor referral and prior authorization are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Blue Cross Medicare Advantage Secure (HMO) plan. You will have no copay for days 1-20, a $214 copay for days 21-39, and no copay for days 40-100.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and Meal Benefits, with no copay for either. Acupuncture, 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, and Self-Directed Personal Assistance Services are not covered.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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