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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 2026, 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/La Salle HMO. This plan received an overall rating of 3.5 out of 5 stars in 2026.
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 a $450.00 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 $4750.00 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 features an annual drug deductible of $450. You will pay no copay for Tier 1 preferred generic drugs filled through a preferred pharmacy or preferred mail-order service. Tier 2 generic drugs are also highly affordable, with copays starting at just $1 for a one-month supply at preferred locations. For higher-tier medications, cost sharing is based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require 17% coinsurance at preferred pharmacies and 21% coinsurance at standard pharmacies. Tier 4 non-preferred drugs carry a 38% to 42% coinsurance, while Tier 5 specialty drugs require a flat 27% coinsurance regardless of your pharmacy choice.
Additional Benefits
The Blue Cross Medicare Advantage Secure (HMO) plan features robust coverage for core medical needs, highlighting no copays for primary care visits, home health services, and annual preventive care. Specialized medical care, such as specialist visits and Medicare-covered dental exams, carries a low $30 to $35 copay, while emergency care is covered with a $130 copay. Inpatient hospital stays require a $300 daily copay for the first eight days with no copay thereafter, whereas outpatient hospital services carry a flat $300 copay. Members can take advantage of essential wellness benefits, including routine vision and dental cleanings with no copay, alongside a $40 quarterly over-the-counter item allowance. Skilled nursing facility stays feature no copay for days 1 through 20 and days 40 through 100, though a $218 daily copay applies for days 21 through 39. Most durable medical equipment, dialysis services, and therapeutic radiological services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Blue Cross Medicare Advantage Secure (HMO) covers inpatient acute hospital stays with no coinsurance, requiring a $300 daily copay for days 1 through 8 and no copay for additional days, though upgrades and non-Medicare-covered stays are not covered. Inpatient psychiatric hospital stays are also covered with no coinsurance, requiring a $260 daily copay for days 1 through 7 and no copay for days 8 through 90, but additional psychiatric days are not covered.
Outpatient Services See details
Blue Cross Medicare Advantage Secure (HMO) covers outpatient services with no coinsurance, featuring a $300 copay for outpatient hospital and observation services, a $200 copay for ambulatory surgical center services, and a $75 copay for substance abuse sessions. Outpatient blood services are covered with no copay and no deductible, and most of these services require prior authorization and a referral.
Partial Hospitalization See details
Blue Cross Medicare Advantage Secure (HMO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization and a referral are required to receive coverage for these services.
Ambulance and Transportation Services See details
Blue Cross Medicare Advantage Secure (HMO) covers ambulance services with a $250 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport, both requiring prior authorization. Routine transportation services are not covered by the plan.
Emergency Services See details
Blue Cross Medicare Advantage Secure (HMO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if admitted to the hospital within 3 days, and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency and urgent services are partially covered with a $130 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Blue Cross Medicare Advantage Secure (HMO) provides primary care and telehealth services with no copay and no coinsurance, while specialist, mental health, and psychiatric visits carry a $30 copay with no coinsurance. Physical, occupational, and speech therapies require a $45 copay with no coinsurance, whereas chiropractic and podiatry services are not covered.
Preventive Services See details
Blue Cross Medicare Advantage Secure (HMO) preventive services are covered with no copay and no coinsurance, including annual physicals, kidney disease education, fitness benefits, and remote access technologies. However, 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, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Hearing services are covered by Blue Cross Medicare Advantage Secure (HMO), featuring no coinsurance for all services, no copay for annual routine exams and fitting evaluations, and a $35 copay for Medicare-covered exams. Prescription hearing aids are partially covered with copays between $699 and $999 for up to two aids per year, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Blue Cross Medicare Advantage Secure (HMO) partially covers vision services, providing one routine eye exam per year with no copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered up to a $100 annual maximum with no coinsurance and copays up to $35 (including contact lenses, lenses, and frames with no copay), but upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by Blue Cross Medicare Advantage Secure (HMO), featuring Medicare-covered dental with a $35 copay and no coinsurance, and preventive care like exams, cleanings, and x-rays with no copay and no coinsurance. However, several services are not covered, including fluoride, restorative treatments, endodontics, periodontics, prosthodontics, implants, and oral surgery.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the Blue Cross Medicare Advantage Secure (HMO) plan with no copay, subject to prior authorization. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Blue Cross Medicare Advantage Secure (HMO) covers dialysis services with no copay and a 20% coinsurance. Both prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
Blue Cross Medicare Advantage Secure (HMO) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and a 20% coinsurance for most items. Diabetic supplies feature coinsurance ranging from no coinsurance to 20%, and prior authorization is required for these covered services.
Diagnostic and Radiological Services See details
Blue Cross Medicare Advantage Secure (HMO) covers diagnostic and radiological services with no copay for lab services and outpatient X-rays, and no coinsurance with a $0 to $50 copay for diagnostic tests. Diagnostic radiological services require a minimum copay of $0, therapeutic radiological services carry a minimum 20% coinsurance, and prior authorization and referrals are required.
Home Health Services See details
Blue Cross Medicare Advantage Secure (HMO) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to receive this covered benefit.
Cardiac Rehabilitation Services See details
Blue Cross Medicare Advantage Secure (HMO) provides Cardiac Rehabilitation Services with no coinsurance, though only some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered. These services require prior authorization and referrals, and they carry copayments ranging from $20 to $30.
Skilled Nursing Facility (SNF) See details
Blue Cross Medicare Advantage Secure (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, though prior authorization and referrals are required. There is no copay for days 1 through 20 and days 40 through 100, a $218 daily copay for days 21 through 39, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Blue Cross Medicare Advantage Secure (HMO) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance up to a maximum benefit of $40 every three months. Acupuncture and meal benefits are not covered under this plan.
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