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Healthy Blue + Medicare (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Healthy Blue + Medicare (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 Healthy Blue + Medicare (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
Healthy Blue + Medicare (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by CuraCor Solutions Corp. available for enrollment in 2025 to people living in Select North Carolina Counties. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Healthy Blue + Medicare (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:
Healthy Blue + Medicare (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 Healthy Blue + Medicare (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 Healthy Blue + Medicare (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $18.70. 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 $615.00 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 $9250.00 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 Healthy Blue + Medicare (HMO-POS D-SNP) plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 (Preferred Generic), Tier 2 (Generic), and Tier 6 (Select Care Drugs) prescriptions filled through standard pharmacies or standard mail order. This zero-cost benefit applies to one-month, two-month, and three-month supplies, helping you save on essential medications. For higher-tier medications, including Tier 3 (Preferred Brand) and Tier 4 (Non-Preferred Drug), you will pay a 25% coinsurance for standard pharmacy and mail order fills. Tier 5 (Specialty Tier) drugs also carry a 25% coinsurance for a one-month supply. This structure helps you easily estimate your out-of-pocket costs when managing more complex health needs.
Additional Benefits
The Healthy Blue + Medicare (HMO-POS D-SNP) plan offers robust coverage with no copay and no coinsurance for inpatient hospital stays, home health services, skilled nursing facilities, and cardiac rehabilitation. For outpatient care, specialist visits, primary care, diagnostic services, and durable medical equipment, members generally pay no copay and a 20% coinsurance. Emergency care is available with a $115 copay, while urgent care requires a $40 copay, both with no coinsurance. This plan also features strong supplemental benefits, including dental and vision care with no copay and no coinsurance up to specified annual maximums. Members also benefit from up to 48 one-way transportation trips per year and select prescription hearing aids with no copay and no coinsurance. Additionally, eligible members receive a monthly allowance of $250 for over-the-counter items with no copay and no coinsurance.
Inpatient Hospital See details
Healthy Blue + Medicare (HMO-POS D-SNP) partially covers inpatient hospital services, offering acute and psychiatric care with no copay and no coinsurance, though prior authorization is required. However, additional days, non-Medicare-covered stays, and upgrades are not covered under this plan.
Outpatient Services See details
Healthy Blue + Medicare (HMO-POS D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copays and a 20% coinsurance. Prior authorization is required for select services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Healthy Blue + Medicare (HMO-POS D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Healthy Blue + Medicare (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are also covered with no copay or coinsurance for up to 48 one-way trips per year to any health-related location, though plan-approved health-related locations are specifically not covered.
Emergency Services See details
Healthy Blue + Medicare (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance, up to a maximum plan benefit of $100,000.
Primary Care See details
Healthy Blue + Medicare (HMO-POS D-SNP) covers primary care, specialist, therapy, mental health, telehealth, and opioid treatment services with no copay and a 20% coinsurance. Routine and other chiropractic services are not covered under this plan.
Preventive Services See details
Healthy Blue + Medicare (HMO-POS D-SNP) provides partially covered preventive services with no copays or coinsurance for annual physicals, kidney disease education, fitness benefits, and caregiver support. While services like health education and nutritional therapy are not covered, other benefits such as glaucoma screenings and diabetes self-management training are available with no copay and a 20% coinsurance.
Hearing Services See details
Healthy Blue + Medicare (HMO-POS D-SNP) covers hearing services with no deductible, featuring annual routine hearing exams with no copay and a 20% coinsurance, and fitting evaluations with no copay. Prescription hearing aids are partially covered with no copay and no coinsurance for up to two aids every three years, though inner ear, outer ear, over-the-ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Healthy Blue + Medicare (HMO-POS D-SNP) vision services are partially covered with an annual maximum benefit of $400 and no deductibles. One routine eye exam per year and contact lenses are covered with no copay and 20% coinsurance, while eyeglasses, lenses, and frames have no copay and no coinsurance; other eye exams and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Healthy Blue + Medicare (HMO-POS D-SNP), with Medicare-covered dental services requiring no copay and a 20% coinsurance. Other covered preventive and comprehensive dental services have no copay and no coinsurance up to a $3,000 annual maximum, though implants, orthodontics, and fixed prosthodontics are not covered.
Home Infusion bundled Services See details
Healthy Blue + Medicare (HMO-POS D-SNP) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Healthy Blue + Medicare (HMO-POS D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Healthy Blue + Medicare (HMO-POS D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and a 20% coinsurance. Prior authorization is required for these covered items, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Healthy Blue + Medicare (HMO-POS D-SNP) with no copay and a 20% coinsurance, subject to prior authorization. This comprehensive coverage includes outpatient diagnostic procedures, lab services, therapeutic and diagnostic radiological services, and outpatient X-rays.
Home Health Services See details
Home Health Services are covered by Healthy Blue + Medicare (HMO-POS D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Healthy Blue + Medicare (HMO-POS D-SNP) with no copay and no coinsurance, meaning some services are covered. However, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Healthy Blue + Medicare (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required. Admission does not require a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Healthy Blue + Medicare (HMO-POS D-SNP) partially covers other services, offering over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance, while acupuncture is not covered. Eligible members receive up to $250 monthly for OTC items, and the meal benefit is available with a referral for chronic illness.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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