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Blue Cross Medicare Advantage Saver (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue Cross Medicare Advantage Saver (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 Saver (HMO) in 2026, please refer to our full plan details page.
Blue Cross Medicare Advantage Saver (HMO) is a HMO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in TX MAPD Buydown HMO. This plan received an overall rating of 2.5 out of 5 stars in 2026.
It's important to know that Blue Cross Medicare Advantage Saver (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 Saver (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 Saver (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. Additionally, this plan comes with a Part B Premium reduction of $40.00. 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 $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 $7500.00 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 Saver (HMO)
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Drug Coverage
The Blue Cross Medicare Advantage Saver (HMO) plan features an annual prescription drug deductible of $450. For Tier 1 preferred generic drugs, members pay no copay when filling prescriptions through a preferred pharmacy or preferred mail order service. Tier 2 generic medications are also highly affordable, with copays starting at just $1.00 for a one-month supply at preferred locations. Higher-tier medications under this plan are subject to coinsurance rather than flat copays during the initial coverage phase. Tier 3 preferred brand drugs carry an 18% coinsurance at preferred pharmacies and 21% at standard pharmacies, while Tier 4 non-preferred drugs require 39% or 42% coinsurance. Specialty drugs in Tier 5 have a flat 27% coinsurance for a one-month supply regardless of whether you use a preferred or standard pharmacy.
Additional Benefits
The Blue Cross Medicare Advantage Saver (HMO) provides affordable coverage for essential medical needs, featuring no copays and no coinsurance for primary care visits, telehealth services, and home health care. Specialist visits require a low $20 copay, while emergency room visits carry a $100 copay that is waived if you are admitted. Inpatient hospital stays are covered with no coinsurance, requiring daily copays for the first several days before transitioning to no copay for the remainder of your stay. Diagnostic lab work, outpatient x-rays, and routine vision and hearing exams are also available with no copays or coinsurance. For other services like dialysis, durable medical equipment, and Part B drugs, members can expect up to a 20% coinsurance with no copay. While the plan covers a range of preventive services and Medicare-covered dental and hearing needs, it does not cover routine dental care, eyewear, acupuncture, or over-the-counter items.
Inpatient Hospital See details
Blue Cross Medicare Advantage Saver (HMO) covers inpatient hospital services with no coinsurance, requiring a $340 daily copay for days 1 through 6 of acute stays and a $250 daily copay for days 1 through 5 of psychiatric stays, followed by no copay for remaining days. While unlimited additional acute days are fully covered with no copay, non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Blue Cross Medicare Advantage Saver (HMO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services which both feature no copays. Outpatient hospital services require a copay ranging from $0 to $395 (with a $395 copay per stay for observation services), and outpatient substance abuse sessions carry a $75 copay, all with no coinsurance.
Partial Hospitalization See details
Blue Cross Medicare Advantage Saver (HMO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization and a referral are required to access this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by the Blue Cross Medicare Advantage Saver (HMO), with ground ambulance services requiring a $275 copay and air ambulance services requiring 20% coinsurance, subject to prior authorization. However, transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Blue Cross Medicare Advantage Saver (HMO) covers emergency services with a $100 copay and no coinsurance—waived if admitted to the hospital within 3 days—and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent care are partially covered with a $100 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Blue Cross Medicare Advantage Saver (HMO) covers primary care physician services and telehealth benefits with no copay and no coinsurance, while specialist visits require a $20 copay and no coinsurance. Physical, occupational, speech, and mental health therapies are covered with a $35 copay and no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Blue Cross Medicare Advantage Saver (HMO) preventive services are partially covered with no copays and no coinsurance for annual physical exams, fitness benefits, remote access technologies, and various screenings. However, several supplemental services are not covered under this plan, including health education, weight management programs, in-home safety assessments, and nutritional counseling.
Hearing Services See details
Hearing services are partially covered by Blue Cross Medicare Advantage Saver (HMO), which features a $35 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for one routine exam and unlimited fitting evaluations yearly. Prescription hearing aids are covered with no coinsurance and a copay of $699 to $999 for up to two aids per year, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Blue Cross Medicare Advantage Saver (HMO), which offers one routine eye exam per year with no copay and no coinsurance. Other eye exams and all eyewear, including contact lenses and eyeglasses, are not covered.
Dental Services See details
Blue Cross Medicare Advantage Saver (HMO) offers partial coverage for dental services, covering Medicare-covered dental care with a $35 copay and no coinsurance. All other preventive and comprehensive dental services, including cleanings, exams, x-rays, fluoride, and restorative procedures, are not covered.
Home Infusion bundled Services See details
Blue Cross Medicare Advantage Saver (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Under this plan, Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance with no copay, while Part B insulin drugs require a $35 copay and a 0% to 20% coinsurance.
Dialysis Services See details
Blue Cross Medicare Advantage Saver (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
Medical equipment is covered by Blue Cross Medicare Advantage Saver (HMO) with no copays and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are also covered with no copay and coinsurance ranging from 0% (no coinsurance) to 20%, though prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Blue Cross Medicare Advantage Saver (HMO) covers diagnostic services with no coinsurance, featuring no copay for lab services and a copay ranging from no copay to $100 for diagnostic tests. Covered radiological services include outpatient X-rays with no copay, diagnostic radiology starting at no copay, and therapeutic radiology with a minimum 20% coinsurance. Prior authorization and referrals are required for both service categories.
Home Health Services See details
Home health services are covered under the Blue Cross Medicare Advantage Saver (HMO) with no copay and no coinsurance. Prior authorization and a referral are required to access these services.
Cardiac Rehabilitation Services See details
Blue Cross Medicare Advantage Saver (HMO) covers some cardiac rehabilitation services with no coinsurance, though prior authorization and referrals are required. However, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Blue Cross Medicare Advantage Saver (HMO) covers Skilled Nursing Facility (SNF) care with no coinsurance, offering no copay for days 1 to 20 and days 60 to 100, and a $218 daily copay for days 21 to 59. Prior authorization and referrals are required, and additional days beyond the standard 100-day Medicare benefit period are not covered.
Other Services See details
Other services are not covered under the Blue Cross Medicare Advantage Saver (HMO), which means members do not have coverage for acupuncture, over-the-counter (OTC) items, or meal benefits.
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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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