Blue adVantage Dual Plus (HMO-POS D-SNP)
Louisiana Medicare-Medicaid Dual Eligible D-SNP Plan (2024 Plan)
Monthly Premium
Additional Coverage
Overall Government Star Rating
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Plan Overview
Blue adVantage Dual Plus (HMO-POS D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in Louisiana and offered by the health insurance company Blue Cross and Blue Shield of Louisiana. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.
Cost Summary
Blue adVantage Dual Plus (HMO-POS D-SNP) has a monthly premium cost of $30 per month, with an annual deductible of $0 or $500 Out-of-network and a maximum out of pocket cost sharing of $8,850 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Blue adVantage Dual Plus (HMO-POS D-SNP) are defined below.
Additional Benefits and Coverage
Blue adVantage Dual Plus (HMO-POS D-SNP) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Blue adVantage Dual Plus (HMO-POS D-SNP) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Blue adVantage Dual Plus (HMO-POS D-SNP) includes coverage for the following additional benefits:
Other benefits
Comparing the Quality Score of Blue adVantage Dual Plus (HMO-POS D-SNP) to Other Plans in Louisiana
Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2024, Blue adVantage Dual Plus (HMO-POS D-SNP) received an overall government quality rating of 4.5 stars out of 5 stars.
Blue adVantage Dual Plus (HMO-POS D-SNP) performed better than Louisiana’s State average overall quality score of 4.0 stars.
The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.
Blue adVantage Dual Plus (HMO-POS D-SNP) received 4.5 stars for its health plan quality score which is better than the Louisiana State average health plan quality score of 4.0 stars.
Blue adVantage Dual Plus (HMO-POS D-SNP) received 4 stars for its drug plan quality score which is better than the Louisiana State average drug plan quality score of 3.9 stars.
Plan Benefits and Coverage Details
Medical Benefits
Doctor Services
Out-of-network: 50% coinsurance per visit
Out-of-network: 50% coinsurance per visit
Tests, labs, & imaging
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Hospital Services
$1,632 deductible for days 1 through 60
$408 copay per day for days 61 through 90
Out-of-network: 50% per stay
Out-of-network: 50% coinsurance per visit
Skilled nursing facility
$0 copay for days 1 through 20
$204 copay per day for days 21 through 100
Out-of-network: 50% per stay
Preventive services
Out-of-network: 50% coinsurance
Ambulance
Out-of-network: 50% coinsurance
Therapy services
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Mental health services
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Opioid treatment services
Other services
Out-of-network: 50% coinsurance per item
Out-of-network: 50% coinsurance per item
Out-of-network: 50% coinsurance per item
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
| Tiers | Initial coverage phase | Gap coverage phase | Catastrophic coverage phase |
|---|---|---|---|
| Preferred Generic |
Brand-name drugs :
|
Brand-name drugs :
| |
| Generic | |||
| Preferred Brand | |||
| Non-Preferred Drug | |||
| Specialty Tier |
Part B Drugs
Out-of-network: $35 copay or 0-50% coinsurance
Out-of-network: $35 copay or 0-50% coinsurance
Extra Benefits
Hearing
Out-of-network: 50% coinsurance
Out-of-network: $0 copay
Out-of-network: $0 copay
Preventive Dental
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Comprehensive dental
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Vision
Out-of-network: 50% coinsurance
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
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