Blue adVantage Dual Plus (HMO-POS D-SNP)

Louisiana Medicare-Medicaid Dual Eligible D-SNP Plan (2025 Plan)

Monthly Premium

Your Cost

$38

by Blue Cross and Blue Shield of Louisiana

Additional Coverage

HearingVisionDental

Overall Government Star Rating

3.5

out of 5 stars

Ready to Enroll Online?

Plan Name

Blue adVantage Dual Plus (HMO-POS D-SNP)

Insurance Carrier

Blue Cross and Blue Shield of Louisiana

Plan Type

Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP)

Network Type

HMO

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.

Monthly Premium

$38

Annual Deductible

$0 or $500 Out-of-network

Max Out-of-Pocket

$9,350

Primary doctor visit

0% or 20% coinsurance per visit

Specialist visit

0% or 20% coinsurance per visit

ER visit

0% or 20% coinsurance per visit (always covered)

Ambulance

0% or 20% coinsurance

Blue adVantage Dual Plus (HMO-POS D-SNP) has a monthly premium cost of $38 per month, with an annual deductible of $0 or $500 Out-of-network and a maximum out of pocket cost sharing of $9,350 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.

Yes

Part D Prescription Drug Coverage

Yes

Dental

Yes

Vision

Yes

Hearing

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

Fitness benefit

Limited coverage

Over the counter drug benefits

Limited coverage

In-home support services

Not covered

Home and bathroom safety devices

Not covered

Meals for short duration

Not covered

Annual physical exams

Limited coverage

Telehealth

Limited coverage

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 2025, Blue adVantage Dual Plus (HMO-POS D-SNP) received an overall government quality rating of 3.5 stars out of 5 stars.

Blue adVantage Dual Plus (HMO-POS D-SNP) performed worse than Louisiana’s State average overall quality score of 3.7 stars.

This Plan’s 5-star Gov’t Quality Score

Louisiana State Average Score

Overall Government 5 Star Quality Rating

3.5

3.7

Summary rating of health plan quality

3.8

Staying healthy: screenings, tests, & vaccines

3.0

Managing chronic (long term) conditions

3.5

Member experience with health plan

4.0

Member complaints & changes in the health plan's performance

3.5

Health plan customer service

3.7

Summary rating of drug plan quality

3.5

Drug plan customer service

4.1

Member complaints & changes in the drug plan's performance

3.3

Member experience with the drug plan

4.0

Drug safety & accuracy of drug pricing

3.0

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 stars for its health plan quality score which is better than the Louisiana State average health plan quality score of 3.8 stars.

Blue adVantage Dual Plus (HMO-POS D-SNP) received 3.5 stars for its drug plan quality score which is the same as the Louisiana State average drug plan quality score of 3.5 stars.

Monthly Premium

$38

Health Portion of Premium

Drug Portion of Premium

$38

Health Plan Deductible

$0 or $500 Out-of-network

Health Plan Max Out-of-Pocket

$9,350 In-network

Nationwide Coverage included

Hearing Coverage included

Yes

Vision Coverage included

Yes

Dental Coverage included

Yes

Doctor Lookup Link

http://www.bcbsla.com/blueadvantage

Plan Link

http://www.bcbsla.com/blueadvantage

Doctor Services

Primary doctor visit

In-network: 0% or 20% coinsurance per visit
Out-of-network: 50% coinsurance per visit

Specialist visit

In-network: 0% or 20% coinsurance per visit
Out-of-network: 50% coinsurance per visit

Tests, labs, & imaging

Diagnostic tests & procedures

In-network: 0% or 20% coinsurance
Out-of-network: 50% coinsurance

Lab services

In-network: $0 copay
Out-of-network: 50% coinsurance

Diagnostic radiology services (like MRI)

In-network: 0% or 20% coinsurance
Out-of-network: 50% coinsurance

Outpatient x-rays

In-network: 0% or 20% coinsurance
Out-of-network: 50% coinsurance

Emergency care

0% or 20% coinsurance per visit (always covered)

Urgent care

0% or 20% coinsurance per visit (always covered)

Hospital Services

Inpatient hospital coverage

In-network: Coming soon
Out-of-network: 50% per stay

Outpatient hospital coverage

In-network: 0% or 20% coinsurance per visit
Out-of-network: 50% coinsurance per visit

Skilled nursing facility

In-network: Coming soon
Out-of-network: 50% per stay

Preventive services

In-network: $0 copay
Out-of-network: 50% coinsurance

Ambulance

Ground ambulance

In-network: 0% or 20% coinsurance
Out-of-network: 50% coinsurance

Therapy services

Occupational therapy visit

In-network: 0% or 20% coinsurance
Out-of-network: 50% coinsurance

Physical therapy & speech & language therapy visit

In-network: 0% or 20% coinsurance
Out-of-network: 50% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist

In-network: 0% or 20% coinsurance
Out-of-network: 50% coinsurance

Outpatient individual therapy with a psychiatrist

In-network: 0% or 20% coinsurance
Out-of-network: 50% coinsurance

Outpatient group therapy visit

In-network: 0% or 20% coinsurance
Out-of-network: 50% coinsurance

Outpatient individual therapy visit

In-network: 0% or 20% coinsurance
Out-of-network: 50% coinsurance

Opioid treatment services

Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)

In-network: 0% or 20% coinsurance per item
Out-of-network: 50% coinsurance per item

Prosthetics (like braces, artificial limbs)

In-network: 0% or 20% coinsurance per item
Out-of-network: 50% coinsurance per item

Diabetes supplies

In-network: 0% or 20% coinsurance per item
Out-of-network: 50% coinsurance per item

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Tiers	Initial coverage phase	Catastrophic coverage phase
Preferred Generic	Generic drugs : 25% coinsurance Brand-name drugs : 25% coinsurance	Generic drugs : 0% coinsurance Brand-name drugs : 0% coinsurance
Generic
Preferred Brand
Non-Preferred Drug
Specialty Tier

Part B Drugs

Chemotherapy drugs

In-network: 0% or 0-20% coinsurance
Out-of-network: $35 copay or 0-50% coinsurance

Other Part B drugs

In-network: 0% or 0-20% coinsurance
Out-of-network: $35 copay or 0-50% coinsurance