Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)

by Blue Cross and Blue Shield of New Mexico

2026 Medicare-Medicaid Dual Eligible D-SNP plan available in New Mexico

Plan ID H3251-029-0

Additional coverage:

RxHearingVisionDental

Medicare-Medicaid Dual Eligible D-SNP HMO $0 premium 2.5 Overall

Monthly plan premium $0 / mo

Annual deductible $0 / yr

Max out-of-pocket · in-network $9,250 / yr

Drug deductible $615 / yr

2.5 Overall Government Star Rating 2026 · out of 5 stars

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Plan Overview

Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in New Mexico and offered by the health insurance company Blue Cross and Blue Shield of New Mexico. This plan's network type is HMO, which determines the in-network doctors who accept the plan and whether a referral is needed.

Plan Name Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)

Insurance Carrier Blue Cross and Blue Shield of New Mexico

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

Network Type HMO

Cost Summary

Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 or $283 per year for in-network services. and a maximum out-of-pocket cost sharing of $9,250. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.

Monthly Premium $0 / mo

Health portion of premium $0

Drug portion of premium $0

Annual Deductible $0 or $283 per year for in-network services. / yr

Max Out-of-Pocket · in-network $9,250 / yr

Primary doctor visit 20% coinsurance

Specialist visit 20% coinsurance

ER visit 20% coinsurance

Ambulance 20% coinsurance

Additional Benefits and Coverage

Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) is a Medicare Advantage plan which includes Medicare Part D prescription drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) includes coverage for hearing, vision, dental.

Part D Prescription Drug Coverage Yes

Dental Yes

Vision Yes

Hearing Yes

Nationwide Coverage No

Other benefits

Fitness benefit Limited coverage

Over-the-counter drug benefits Limited coverage

In-home support services Not covered

Home & bathroom safety devices Not covered

Meals for short duration Limited coverage

Annual physical exams Not covered

Telehealth Limited coverage

Medical Benefits

Doctor Services

Primary doctor visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Specialist visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Tests, labs & imaging

Diagnostic tests & procedures In-network: $0 copay
Out-of-network: $0 copay

Lab services In-network: $0 copay
Out-of-network: $0 copay

Diagnostic radiology services (like MRI) In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Outpatient x-rays In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Emergency care 20% coinsurance

Urgent care 20% coinsurance

Hospital Services

Inpatient hospital coverage Tier 1
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150

Outpatient hospital coverage In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Skilled nursing facility

Skilled nursing facility Tier 1
$0 per day for days 1-20
$217 per day for days 21-100

Preventive services

Preventive services In-network: $0 copay
Out-of-network: $0 copay

Ambulance

Ground ambulance In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Therapy services

Occupational therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Physical therapy & speech & language therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Outpatient individual therapy with a psychiatrist In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Outpatient group therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Outpatient individual therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Opioid treatment services

Opioid treatment services Covered

Other services

Durable medical equipment (like wheelchairs & oxygen) In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Diabetes supplies In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Prescription drugs (Part D benefits)

Drug tier standard retail · 1-month supply Initial coverage Catastrophic

Generic Drugs 25% coinsurance 0% coinsurance

Brand Name Drugs 25% coinsurance 0% coinsurance

Part B drugs

Chemotherapy drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Other Part B drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Medicare star rating

Each year the federal government rates Medicare Advantage and Part D plans on a 5-star system covering quality of care, chronic-condition management, member experience, and customer service. For 2026, Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) earned an overall rating of 2.5 stars — worse than New Mexico's state average of 3.2 stars.

Rating category This plan State average

Overall star rating ★ 2.5 3.2

Health plan quality

Summary rating of health plan quality ★ 3.0 3.3

Staying healthy: screenings, tests & vaccines ★ 4.0 3.8

Managing chronic (long-term) conditions ★ 3.0 3.0

Member experience with health plan ★ 2.0 2.7

Member complaints & changes in performance ★ 3.0 4.0

Health plan customer service ★ 4.0 4.2

Drug plan quality

Summary rating of drug plan quality ★ 2.5 2.9

Drug plan customer service ★ 4.0 4.4

Member complaints & changes in performance ★ 3.0 3.3

Member experience with the drug plan ★ 2.0 2.7

Drug safety & accuracy of drug pricing ★ 3.0 3.6

Extra Benefits

Hearing

Hearing exam In-network: $0 copay
Out-of-network: $0 copay

Fitting/evaluation In-network: $0 copay
Out-of-network: $0 copay

Hearing aids - prescription In-network: $0 copay
Out-of-network: $0 copay

Hearing aids - over the counter Not covered

Preventive dental

Oral exam In-network: $0 copay
Out-of-network: $0 copay

Cleaning In-network: $0 copay
Out-of-network: $0 copay

Fluoride treatment Not covered

Dental x-rays In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

Restorative services In-network: $0 copay
Out-of-network: $0 copay

Endodontics In-network: $0 copay
Out-of-network: $0 copay

Periodontics In-network: $0 copay
Out-of-network: $0 copay

Prosthodontics, removable In-network: $0 copay
Out-of-network: $0 copay

Prosthodontics, fixed In-network: $0 copay
Out-of-network: $0 copay

Maxillofacial prosthetics In-network: $0 copay
Out-of-network: $0 copay

Implant services Not covered

Oral and maxillofacial surgery In-network: $0 copay
Out-of-network: $0 copay

Orthodontics Not covered

Adjunctive general services In-network: $0 copay
Out-of-network: $0 copay

Vision

Routine eye exam In-network: $0 copay
Out-of-network: $0 copay

Contact lenses In-network: $0 copay
Out-of-network: $0 copay

Eyeglasses (frames & lenses) Not covered

Eyeglass frames (only) In-network: $0 copay
Out-of-network: $0 copay

Eyeglass lenses (only) In-network: $0 copay
Out-of-network: $0 copay

Upgrades Not covered

Plan documents & tools

Plan details (carrier site)Provider directory Drug list (formulary)

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