Security Blue HMO-POS Basic (HMO-POS)

HMO-POS
Highmark
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Monthly Premium
Not Applicable
Part C
$20.00
Part D
Out-of-Pocket Max
$5,900.00
/yr
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Key Benefits at a Glance

Dental Up to 

/yr

Vision 

$425.00

 eyewear allowance

Hearing 

/yr hearing aids

OTC 

/quarter credit

Transport 

24

 rides/year

Fitness 

Meals After Hosp 

{meal benefit}

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Overall Rating
Part C Rating
Part D Rating

Plan Benefits —
Copays & Cost Sharing

Benefit
In-Network Cost
Primary Care Visit
$15
Specialist Visit
$30
Emergency Room
$130
Urgent Care
Hospital Inpatient (day 1-5)
$340.00
Mental Health Outpatient
Telehealth
$0
Preventive Visit
$15
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Drug Formulary Tiers

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Medicare Questions About 

Medicare Advantage HMO-POS

 Plans

Understanding 

Medicare Advantage HMO-POS

An HMO-POS (Point of Service) plan works like a standard HMO but gives you the option to see out-of-network providers at a higher cost. You still have a primary care doctor and generally need referrals for specialists, but you're not completely locked out of seeing providers outside the network when you need to.

The HMO-POS is a middle-ground option. You get some of the cost savings that come with an HMO, but with a built-in escape hatch if you end up needing care that isn't available in-network. That might mean seeing a specialist with a narrow subspecialty, getting a second opinion at a major academic medical center, or accessing care when you're traveling.

The tradeoff is cost. Out-of-network care under an HMO-POS typically comes with higher copays and a separate (higher) out-of-pocket limit. Make sure you understand both the in-network and out-of-network maximums before enrolling — the gap between them can be significant.

In Utah, HMO-POS plans are available through several carriers including SelectHealth and Regence BlueCross. If you spend time both along the Wasatch Front and in rural areas where your primary network may not reach, this plan type is worth comparing side by side with a standard PPO. The premium difference is often small but the network access difference can be meaningful.

When comparing HMO-POS plans, pay attention to whether the out-of-network benefit applies nationwide or only within your service area. Plans vary on this point, and it matters if you travel outside your home region for care. Getting a clear answer on that before you enroll takes five minutes and could save you a real headache later.

Go to Plan Type
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HMO vs PPO — Which Is Right for You?

Not sure if this plan is right for you?

Peter Abilla is a licensed Medicare agent. He can walk you through this plan's costs, coverage, and whether your doctors are in-network.

Independent agent. Not affiliated with any insurance carrier.
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