Security Blue HMO-POS Basic (HMO-POS) 2025 Plan Details for Beaver County, Pennsylvania Residents
Security Blue HMO-POS Basic (HMO-POS) 2025 Plan Details for Beaver County, Pennsylvania Residents
Navigating your Medicare Advantage options in Beaver County for 2025 can be overwhelming, but we're here to help. With Security Blue HMO-POS Basic (HMO-POS) included in your plan options, you can evaluate it alongside other plans to make an informed decision. Enroll online quickly, or consult with a licensed agent if you need assistance.
Based on May, 2025 CMS enrollment data, an estimated 167 Medicare beneficiaries are enrolled in this plan, with 21 members in Beaver County, PA.
Security Blue HMO-POS Basic Overview
| Plan ID H3957-043-1 Overview | |
|---|---|
| Health Plan ID: | H3957-043-1 |
| Medicare Advantage Plan Type: | HMO-POS |
| Plan Year: | 2025 |
| Monthly Premium: | $30.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $5,900.00 (In-Network) |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Beaver County, PA |
| Insured By: | Highmark Blue Cross Blue Shield or Highmark Blue Shield |
Why Choose Security Blue HMO-POS Basic ?
This Medicare Advantage HMO-POS plan gives you structured benefits with added flexibility. With a monthly premium of $30.00, Security Blue HMO-POS Basic covers all the essentials of Medicare Part A and Part B, while giving you the option to see out-of-network providers in certain situations. You’ll typically pay less when staying in-network, but have the freedom to go outside when needed — a nice middle ground for those who want more control over their care.
Primary care visits have a not covered, specialist visits come with a $30 copay, urgent care services carry a $50 copay, and ambulance transportation is $125 copay. These costs all apply toward the plan’s annual maximum out-of-pocket (MOOP) limit of $5,900.00 . Once you reach that cap, your in-network services are covered at 100% for the rest of the year. It’s a dependable option if you’re looking for predictable costs and the flexibility to step outside the network when needed.
This plan is registered with CMS under ID H3957-043-1. You’ll find a summary of its cost sharing below, including what you can expect to pay for primary care, specialists, urgent care, and more. Still have questions? Check the FAQ section for more details.
| We're Here to Help You Enroll |
|---|
Out-of-Pocket Expenses
Security Blue HMO-POS Basic has cost-sharing, meaning you'll have out-of-pocket costs when using approved healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H3957-043-1.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | Not Covered |
| Specialist: | $30 Copay |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $125 Copay |
| Urgent care: | $50 Copay |
| Ground ambulance: | $125 Copay |
| Inpatient hospital care: | $340.00 per stay |
| Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $214.00 per day for days 21 and beyond |
This section covers Medicare-approved foot care services, including exams and routine foot care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | $30 Copay |
| Routine Foot Care: | $30 Copay |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | $15 Copay Prior Authorization Required |
| Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | $30 Copay |
| Outpatient group therapy: | $30 Copay |
| Inpatient psychiatric hospital care: | $340.00 per stay |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | $30 Copay Prior Authorization Required |
| Occupational therapy: | $30 Copay Prior Authorization Required |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | 20% Coinsurance Prior Authorization Required |
| Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
| Prosthetics: | 20% Coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | $100 Copay Prior Authorization Required |
| Lab services: | $20 Copay Prior Authorization Required |
| Outpatient x-rays: | $25 Copay Prior Authorization Required |
| Diagnostic tests and procedures: | $20 Copay Prior Authorization Required |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | 20% Coinsurance |
| Other Part B drugs (Medicare-covered): | 20% Coinsurance |
This section details the dental services covered under your plan including, Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | $30 Copay |
| Oral exam | |
| Dental x-rays | |
| Cleaning | |
| Periodontics | |
| Endodontics | |
| Restorative Services |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Covered Limits may apply |
| Hearing aids | Covered Limits may apply |
| Hearing exam | Not Covered |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | $30 Copay |
| Routine eye exam (in-network) | Covered Limits may apply |
| Eyewear benefits | Eyeglasses: Yes Contact Lenses: Yes Eyeglass Lenses: Yes Eyeglass Frames: Yes Eyewear Upgrades: Yes |
Maximum eyewear benefit: | $425.00 Every year |
Certain preventive services are covered 100% by Security Blue HMO-POS Basic as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
Understanding CMS Star Ratings
The Centers for Medicare & Medicaid Services (CMS) reviews and rates Medicare Advantage (Part C) and drug plans (Part D) annually, using a 5-star system to measure aspects such as member satisfaction, preventive services, and management of chronic conditions.
Higher star ratings generally indicate better plan performance, which can be a useful factor to consider when deciding on a plan that aligns with your healthcare goals and preferences.
| CMS Measure | Star Rating |
|---|---|
| 2025 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Am I Eligible for Security Blue HMO-POS Basic ?
To enroll in Security Blue HMO-POS Basic , you must meet the following criteria:
- Be eligible for Medicare Part A and Part B.
- Reside in the plan’s service area.
If you meet these requirements, you are eligible to enroll in Security Blue HMO-POS Basic and benefit from its comprehensive coverage options.
Enrollment Periods for Security Blue HMO-POS Basic
To ensure you don’t miss your chance to enroll in Security Blue HMO-POS Basic , be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to get assistance from a licensed insurance agent.
How to Enroll in Security Blue HMO-POS Basic
Joining Security Blue HMO-POS Basic is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join Security Blue HMO-POS Basic .
- Direct Enrollment: You can also choose to enroll directly with Security Blue HMO-POS Basic . The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Here are some of the most frequently asked questions people have about plan ID H3957-043-1:
Is there a premium for this plan in 2025?
Members pay their Part B premium and the plan's of $30.00 per month to be in this 2025 plan.
How high can my costs go in a worst-case year?
The annual in-network MOOP is $5,900.00 , protecting you from larger bills once you hit that limit.
What’s the CMS star score for Security Blue HMO-POS Basic ?
CMS rates it ★5.0 out of 5 stars for 2025.
Is Security Blue HMO-POS Basic popular?
CMS reports 167 members in the latest file.
Contact Highmark Blue Cross Blue Shield or Highmark Blue Shield
| Website: | Highmark Blue Cross Blue Shield or Highmark Blue Shield Plan Page |
|---|---|
| Providers: | Highmark Blue Cross Blue Shield or Highmark Blue Shield Providers Page |
| New Member Health Plan Help: | (866)670-5844 |
| New Member Health Plan TTY: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed October 15, 2024
- CMS.gov, Medicare Part C & D Performance — Last accessed October 15, 2024
- CMS.gov, Plan Benefits Package — Last accessed October 15, 2024
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed July 31, 2025
Learn more about how we use CMS data.
- Highmark Blue Cross Blue Shield or Highmark Blue Shield, http://medicare.highmark.com — Last accessed June 1, 2025
- CMS.gov, "Medicare Advantage Plan Fact Sheet" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content managed by David Bynon, Medicare Analyst.
Medicare Advantage and Part D plans and benefits offered by: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.