Medicare HMO Blue ValueRx (HMO)

BCBS OF MASSACHUSETTS HMO BLUE, INC. · 2026 plan year

Plan ID H2261-022-002

HMO★ 4.5 CMS Stars
MOOP (in-network)
$3,750
MOOP (combined)
—
Monthly premium
$79/mo
Part C $43 + Part D $36, before Extra Help
Prescription drugs
Included

This plan in 2027

Plan information

Contract / Plan / Segment
H2261-022-002
Medical deductible
$0 — no deductible
Part D premium
$36/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$320/yr
Also owed
Your Medicare Part B premium, paid separately

Other segments for this plan:

More BCBS OF MASSACHUSETTS HMO BLUE, INC. plans in MA

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$350/day for days 1–7, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$275/day for days 1–5, $0 after
Inpatient Hospital — Additional Days (Psychiatric)No charge
Worldwide Urgent Care Coverage$105

Pharmacy

BenefitIn-network
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Part B DrugsSee plan details
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health — Group Sessions$25
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$0-$25
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Hearing — Prescription Hearing AidsSee plan details
Intensive Cardiac Rehabilitation — Additional Sessions$15
Pulmonary Rehabilitation — Additional Sessions$15
Supervised Exercise Therapy (SET)$15
Skilled Nursing Facility (SNF)$0/day for days 1–20, $160/day for days 21–44, $0 after
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions$15
Emergency Services$140
Urgently Needed Services$0-$40
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$105
Worldwide Emergency Transportation$105
Partial Hospitalization Program$55
Intensive Outpatient Program (IOP)$55
Home Health ServicesNo charge
Primary Care Physician Services$10
Chiropractic Services$20
Occupational Therapy Services$20
Physician Specialist Services$0-$40
Podiatry Services$10-$40
Other Health Care Professional Services$10-$40
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$25
Psychiatric Services — Group Sessions$25
Physical Therapy & Speech-Language Pathology$20
Additional Telehealth Services (Part B)$0-$40
Opioid Treatment Program ServicesNo charge
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$10
Laboratory Services$0-$10
Radiological ServicesSee plan details
Diagnostic Radiology$250
Therapeutic RadiologyNo charge
X-Ray Services$10
Outpatient Hospital Services$250
Hospital Observation Services$250 per stay
Ambulatory Surgical Center (ASC)$200
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$25
Substance Abuse — Group Sessions$25
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$250
Air Ambulance$250
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & InsertsNo charge
Dialysis Services20% coinsurance
Meal BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Health EducationNo charge
Fitness BenefitNo charge
Enhanced Disease ManagementNo charge
Remote Access TechnologiesNo charge
Wigs for Chemotherapy Hair LossNo charge
Weight Management ProgramNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services$40
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Prophylaxis (Cleaning)No charge
Vision — Eye Exams$10-$40
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Hearing — Exams$10-$40
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Hearing Aids (All Types)$699-$999

Service area

  • MA: 1 county

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