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

HEALTH CARE SERVICE CORPORATION · 2027 plan year

Plan ID H3822-018-000

HMOPOS★ 3 CMS StarsDual-Eligible SNP
MOOP (in-network)
$5,000
MOOP (combined)
—
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H3822-018-000
Medical deductible
Medicare Part B deductible (CMS has not yet announced the 2027 amount)
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$200/yr
Also owed
Your Medicare Part B premium, paid separately

More HEALTH CARE SERVICE CORPORATION plans in NM

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — AcuteOriginal Medicare cost sharing
Inpatient Hospital — PsychiatricOriginal Medicare cost sharing
Worldwide Urgent Care Coverage$130

Pharmacy

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

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions20% coinsurance
Mental Health — Group Sessions20% coinsurance
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Skilled Nursing Facility (SNF)Original Medicare cost sharing
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions20% coinsurance
Intensive Cardiac Rehabilitation — Additional Sessions20% coinsurance
Pulmonary Rehabilitation — Additional Sessions20% coinsurance
Supervised Exercise Therapy (SET)20% coinsurance
Emergency Services20% coinsurance (max $115)
Urgently Needed Services20% coinsurance (max $40)
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$130
Substance Abuse — Group Sessions$35
Worldwide Emergency Transportation20% coinsurance
Partial Hospitalization Program20% coinsurance
Intensive Outpatient Program (IOP)20% coinsurance
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services20% coinsurance
Occupational Therapy Services$35
Physician Specialist Services$25
Podiatry Services$35
Other Health Care Professional Services$0-$25
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions20% coinsurance
Physical Therapy & Speech-Language Pathology$35
Additional Telehealth Services (Part B)No charge
Opioid Treatment Program Services$35
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$50
Laboratory Services0%-20% coinsurance
Radiological ServicesSee plan details
Diagnostic Radiology$0-$260
Therapeutic Radiology20% coinsurance
X-Ray Services$25
Outpatient Hospital Services$0-$550
Hospital Observation Services$550 per stay
Ambulatory Surgical Center (ASC)$0-$500
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$35
Outpatient Blood Services20% coinsurance
Ambulance ServicesSee plan details
Ground Ambulance$275
Air Ambulance20% coinsurance
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Supplies20% coinsurance
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic Monitors20% coinsurance
Dialysis Services20% coinsurance
Over-the-Counter (OTC) ItemsNo charge
Meal BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
Fitness BenefitNo charge
Remote Access TechnologiesNo 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 Services20% coinsurance
Vision — Eye ExamsSee plan details
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — ComprehensiveSee plan details
Dental — Restorative ServicesNo charge
Dental — Endodontics (Root Canal)No charge
Dental — Periodontics (Gum Care)No charge
Dental — Removable Prosthodontics (Dentures)No charge
Dental — Implant ServicesNo charge
Dental — Fixed Prosthodontics (Bridges)No charge
Dental — Oral & Maxillofacial SurgeryNo charge
Dental — Adjunctive General ServicesNo charge
Vision — Eye Exams20% coinsurance
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Hearing — Exams20% coinsurance
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)No charge
Psychiatric Services — Group Sessions20% coinsurance
Vision — Routine Eye ExamsNo charge
Vision — Eyewear20% coinsurance
Vision — EyewearSee plan details

Service area

  • NM: 33 counties

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