Blue Advantage HMOSM Product Overview

(51–150 employees) (151+ employees)

BlueAdvantage HMO members receive Primary Care Physician (PCP) coordinated care. See how members can work together with their doctor when making health care decisions:


A PCP who:

  • Knows and understands a member's healthcare needs
  • Is informed about a member's medical history
  • Provides basic medical care
  • Prescribes medication
  • Coordinates care and treatment with specialists and provides appropriate referrals

Additionally, members enjoy:

  • Choice of a PCP from a large network of contracting HMO medical groups/independent practice associations
  • No claim forms
  • Flexible plan design options with deductible/coinsurance and copay features


Members have access to a range of benefits with the BlueAdvantage HMO product.

  • Doctor office visits
  • Preventive care and wellness services for children and adults such as:
    • routine physicals
    • immunizations
    • tests and screenings for breast and cervical cancer, prostate and colon cancer
  • Outpatient surgery and diagnostic tests
  • Outpatient and inpatient hospital services and treatments
  • Maternity care
  • Behavioral health services (inpatient and outpatient)
  • Rehabilitative therapy (such as physical, speech and occupational)

Other coverage and discounts on services such as:

  • Emergency care
  • Out-of-area coverage (traveling/temporarily living out of state)
  • Vision exams at the cost of an office visit copay and discounts on lenses, frames and permanent contact lenses, vision correction surgery and disposable contact lenses
  • Discounts on hearing aids
  • Discounts on chiropractic care, acupuncture and massage therapy and health and wellness products
  • Prescription drug card benefit with 90-day supply for maintenance medications


BlueAdvantage HMO offers one of the largest provider networks of primary care physicians (PCPs) and hospitals in the state.

Search for Doctors and Hospitals