Blue Medicare Medical Only (HMO-POS)

Available to residents of Caswell County, NC for 2027. Contract H3449, plan 012, segment 0.

2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.

New for 2027. This plan has no 2026 predecessor in the CMS crosswalk. Every NC plan’s 2026–2027 changes →

Plan details

Monthly premium (Part C + D)	$0.00
— medical (Part C) part	$0.00
— drug (Part D) part	—?
Part B premium reduction (giveback)	$35.00 a month?You must continue to pay your Medicare Part B premium.
Health plan deductible (in-network)	None
In-network out-of-pocket maximum	$3,900.00?
Drug deductible	this plan has no drug coverage
Plan type	HMO-POS?
Contract / plan	H3449-012-0
Offered by	Blue Cross and Blue Shield of North Carolina
Parent organization	CuraCor Solutions Corp.
Pharmacy search	medicare.bluecrossnc.com/prescription-drug-coverage
Member services	(866)760-0823TTY 711

CMS star ratings

Overall: 4 out of 5 stars for Overall
Health plan (Part C): 4.5 out of 5 stars for Health plan (Part C)
Drug plan (Part D): 3 out of 5 stars for Drug plan (Part D)

Published per contract — every plan under contract H3449 shares this rating.

Plan health benefits

Service	In-network
Doctor visits
Primary care doctor	$0 copay
Specialist	$25 copay
Other health care professional	$0–$25 copay
Additional telehealth services	$0–$25 copay(authorization required)
Preventive care
Medicare-covered preventive services	$0 copay
Annual physical exam	$0 copay
Kidney disease education	$0 copay
Glaucoma screening	$0 copay
Diabetes self-management training	$0 copay
Diagnostic tests, labs and imaging
Diagnostic tests and procedures	$0–$25 copay(authorization required)
Lab services	$0–$25 copay(authorization required)
Diagnostic radiology (e.g. MRI, CT)	$0–$300 copay; 20% coinsurance(authorization required)
Therapeutic radiology	$0–$60 copay; 20% coinsurance(authorization required)
Outpatient x-rays	$0–$30 copay(authorization required)
Emergency and urgent care
Emergency room	$150 copay
Urgent care	$65 copay
Worldwide emergency coverage	$150 copay · $100,000 plan limit
Worldwide urgent care	$65 copay · $100,000 plan limit
Worldwide emergency transportation	$250 copay
Hospital care
Inpatient hospital stay	$295 per day for days 1–6; $0 per day for days 7–90; $0 per day for days 91–999 (additional days)(authorization required)
Outpatient hospital services	$0–$275 copay(authorization required)
Outpatient observation	$0 copay
Ambulatory surgical center	$0–$225 copay(authorization required)
Outpatient blood services	$0 copay
Skilled nursing and home health
Skilled nursing facility	$0 per day for days 1–20; $221 per day for days 21–100(authorization required)
Home health care	$0 copay(authorization required)
Kidney dialysis	20% coinsurance
Rehabilitation
Occupational therapy	$25 copay
Physical therapy and speech-language therapy	$25 copay
Cardiac rehabilitation	$20 copay
Pulmonary rehabilitation	$15 copay
Mental health and substance use
Inpatient psychiatric hospital stay	$295 per day for days 1–5; $0 per day for days 6–90(authorization required)
Outpatient mental health, individual session	$25 copay
Outpatient mental health, group session	$25 copay
Psychiatrist, individual session	$25 copay
Psychiatrist, group session	$25 copay
Partial hospitalization	$40 copay(authorization required)
Intensive outpatient program	$40 copay(authorization required)
Outpatient substance use, individual session	$25 copay
Outpatient substance use, group session	$25 copay
Opioid treatment program	$10 copay
Ambulance and transportation
Ground ambulance	$250 copay(authorization required)
Air ambulance	$250 copay(authorization required)
Transportation to plan-approved locations	Not covered
Medical equipment and supplies
Durable medical equipment (e.g. wheelchairs, oxygen)	20% coinsurance(authorization required)
Prosthetics (e.g. braces, artificial limbs)	20% coinsurance(authorization required)
Medical supplies	20% coinsurance(authorization required)
Diabetes supplies	0%–20% coinsurance(authorization required)
Diabetic therapeutic shoes or inserts	20% coinsurance(authorization required)
Chiropractic, acupuncture and foot care
Chiropractic (Medicare-covered)	$20 copay
Routine chiropractic care	Not covered
Acupuncture	Not covered
Foot exams and treatment (Medicare-covered)	$25 copay
Routine foot care	Not covered
Dental?
Medicare-covered dental services	$25 copay(authorization required)
Preventive dental plan limit	$2,000 plan limit every year
Oral exams	$0 copay(limits apply)
Cleanings	$0 copay(limits apply)
Fluoride treatment	$0 copay(limits apply)
Dental x-rays	$0 copay(limits apply)
Other diagnostic dental services	Not covered
Other preventive dental services	Not covered
Restorative services (fillings, crowns)	$0 copay(limits apply)
Endodontics (root canals)	$0 copay(limits apply)
Periodontics (gum disease)	$0 copay(limits apply)
Dentures and other removable prosthodontics	$0 copay(limits apply)
Maxillofacial prosthetics	Not covered
Implants	Not covered
Bridges and other fixed prosthodontics	Not covered
Oral and maxillofacial surgery	$0 copay(limits apply)
Orthodontics	Not covered
Adjunctive general services	$0 copay(limits apply)
Vision?
Eye exam (Medicare-covered)	$0–$25 copay(limits apply)
Routine eye exam	$0 copay(limits apply)
Eyewear after cataract surgery (Medicare-covered)	20% coinsurance(limits apply)
Contact lenses	$0 copay(limits apply)
Eyeglasses (frames and lenses)	$0 copay(limits apply)
Eyeglass lenses	$0 copay(limits apply)
Eyeglass frames	$0 copay(limits apply)
Eyewear upgrades	$0 copay(limits apply)
Hearing?
Hearing exam (Medicare-covered)	$20 copay
Routine hearing exam	$0 copay(limits apply)
Hearing aid fitting and evaluation	$0 copay
Hearing aids (all types)	$499–$999 copay(limits apply)
Hearing aids, inner ear	Not covered
Hearing aids, outer ear	Not covered
Hearing aids, over the ear	Not covered
Medicare Part B drugs
Part B insulin	$35 copay(authorization required, step therapy may apply)
Chemotherapy and radiation drugs	0%–20% coinsurance(authorization required, step therapy may apply)
Other Part B drugs	0%–20% coinsurance(authorization required, step therapy may apply)
Other extra benefits?
Over-the-counter (OTC) allowance	$100 allowance every three months
Meals after a hospital stay or for a chronic condition	$0 copay(referral required)
Fitness benefit	$0 copay
Health education	Not covered
Nutritional / dietary benefit	Not covered
Extra smoking and tobacco cessation counseling	$0 copay
Enhanced disease management	Not covered
Telemonitoring	Not covered
Remote access technologies (web/phone, nurse line)	Not covered
Home and bathroom safety devices	Not covered
Counseling services	Not covered
In-home safety assessment	Not covered
Personal emergency response system (PERS)	$0 copay
Medical nutrition therapy	Not covered
Post-discharge in-home medication reconciliation	Not covered
Re-admission prevention	Not covered
Wigs for hair loss from chemotherapy	Not covered
Weight management programs	Not covered
Alternative therapies	Not covered
Therapeutic massage	Not covered
Adult day health services	Not covered
Home-based palliative care	Not covered
In-home support services	Not covered
Support for caregivers	$0 copay

In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2027). A range means the cost depends on the service or setting. Rows the filing does not state are left out rather than guessed. Contact the plan for the full Evidence of Coverage.

Star rating measures

Measures are paired between the two years by name, not by the C/D number: CMS reuses those numbers, and in 2027 nineteen of them refer to a different measure than they did in 2026. A measure introduced for 2027 has no 2026 score to show. Published per contract — every plan under H3449 shares it.

Benefits in plain text

Blue Medicare Medical Only (HMO-POS) (H3449-012-0) is a 2027 HMO-POS Medicare Advantage health plan without drug coverage offered by Blue Cross and Blue Shield of North Carolina, available to residents of Caswell County, NC.

The monthly premium is $0.00.

The plan reduces the member's Medicare Part B premium by $35.00 a month (a "giveback"); the Part B premium itself must still be paid.

There is no in-network deductible for health services.

Its in-network out-of-pocket maximum is $3,900.00.

CMS gives the plan's contract (H3449) an overall rating of 4 out of 5 stars.

Email a copy of the plan benefit details

Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.