Blue Medicare Medical Only (HMO-POS) Medicare Advantage Plan H3449-012 • 2027 • Durham County, NC
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $3900.00In-network
- Part B Giveback
- −$35.00 reduction
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Durham County, NC
- Local Enrollment
- 130 beneficiaries in Durham County
Blue Medicare Medical Only (HMO-POS) Introduction
CMS Plan ID H3449-012 identifies Blue Medicare Medical Only, a Medicare Advantage HMO-POS plan offered by Blue Cross and Blue Shield of North Carolina. The plan uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network and comes without prescription drug coverage. Its costs for the 2027 plan year include a $0.00 monthly premium, $0.00 medical deductible, and $3900.00 in-network maximum out-of-pocket.
This plan is available to eligible beneficiaries who live in Durham County, North Carolina. CMS reports local enrollment of 130 beneficiaries for this plan in Durham County. New members can contact the plan at (866)760-0823 (TTY 711) for help and additional plan information.
Compare Similar Plans in Durham County
Compare this plan with the two most-enrolled HMO-POS plans available in Durham County, North Carolina. Enrollment is based on CMS local enrollment data.
| Plan Detail | Blue Medicare Medical Only | Blue Medicare Essential Plus | Humana Gold Plus H1036-335 |
|---|---|---|---|
| CMS Plan ID | H3449-012-0 |
H3449-023-2 |
H1036-335-2 |
| Local Enrollment | 130 | 2,489 | 2,148 |
| Monthly Premium | $0.00 | $0.00 | $0.00 |
| Medical Deductible | $0.00 | $150 | $0.00 |
| Maximum Out-of-Pocket | $3,900.00 | $7,000.00 | $3,950.00 |
| Part B Giveback | −$35.00 reduction | Not offered | −$1.00 reduction |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $25 copay | $40 copay | $10 copay |
| Part D Deductible | Not Applicable | $700.00 | $700.00 |
| CMS Star Rating | 4.0 | 4.0 | 4.5 |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Want to explore more options? Browse all Medicare Advantage plans in Durham County, or compare Medicare Advantage plans across North Carolina, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Blue Medicare Medical Only includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H3449-012.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H3449-012-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $25 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- In-network: $0-$25 copay
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0-$300 copay, 20% coinsurance
- Lab services
- In-network: $0-$25 copay
- Outpatient x-rays
- In-network: $0-$30 copay
- Diagnostic tests and procedures
- In-network: $0-$25 copay
Emergency and Urgent Care Services
- Emergency room care
- $150 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $65 copay
- Inpatient hospital care
- In-network:
Tier 1
$295 per day for days 1-6
$0 per day for days 7-90
$0 per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$221 per day for days 21-100 - Ground ambulance
- In-network: $250 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $25 copay
- Outpatient group therapy
- In-network: $25 copay
- Inpatient psychiatric hospital care
- In-network:
Tier 1
$295 per day for days 1-6
$0 per day for days 7-90
$0 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $25 copay
- Occupational therapy
- In-network: $25 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: 0%-20% coinsurance
- Durable medical equipment
- In-network: 20% coinsurance
- Prosthetics
- In-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
- Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
Out-of-network: 20%-40% coinsurance - Dental x-rays
- In-network: $0 copay
Out-of-network: 20%-40% coinsurance - Cleaning
- In-network: $0 copay
Out-of-network: 20%-40% coinsurance - Periodontics
- In-network: $0 copay
Out-of-network: 20%-40% coinsurance - Endodontics
- In-network: $0 copay
Out-of-network: 20%-40% coinsurance - Restorative services
- In-network: $0 copay
Out-of-network: 20%-40% coinsurance - Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: $0 copay
Out-of-network: 20%-40% coinsurance
Vision Services
- Routine eye exam
- In-network: $0 copay
- Contact lenses
- In-network: $0 copay
- Eyeglass frames only
- In-network: $0 copay
- Eyeglass lenses only
- In-network: $0 copay
- Eyeglasses (frames & lenses)
- In-network: $0 copay
- Upgrades
- In-network: $0 copay
Hearing Services
- Hearing exam
- In-network: $0 copay
- Fitting/evaluation
- In-network: $0 copay
- Prescription hearing aids
- In-network: $499-$999 copay
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Blue Medicare Medical Only as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Performance Ratings (Contract ID: H3449)
CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 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 |
Contact Information for Blue Cross and Blue Shield of North Carolina
- Website
- Blue Cross and Blue Shield of North Carolina Plan Page
- Providers
- Blue Cross and Blue Shield of North Carolina Providers Page
- Formulary
- Blue Cross and Blue Shield of North Carolina Formulary Page
- Pharmacy
- Blue Cross and Blue Shield of North Carolina Pharmacy Page
- New Member Health Plan Help
- (866)760-0823
- New Member Health Plan TTY
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Blue Cross and Blue Shield of North Carolina (official source) | https://www.bluecrossnc.com/medicare | October 4, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
MedicarePlans.com is an independent, non-government informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.