Medicare Blue Choice 033 (HMO-POS) Medicare Advantage Plan H3351-033 • 2027
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $6500.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 0 beneficiaries
Medicare Blue Choice 033 (HMO-POS) Introduction
CMS Plan ID H3351-033 identifies Medicare Blue Choice 033, a Medicare Advantage HMO-POS plan offered by Excellus Health Plan, Inc. 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 $6500.00 in-network maximum out-of-pocket.
Plan Benefits
Medicare Blue Choice 033 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 H3351-033.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: $5 copay Out-of-network: 30% coinsurance |
Coming soon |
| Specialist | In-network: $35 copay Out-of-network: 30% coinsurance |
Coming soon |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | In-network: $0 copay | Coming soon |
| Telehealth benefit | In-network: $0-$35 copay, 20% coinsurance | Coming soon |
| Routine chiropractic | Not covered | Coming soon |
| Fitness benefits | Coming soon | Coming soon |
| Health education | Not covered | Coming soon |
| Counseling services | Not covered | Coming soon |
| Over-the-counter drug benefits | Not covered | Coming soon |
| Health transportation (non-emergency) | Coming soon | Coming soon |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: $150 copay Out-of-network: 30% coinsurance |
Coming soon |
| Lab services | In-network: $15 copay Out-of-network: 30% coinsurance |
Coming soon |
| Outpatient x-rays | In-network: $40 copay Out-of-network: 30% coinsurance |
Coming soon |
| Diagnostic tests and procedures | In-network: $15 copay Out-of-network: 30% coinsurance |
Coming soon |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $115 copay | Coming soon |
| Worldwide emergency care | Coming soon | Coming soon |
| Urgent care | $40 copay | Coming soon |
| Inpatient hospital care | In-network: Tier 1 $325 per day for days 1-5 $0 per day for days 6-90 $0 per stay Out-of-network: 30% per stay |
Coming soon |
| Skilled Nursing Facility | In-network: Tier 1 $0 per day for days 1-20 $221 per day for days 21-100 Out-of-network: 30% per stay |
Coming soon |
| Ground ambulance | In-network: $200 copay Out-of-network: $200 copay |
Coming soon |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: $0 copay Out-of-network: 30% coinsurance |
Coming soon |
| Outpatient group therapy | In-network: $0 copay Out-of-network: 30% coinsurance |
Coming soon |
| Inpatient psychiatric hospital care | In-network: Tier 1 $325 per day for days 1-5 $0 per day for days 6-90 $0 per stay Out-of-network: 30% per stay |
Coming soon |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $35 copay Out-of-network: 30% coinsurance |
Coming soon |
| Occupational therapy | In-network: $35 copay Out-of-network: 30% coinsurance |
Coming soon |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: $5 copay, 20% coinsurance Out-of-network: 30% coinsurance |
Coming soon |
| Durable medical equipment | In-network: 20% coinsurance Out-of-network: 30% coinsurance |
Coming soon |
| Prosthetics | In-network: 20% coinsurance Out-of-network: 30% coinsurance |
Coming soon |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
Coming soon |
| Other Part B drugs (Medicare-covered) | In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
Coming soon |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | In-network: $0 copay | Coming soon |
| Dental x-rays | In-network: $0 copay | Coming soon |
| Cleaning | In-network: $0 copay | Coming soon |
| Periodontics | Not covered | Coming soon |
| Endodontics | Not covered | Coming soon |
| Restorative services | Not covered | Coming soon |
| Implant services | Not covered | Coming soon |
| Orthodontics | Not covered | Coming soon |
| Oral/Maxillofacial surgery | Not covered | Coming soon |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | In-network: $0 copay | Coming soon |
| Contact lenses | In-network: $0 copay | Coming soon |
| Eyeglass frames only | Not covered | Coming soon |
| Eyeglass lenses only | Not covered | Coming soon |
| Eyeglasses (frames & lenses) | In-network: $0 copay | Coming soon |
| Upgrades | Not covered | Coming soon |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | In-network: $0 copay | Coming soon |
| Fitting/evaluation | In-network: $0 copay | Coming soon |
| Prescription hearing aids | In-network: $299-$799 copay | Coming soon |
| OTC hearing aids | Not covered | Coming soon |
Additional and Special Needs Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Adult day health services | Not covered | Coming soon |
| Home-based palliative care | Not covered | Coming soon |
| Personal emergency response system | Coming soon | Coming soon |
| Weight management programs | Not covered | Coming soon |
| Wigs for chemotherapy-related hair loss | Coming soon | Coming soon |
| Alternative therapies | Not covered | Coming soon |
| Massage therapy | Not covered | Coming soon |
| Home/bathroom safety devices | Not covered | Coming soon |
Certain preventive services are covered 100% by Medicare Blue Choice 033 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: H3351)
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 Excellus Health Plan, Inc
- Website
- Excellus Health Plan, Inc Plan Page
- Providers
- Excellus Health Plan, Inc Providers Page
- Formulary
- Excellus Health Plan, Inc Formulary Page
- Pharmacy
- Excellus Health Plan, Inc Pharmacy Page
- New Member Health Plan Help
- (800)659-1986
- 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.
Plan Availability
Medicare Blue Choice 033 (H3351-033-0) is available in the following locations:
Frequently Asked Questions
Here are some of the most frequently asked questions about this plan (click to open).
Frequently Asked Questions About Medicare Blue Choice 033 (HMO-POS)
Is there a monthly premium for this plan in 2027?
For 2027, the monthly premium is $0.00. Medicare Part B premiums apply in addition to this amount.
What is the MOOP for Medicare Blue Choice 033 in 2027?
For 2027, the in-network maximum out-of-pocket is $6500.00. The plan pays 100% of covered in-network services beyond this amount.
How many beneficiaries are enrolled in this plan?
CMS reports 0 beneficiaries enrolled in this plan.
What is the Part D deductible for plan H3351-033?
The plan’s Part D deductible is $0.00, applied to covered prescription drug costs.
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 |
|---|---|---|
| Excellus Health Plan, Inc (official source) | http://www.UniveraMedicare.com | October 4, 2026 |
| Medicare.gov | Compare types of Medicare Advantage Plans | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
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Data provenance is documented in accordance with 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.