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Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

Blue adVantage Giveback, 2027

H6453Contract021Plan

HMO-POS · 31 counties in Louisiana

Run by HMO Louisiana, Inc. (contract H6453), sold as Blue Cross and Blue Shield of Louisiana, owned by Louisiana Health Service & Indemnity Company

Takes in 1 plan

2026 star rating, contract H6453: 4 of 5

Blue adVantage Giveback (H6453-021) costs $0 a month in 2027, with an in-network out-of-pocket limit of $5,500. It is a new plan for 2027. It takes in the members of H6453-020.

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it.
What you pay or get20262027Change
Monthly premiumnot offered$0new for 2027
In-network out-of-pocket limitnot filed$5,500new for 2027
Drug deductiblenot filed$700new for 2027
Part B premium reduction, monthlynone$57added
Primary care visitnot offered$0 copaychanged
Specialist visitnot offered$75 copaychanged
Emergency roomnot offered$130 copaychanged
Hospital stay, in networknot offered$295 a day for days 1–7, then $0 a day for days 8–90changed
Skilled nursing facility, in networknot offered$0 a day for days 1–20, then $200 a day for days 21–100changed
Ground ambulance, in networknot offered$250 copaychanged
Eyewear, yearly limitnot offered$100 a yearadded
Hearing aids, yearly limit for both earsnot offered$266.67 a yearadded
4 lines do not change
Medical deductible, in networknonenoneno change
Comprehensive dental, yearly limitnot offerednot offeredno change
Over-the-counter items, yearlynot offerednot offeredno change
Counties servednot offered31new for 2027

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

What will prescriptions cost?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked. The plan charges less at its preferred pharmacies
TierWhat the tier holds2026, standard pharmacy2027, standard pharmacy2027, preferred pharmacy
Tier 1Preferred Genericnot offered$10$0
Tier 2Genericnot offered$18$12
Tier 3Preferred Brandnot offered$47$45
Tier 4Non-Preferred Drugnot offered50% of the cost50% of the cost
Tier 5Specialty Tiernot offered25% of the cost25% of the cost

Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.

How does it compare with plans sold where it is?

In the counties it serves, 36 plans open to everyone are sold for 2027, this one included. Against the others, 11 plans have a lower out-of-pocket limit, 24 a higher one. On the premium, 25 the same, 10 a higher one.

Out-of-pocket limits of the 36 plans open to everyone

$0 to under $2,0000 plans
$2,000 to under $4,0002 plans
$4,000 to under $6,000 (this plan)12 plans
$6,000 to under $8,00018 plans
$8,000 to $10,0004 plans

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

The premium and the out-of-pocket limit are the same in all 31 counties: $0 a month and $5,500.

Louisiana

AcadiaAllenAvoyellesBeauregardBossierCaddoCalcasieuCameronCatahoulaDe SotoEast CarrollEvangelineFranklinIberiaJefferson DavisLaSalleLafayetteLincolnMorehouseOuachitaRichlandSabineSt. LandrySt. MartinSt. MaryTensasVermilionVernonWebsterWest CarrollWinn

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Which 2026 plans move into it, and what changes for their members?

For 2027 this plan takes in the members of 1 other plan. In 2027 it costs $0 a month with a $5,500 limit; each row compares that with the plan its members had in 2026.

2026 planMembers, Sept. 2026Members who movePremium 2026Premium changeLimit 2026Limit change
Blue adVantage GivebackH6453-0203,8981,233$0no change$5,500no change

Only the members of Blue adVantage Giveback (H6453-020) who live in the 31 counties where this plan is sold move into it (1,233 of its 3,898 members); in its other 33 counties the plan ends and members choose a new one. What happens where.

Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision). Each moving plan's own page lists every line that changes for its members.

Who runs this plan?

Plan ID
H6453-021
Legal name of the contract
HMO Louisiana, Inc.
Sold as
Blue Cross and Blue Shield of Louisiana
Parent company
Louisiana Health Service & Indemnity Company
Plan type
HMO-POS
2026 star rating of the contract
4 of 5 overall; health plan 4 of 5, drug plan 4.5 of 5
Plan website, as filed with CMS
www.lablue.com/blueadvantage

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.