A non-government entity
BCN Advantage Elements (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BCN Advantage Elements (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on BCN Advantage Elements (HMO-POS) in 2025, please refer to our full plan details page.
BCN Advantage Elements (HMO-POS) is a HMO-POS plan offered by Blue Cross Blue Shield of Michigan Mutual Ins. Co. available for enrollment in 2025 to people living in Michigan. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that BCN Advantage Elements (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about BCN Advantage Elements (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For BCN Advantage Elements (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $20.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $4500.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $4500.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for BCN Advantage Elements (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
Prescription drugs are not covered by BCN Advantage Elements (HMO-POS).
Additional Benefits
The BCN Advantage Elements (HMO-POS) plan offers a variety of benefits with varying cost-sharing. Inpatient hospital stays have a $205 copay for days 1-7, and no copay for days 8-90. The plan covers outpatient services, primary care, preventive services, hearing, vision, dental, home infusion, dialysis, medical equipment, diagnostic and radiological services, home health, and skilled nursing facility services. The plan includes copays for services such as outpatient, emergency, and specialist visits, as well as hearing exams and some dental work. The plan also covers ambulance, transportation, and offers additional benefits like over-the-counter items and a meal benefit. Be aware that some services like Cardiac Rehabilitation Services are not covered by this plan.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered. For days 1-7, there is a $205 copay, and for days 8-90, there is no copay.
Outpatient Services See details
Outpatient Services, including outpatient hospital services and observation services, are covered under the plan. Outpatient hospital services have a $200 copay, while Ambulatory Surgical Center (ASC) Services have no copay. Outpatient Substance Abuse Services have a $35 copay for both individual and group sessions. Outpatient Blood Services are covered, with a waived deductible for three pints.
Partial Hospitalization See details
Partial Hospitalization is covered by the BCN Advantage Elements (HMO-POS) plan, requiring prior authorization, and has a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the BCN Advantage Elements (HMO-POS) plan. Ground and Air Ambulance Services have a $300 copay, and Transportation Services to any health-related location are covered for one round trip per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the BCN Advantage Elements (HMO-POS) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $45; both have no coinsurance. Worldwide Emergency Services include Worldwide Emergency Coverage with a $125 copay, Worldwide Urgent Coverage with a $45 copay, and Worldwide Emergency Transportation with a $300 copay, and all of these have no coinsurance.
Primary Care See details
The BCN Advantage Elements (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $30 copay, physician specialist services with a $35 copay, mental health specialty services with a $20 copay for individual and group sessions, physical therapy and speech-language pathology services with a $30 copay, additional telehealth benefits, and opioid treatment program services. Podiatry services are not covered. Other health care professional services have a copay that ranges from $0 to $35, and psychiatric services have a $20 copay for individual and group sessions.
Preventive Services See details
The BCN Advantage Elements (HMO-POS) plan covers preventive services, including annual physical exams and additional preventive services. The plan also covers Health Education, Nutritional/Dietary Benefits (up to 6 visits), Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications (up to $100 per year), Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. However, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, and Counseling Services are not covered.
Hearing Services See details
Hearing Services include hearing exams, with a $0 copay for routine hearing exams and fitting/evaluation for hearing aids; and prescription hearing aids, with a maximum plan benefit of $600 per ear every three years. Prescription hearing aids (all types) are covered, but inner ear, outer ear, and over-the-ear hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
Under the BCN Advantage Elements (HMO-POS) plan, vision services include eye exams with a copay of $0 - $35, and eyewear with a combined maximum benefit of $150 per year for frames or elective contact lenses. Contact lenses are covered, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered by the BCN Advantage Elements (HMO-POS) plan, with a maximum plan benefit of $1,500 per year. Oral exams have a copay between $0 and $200 for up to 2 visits per year, while other services like dental x-rays, cleaning, fluoride treatment, and oral surgery are also covered with varying limitations. However, maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay with a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the BCN Advantage Elements (HMO-POS) plan. You will pay 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME) with 0-20% coinsurance and no copay, though Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies are covered with 20% coinsurance and no copay, while Diabetic Equipment is covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $20, while Lab Services are not covered. Diagnostic Radiological Services have a copay up to $100, Therapeutic Radiological Services have a copay up to $25, and Outpatient X-Ray Services have a $20 copay.
Home Health Services See details
Home Health Services are covered by the BCN Advantage Elements (HMO-POS) plan with no copay or coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the BCN Advantage Elements (HMO-POS) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the BCN Advantage Elements (HMO-POS) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other services include coverage for Over-the-Counter (OTC) items, with a maximum benefit of $50 every three months, and a meal benefit for chronic illnesses. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Other 1 has a $20 copay for Mobile Mental Health, and Other 2 has a $90 copay for Ambulance No Transport.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved