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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 2026, 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 2026.
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:
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Drug Coverage
Prescription drugs are not covered by BCN Advantage Elements (HMO-POS).
Additional Benefits
The BCN Advantage Elements (HMO-POS) plan offers comprehensive medical coverage featuring no copays or coinsurance for primary care visits, preventive services, and home health care. Specialist visits and outpatient therapy sessions require a $35 copay with no coinsurance. For hospital stays, members pay a $250 daily copay for the first seven days of inpatient care and no copay for days eight through 90, while emergency room visits carry a $130 copay. This plan also includes valuable supplemental benefits, such as dental coverage up to $1,500 annually and a $100 yearly allowance for eyewear with no copays or coinsurance. Routine hearing exams have no copay, while prescription hearing aids are covered with copays ranging from $495 to $1,695. Additionally, members receive a $50 quarterly allowance for over-the-counter items with no copay and enjoy no copays for the first 20 days of a skilled nursing facility stay.
Inpatient Hospital See details
BCN Advantage Elements (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $250 daily copay for days 1 through 7 and no copay for days 8 through 90 for acute and psychiatric stays. While unlimited additional acute hospital days are covered with no copay, additional psychiatric days, hospital upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
BCN Advantage Elements (HMO-POS) covers outpatient hospital services with a $200 copay and observation services with a $130 copay per stay, both with no coinsurance. Ambulatory surgical center services and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 copay and no coinsurance.
Partial Hospitalization See details
BCN Advantage Elements (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for some of these covered services.
Ambulance and Transportation Services See details
Ambulance services are covered by BCN Advantage Elements (HMO-POS) with a $300 copay and no coinsurance for Medicare-covered ground and air trips, though transportation services to health-related locations are not covered.
Emergency Services See details
BCN Advantage Elements (HMO-POS) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within three days. Urgently needed care has no copay to a $45 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to $50,000 with no coinsurance and copays of $130, $45, and $300 respectively.
Primary Care See details
Primary care and professional services are partially covered by BCN Advantage Elements (HMO-POS), featuring no copay and no coinsurance for primary care provider visits, telehealth, and opioid treatment. Covered specialist, physical therapy, and occupational therapy services require a $35 copay and no coinsurance, while podiatry services are not covered.
Preventive Services See details
BCN Advantage Elements (HMO-POS) covers preventive services, annual physical exams, and kidney disease education with no copay and no coinsurance. Additional preventive services are partially covered, but health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling are not covered.
Hearing Services See details
BCN Advantage Elements (HMO-POS) covers hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copayment ranging from $495 to $1,695 for up to two devices per year, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by BCN Advantage Elements (HMO-POS) with no deductible, offering eye exams for a $0 to $35 copay and no coinsurance, and eyewear with no copay or coinsurance up to a $100 yearly limit. Other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services are partially covered by BCN Advantage Elements (HMO-POS), featuring a $1,500 annual maximum for non-Medicare services with no copay and no coinsurance, while Medicare-covered dental has a $0 to $200 copay and no coinsurance. Covered benefits include exams, cleanings, x-rays, fillings, root canals, and extractions, but other diagnostic services, other preventive services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by BCN Advantage Elements (HMO-POS) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, range from no coinsurance to 20% coinsurance, with insulin also carrying a $35 copay.
Dialysis Services See details
BCN Advantage Elements (HMO-POS) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
BCN Advantage Elements (HMO-POS) partially covers medical equipment with no copay, though prior authorization is required. Covered durable medical equipment and diabetic supplies range from no coinsurance to 20% coinsurance, and prosthetics and medical supplies carry a 20% coinsurance, while diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
BCN Advantage Elements (HMO-POS) partially covers diagnostic and radiological services with no coinsurance, though prior authorization is required for these services. Diagnostic procedures range from no copay to a $20 copay, outpatient x-rays and diagnostic radiology require a minimum $20 copay, and therapeutic radiology requires a minimum $25 copay, while lab services are not covered.
Home Health Services See details
Home Health Services are covered under the BCN Advantage Elements (HMO-POS) plan with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under BCN Advantage Elements (HMO-POS) with no coinsurance and prior authorization required, though some services are covered but cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered and require copays ranging from $10 to $15.
Skilled Nursing Facility (SNF) See details
BCN Advantage Elements (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
BCN Advantage Elements (HMO-POS) partially covers other services, featuring over-the-counter (OTC) items with no copay and no coinsurance up to $50 every three months, mobile mental health services for a $20 copay and no coinsurance, and ambulance no-transport services for a $90 copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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