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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 robust medical coverage with many essential services requiring no copay and no coinsurance. For instance, primary care, telehealth, and home health services feature no copay, while specialist visits carry a low copay between $15 and $35. Inpatient hospital stays require a $250 daily copay for the first seven days and no copay thereafter, while emergency room visits carry a $130 copay that is waived upon admission. Supplemental benefits are also highly affordable, featuring dental care up to $1,500 annually and routine hearing exams with no copay or coinsurance. Routine eye exams have a $0 to $35 copay, which is paired with a $100 annual eyewear allowance with no copay. Furthermore, members benefit from a $50 quarterly over-the-counter reimbursement and no copay for the first 20 days of skilled nursing facility care.
Inpatient Hospital See details
BCN Advantage Elements (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $250 daily copay for days 1 to 7 and no copay for days 8 to 90. Prior authorization is required, and while unlimited additional acute hospital days are covered, additional psychiatric days, 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 fully covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 copay with no coinsurance.
Partial Hospitalization See details
BCN Advantage Elements (HMO-POS) covers partial hospitalization services with a $55 copay and no coinsurance. Prior authorization is required for some of these covered services.
Ambulance and Transportation Services See details
BCN Advantage Elements (HMO-POS) covers Medicare-covered ground and air ambulance services with a $300 copay per service and no coinsurance, which is not waived if you are admitted to the hospital. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
BCN Advantage Elements (HMO-POS) covers emergency services with a $130 copay, which is waived if admitted to the hospital within three days, and no coinsurance. Urgently needed services are covered with no copay to a $45 copay and no coinsurance, while worldwide emergency services are covered up to a $50,000 maximum with no coinsurance and copays ranging from $45 to $300.
Primary Care See details
BCN Advantage Elements (HMO-POS) offers partially covered primary care and specialist services, with podiatry services being not covered under the plan. Primary care, telehealth, and opioid treatment services have no copay and no coinsurance, while specialist visits, therapies, mental health, and chiropractic care carry copays ranging from $15 to $35 and no coinsurance.
Preventive Services See details
BCN Advantage Elements (HMO-POS) covers preventive services, including annual physical exams, kidney disease education, and fitness benefits, with no copay and no coinsurance. While select additional preventive services like nutritional counseling and smoking cessation are included, this benefit is only partially covered as services such as health education, in-home safety assessments, and weight management programs are not covered.
Hearing Services See details
BCN Advantage Elements (HMO-POS) covers hearing services, offering routine hearing exams and fittings with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay between $495.00 and $1,695.00 for up to two aids per year, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
BCN Advantage Elements (HMO-POS) offers partially covered vision services with no deductibles, featuring one routine annual eye exam for a $0 to $35 copay and no coinsurance. Eyewear is covered with no copay or coinsurance up to a $100 annual limit for contact lenses, eyeglass lenses, and frames, while upgrades, other eye exam services, and complete eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by BCN Advantage Elements (HMO-POS) up to a $1,500 annual limit, featuring no copay and no coinsurance for covered preventive and comprehensive care. Medicare-covered dental services require a $0 to $200 copay with no coinsurance, but other diagnostic dental, other preventive dental, 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. Covered Medicare Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%, while chemotherapy, radiation, and other Part B drugs have no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by BCN Advantage Elements (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
BCN Advantage Elements (HMO-POS) partially covers medical equipment with no copays and prior authorization requirements, excluding diabetic therapeutic shoes or inserts which are not covered. Covered durable medical equipment and diabetic supplies feature no coinsurance to 20% coinsurance, while prosthetic devices and medical supplies require 20% coinsurance.
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 and lab services are not covered. Diagnostic procedures and tests range from no copay to a $20 copay, while radiological services require a minimum copay of $20 for diagnostic and X-ray services and $25 for therapeutic services.
Home Health Services See details
Home Health Services are covered by BCN Advantage Elements (HMO-POS) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
BCN Advantage Elements (HMO-POS) covers some Cardiac Rehabilitation Services with no coinsurance, though prior authorization is required. However, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require copayments between $10 and $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. You will pay no copay for days 1 through 20, and a $218 daily copay for days 21 through 100, with no coverage provided for additional days beyond the Medicare-covered limit.
Other Services See details
BCN Advantage Elements (HMO-POS) covers select other services, including over-the-counter (OTC) items with no copay and no coinsurance up to $50 every three months via reimbursement. Non-Medicare-covered mobile mental health is covered with a $20 copay and no coinsurance, and ambulance no-transport services are covered with a $90 copay and no coinsurance, while acupuncture and meal benefits are not covered.
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