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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 coverage with many medical services requiring no coinsurance, including inpatient hospital stays, outpatient care, and preventive visits. For primary care doctor visits, home health services, and routine preventive care, you will pay no copay and no coinsurance. Specialist visits feature low copays ranging from $15 to $35, while emergency room visits require a $130 copay that is waived if you are admitted to the hospital. This plan also includes essential dental, vision, and hearing benefits to help minimize your out-of-pocket expenses. You will pay no copay and no coinsurance for routine hearing exams, routine eye exams, and preventive dental care up to a $1,500 annual limit. Additionally, members receive a $50 allowance every three months for over-the-counter items with no copay or coinsurance.
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 care days are covered at no copay, psychiatric additional days, room upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
BCN Advantage Elements (HMO-POS) covers outpatient services with no coinsurance, featuring a $200 copay for outpatient hospital services and a $130 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while individual and group outpatient substance abuse sessions require a $35 copay with no coinsurance.
Partial Hospitalization See details
Partial hospitalization benefits are covered by BCN Advantage Elements (HMO-POS) with a $55.00 copay and no coinsurance, although some services may require prior authorization.
Ambulance and Transportation Services See details
BCN Advantage Elements (HMO-POS) covers Medicare-covered ground and air ambulance services with a $300 copay and no coinsurance. Transportation services to plan-approved or any other 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, which is waived if you are admitted to the hospital within three days. Urgently needed services feature no coinsurance and a copay ranging from no copay to $45, while worldwide emergency services are covered up to a $50,000 maximum limit with no coinsurance and copays ranging from $45 to $300.
Primary Care See details
BCN Advantage Elements (HMO-POS) primary care benefits are partially covered, featuring no copay and no coinsurance for primary care visits, telehealth, and opioid treatment services. Covered specialist, therapy, psychiatric, and chiropractic services have copays ranging from $15 to $35 with no coinsurance, while podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by BCN Advantage Elements (HMO-POS) with no copay and no coinsurance for covered services such as annual physical exams, select nutritional/dietary visits, and fitness benefits. However, several supplemental services are not covered, including health education, in-home safety assessments, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
BCN Advantage Elements (HMO-POS) hearing services are partially covered, providing routine hearing exams and fitting evaluations with no copay and no coinsurance. Covered prescription hearing aids carry no coinsurance with copayments ranging from $495.00 to $1,695.00, though OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
BCN Advantage Elements (HMO-POS) offers partially covered vision services, including routine eye exams with a $0 to $35 copay and no coinsurance, and eyewear with no copay or coinsurance up to a $100 annual limit. While contact lenses, standard lenses, and frames are covered, other eye exam services, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
BCN Advantage Elements (HMO-POS) offers partially covered dental services with no copay and no coinsurance for most preventive and comprehensive treatments up to a $1,500 annual limit, while Medicare-covered dental services require a $0 to $200 copay and no coinsurance. Other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered under this plan.
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 chemotherapy and other drugs have a coinsurance ranging from 0% (no coinsurance) to 20%, while Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
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 copays, though prior authorization is required. Covered durable medical equipment and diabetic supplies range from no coinsurance to 20% coinsurance, while prosthetic devices and medical supplies require a 20% coinsurance, but diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by BCN Advantage Elements (HMO-POS) with no coinsurance, though prior authorization is required and lab services are not covered. Covered services require no copay to a $20 copay for diagnostic tests, a $20 copay for outpatient X-rays, and minimum copays of $20 for diagnostic radiology and $25 for therapeutic radiology.
Home Health Services See details
BCN Advantage Elements (HMO-POS) covers Home Health Services with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
BCN Advantage Elements (HMO-POS) covers Cardiac Rehabilitation Services with no coinsurance, though only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered, requiring prior authorization and copayments 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 hospital stay. There is no copay for days 1 through 20, a $218 copay for days 21 through 100, and additional days beyond the standard Medicare benefit are not covered.
Other Services See details
BCN Advantage Elements (HMO-POS) provides partial coverage for other services, excluding acupuncture and meal benefits. Covered benefits include over-the-counter items with no copay and no coinsurance up to a $50 maximum every three months, non-Medicare-covered mobile mental health for a $20 copay and no coinsurance, and ambulance no transport for a $90 copay and no coinsurance.
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