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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 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:
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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 a range of benefits, including inpatient hospital stays with a $205 copay for days 1-7 and no copay for days 8-90, and outpatient services with varying copays. Emergency services and ambulance services are covered with copays, and the plan includes coverage for primary care, preventive services, and home health services. The plan also offers additional benefits such as hearing, vision, and dental services with defined copays and annual maximums. You will also have coverage for home infusion, dialysis, medical equipment, and diagnostic services with varying copays and coinsurance.
Inpatient Hospital See details
Inpatient Hospital services are covered by the BCN Advantage Elements (HMO-POS) plan, with a copay of $205 for days 1-7 and no copay for days 8-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered under this plan. For outpatient hospital services, you will pay a $200 copay, while Ambulatory Surgical Center (ASC) Services have no copay. Outpatient Substance Abuse Services, including both individual and group sessions, have a copay between $35 and $35.
Partial Hospitalization See details
Partial Hospitalization is covered by the BCN Advantage Elements (HMO-POS) plan with a $55 copay, and prior authorization is required.
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, while transportation services to any health-related location are covered for one round trip per year via medical transport.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the BCN Advantage Elements (HMO-POS) plan. Emergency Services have a $125 copay, Urgently Needed Services have a copay between $0 and $45, and Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a $45 copay, and Worldwide Emergency Transportation has a $300 copay.
Primary Care See details
The BCN Advantage Elements (HMO-POS) plan covers primary care services, including chiropractic services with a $15 copay, routine chiropractic care with a $35 copay, and other chiropractic services with a $20 copay. Occupational therapy and physical/speech therapy services have a $30 copay, while physician specialist services have a $35 copay. Mental health and psychiatric services, as well as other healthcare professional services, have varied copays, and additional telehealth benefits are also included. Podiatry services are not covered.
Preventive Services See details
Preventive Services are covered by the BCN Advantage Elements (HMO-POS) plan, including services not usually covered by Medicare plans, with services such as In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and others not covered. The plan also covers Home and Bathroom Safety Devices and Modifications up to $100 per year.
Hearing Services See details
Hearing Services include routine hearing exams with a copay between $0 and $35, and fitting/evaluation for hearing aids, with a limit of 1 visit every three years. Prescription hearing aids (all types) are covered up to $600 per ear every three years, but prescription hearing aids for the inner, outer, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a copay of $0-$35, and routine eye exams are covered once per year. Eyewear, including contact lenses, eyeglass lenses, and eyeglass frames, is covered with a combined maximum benefit of $150 per year, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a maximum plan benefit of $1,500 per year. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and oral and maxillofacial surgery are covered, with varying limits on the number of visits and periodicity, and copays ranging from $0 to $200 depending on the service. Other services like maxillofacial prosthetics and orthodontics are not covered, and some services are offered as optional, supplemental benefits.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered with 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the BCN Advantage Elements (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a coinsurance of 0% to 20% with no copay, while Prosthetic Devices and Medical Supplies have a 20% coinsurance with no copay. Some services, such as Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts, are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the BCN Advantage Elements (HMO-POS) plan. Diagnostic Procedures/Tests have a minimum copay of $0 and a maximum copay of $20, while Lab Services are not covered. Diagnostic Radiological Services have a maximum copay of $100 with a minimum copay of $20, Therapeutic Radiological Services have a minimum copay of $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 and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the BCN Advantage Elements (HMO-POS) plan. However, this plan does not cover any of the sub-services, including 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 BCN Advantage Elements (HMO-POS). There is no copay for days 1-20, and a $214 copay for days 21-100; additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The BCN Advantage Elements (HMO-POS) plan covers over-the-counter items with a maximum benefit of $50 every three months, and a meal benefit for chronic illnesses. Acupuncture and several other services are not covered. Other services, such as ambulance no transport, have a copay of $90.
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