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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 with predictable costs, featuring no copay and no coinsurance for primary care visits, telehealth, and routine preventive services. For specialist visits, outpatient hospital care, and emergency services, members pay flat copayments, such as $35 for specialists and $130 for emergency room visits, with no coinsurance required. Inpatient hospital stays require a $250 daily copay for the first seven days, after which there is no copay for days 8 through 90. This plan also includes valuable supplemental benefits, such as dental coverage up to a $1,500 annual limit and routine hearing exams with no copay. Vision care features routine exams with low copays and up to $100 annually for eyewear with no copay, alongside a $50 quarterly allowance for over-the-counter items. Additionally, home health services are fully covered with no copay or coinsurance, helping you manage your health affordably from home.
Inpatient Hospital See details
BCN Advantage Elements (HMO-POS) 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. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
BCN Advantage Elements (HMO-POS) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services require a $200 copay, observation services require a $130 copay per stay, and outpatient substance abuse sessions have a $35 copay.
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
BCN Advantage Elements (HMO-POS) covers ground and air ambulance services with a $300 copay and no coinsurance per service, and this copayment is not waived if you are admitted to the hospital. Routine transportation services to plan-approved or 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 and no coinsurance, which is waived if you are admitted to the hospital within three days. Urgently needed services feature a copay ranging from no copay to $45 with no coinsurance, and 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) covers primary care physician services, telehealth, and opioid treatment with no copay and no coinsurance, while specialist visits and therapy services require a $35 copay and no coinsurance. Mental health, psychiatric, and chiropractic services are covered with copays ranging from $15 to $35 and no coinsurance, though podiatry services are not covered.
Preventive Services See details
BCN Advantage Elements (HMO-POS) provides partially covered preventive services with no copay and no coinsurance for covered benefits like annual physicals, kidney disease education, and fitness programs. Sub-services that are not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for chemotherapy-related hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, home-based palliative care, in-home support services, support for caregivers, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling services.
Hearing Services See details
BCN Advantage Elements (HMO-POS) covers hearing services with no deductible, featuring no copay and no coinsurance for annual routine hearing exams and unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $495.00 to $1,695.00 for up to two devices per year, while 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), offering routine eye exams with a $0 to $35 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and a $100 annual limit for contacts, lenses, and frames, though upgrades and combined eyeglasses are not covered.
Dental Services See details
BCN Advantage Elements (HMO-POS) offers partially covered dental services up to a $1,500 annual limit, with no copay and no coinsurance for covered preventive and comprehensive care like cleanings, exams, X-rays, fillings, and root canals. Medicare-covered dental services have a copay ranging from $0 to $200 and no coinsurance, though orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
BCN Advantage Elements (HMO-POS) covers home infusion bundled services with no copay, subject to prior authorization. Under this plan, Medicare Part B chemotherapy and other drugs carry no copay and 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
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
Medical equipment is partially covered by BCN Advantage Elements (HMO-POS) with no copays, though prior authorization is required. Covered durable medical equipment and diabetic supplies range from no coinsurance to 20% coinsurance, and prosthetics and medical supplies have 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 and lab services are not covered. Diagnostic procedures and tests range from no copay to a $20 copay, while outpatient X-rays require a $20 copay, diagnostic radiological services require a minimum $20 copay, and therapeutic radiological services require a minimum $25 copay.
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 and prior authorization required, though cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
BCN Advantage Elements (HMO-POS) covers skilled nursing facility (SNF) care with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by BCN Advantage Elements (HMO-POS), excluding acupuncture, meal benefits, and Dual Eligible SNPs. Covered benefits include over-the-counter items with no copay and no coinsurance up to $50 every three months, mobile mental health services for a $20.00 copay and no coinsurance, and ambulance services with no transport for a $90.00 copay and no coinsurance.
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