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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 with varying cost-sharing. Inpatient hospital stays require a $205 copay for the first 7 days. Emergency services have a $125 copay, and primary care visits have no copay. This plan includes coverage for outpatient services, mental health, and various therapies with copays, along with preventive services like hearing and vision exams. Additionally, this plan covers dental services up to a $1500 annual maximum.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $205 copay for days 1-7, and no copay for days 8-90; additional days are covered with no copay. For Inpatient Hospital Psychiatric, you will pay a $205 copay for days 1-7, and no copay for days 8-90; additional days are not covered.
Outpatient Services See details
Outpatient services, including all outpatient hospital services, observation services, and outpatient substance abuse services, are covered. Outpatient hospital services have a $200 copay, Ambulatory Surgical Center (ASC) services have no copay, and outpatient substance abuse services have a $35 copay for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for Medicare-covered ground and air ambulance services with a $300 copay, while transportation services to any health-related location are covered for one round trip per year. Transportation Services - Plan Approved Health-related Location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the BCN Advantage Elements (HMO-POS) plan. Emergency Services have a $125 copay with no coinsurance, Urgently Needed Services have a copay between $0 and $45 with no coinsurance, and Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a $45 copay, and Worldwide Emergency Transportation has a $300 copay, all with no coinsurance.
Primary Care See details
The BCN Advantage Elements (HMO-POS) plan covers Primary Care Physician Services with no copay, Chiropractic Services with a $15 copay for Medicare-covered services, Occupational Therapy Services with a $30 copay, Physician Specialist Services with a $35 copay, Mental Health Specialty Services with a $20 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services with a $30 copay, and Additional Telehealth Benefits. Podiatry Services are not covered.
Preventive Services See details
The BCN Advantage Elements (HMO-POS) plan covers preventive services including annual physical exams, health education, nutritional/dietary benefits (6 visits), additional sessions of smoking and tobacco cessation counseling, fitness benefits (memory fitness), remote access technologies, home and bathroom safety devices and modifications ($100 per year), glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and several other services are not covered.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with a maximum benefit of $600 every three years; however, inner ear, outer ear, and over-the-ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services with the BCN Advantage Elements (HMO-POS) plan includes routine eye exams with a copay between $0 and $35, and contact lenses are covered. Eyeglasses (lenses and frames) and upgrades are not covered, while eyeglass lenses and frames are covered, with a maximum benefit of $150 per year.
Dental Services See details
Dental Services are covered, with a maximum benefit of $1500 per year. Oral exams have a copay between $0 and $200 for up to two visits per year, and dental x-rays, prophylaxis (cleaning), and fluoride treatments are also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B insulin drugs, there is a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the BCN Advantage Elements (HMO-POS) plan. There is a 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 0-20% and no copay, but DME for use outside the home and Diabetic Supplies/Therapeutic Shoes/Inserts are not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Equipment requires prior authorization.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the BCN Advantage Elements (HMO-POS) plan. Diagnostic Procedures/Tests have a copay between $0 and $20, Diagnostic Radiological Services have a copay of up to $100 (minimum $20), Therapeutic Radiological Services have a copay of $25 (minimum $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 or coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the BCN Advantage Elements (HMO-POS) plan, but the plan does not cover any of the sub-services related to cardiac rehabilitation. There is a copay for some cardiac and pulmonary rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the BCN Advantage Elements (HMO-POS) plan. There is no copay for days 1-20, and a $214 copay for days 21-100; additional days beyond Medicare and non-Medicare-covered stays are not covered.
Other Services See details
The BCN Advantage Elements (HMO-POS) plan covers Over-the-Counter (OTC) Items with a maximum benefit of $50.00 every three months, and Mobile Mental Health with a $20 copay. The plan also covers Ambulance No Transport with a $90 copay, and Meal Benefit for a chronic illness. However, Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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