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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. You'll have copays for services like inpatient hospital stays ($205 for days 1-7), outpatient services ($200), and specialist visits ($35). Emergency services have a $125 copay, and ambulance services have a $300 copay. This plan includes coverage for preventive services, hearing, vision, and dental, with some copays and annual limits. You'll also have access to home health services with no copay, and other benefits like over-the-counter items with a quarterly allowance.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a $205 copay for days 1-7, and no copay for days 8-90. Additional days for inpatient hospital-acute are covered with no copay, while non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient services with the BCN Advantage Elements (HMO-POS) plan include outpatient hospital services with a $200 copay, observation services, ambulatory surgical center services with no copay, outpatient substance abuse services with a $35-$35 copay for individual and group sessions, and outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered by the BCN Advantage Elements (HMO-POS) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services, as well as transportation services to plan-approved health-related locations. Ground and air ambulance services have a $300 copay, and there is no coinsurance. Transportation services to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by BCN Advantage Elements (HMO-POS), with a $125 copay and no coinsurance for emergency services. Urgently needed services have a copay between $0 and $45, with no coinsurance, and worldwide emergency services have a copay of $125 for worldwide emergency coverage, $45 for worldwide urgent coverage, and $300 for worldwide emergency transportation.
Primary Care See details
The BCN Advantage Elements (HMO-POS) plan covers Primary Care Physician Services, Chiropractic Services with a $15 copay, Occupational Therapy Services with a $30 copay, Physician Specialist Services with a $35 copay, Mental Health Specialty Services with a $20 copay, Other Health Care Professional services with a copay between $0 and $35, Psychiatric Services with a $20 copay, and Physical Therapy and Speech-Language Pathology Services with a $30 copay. 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 smoking cessation counseling, memory fitness, remote access technologies, home and bathroom safety devices and modifications (up to $100 annually), glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. Some services, like in-home safety assessments, personal emergency response systems, medical nutrition therapy, and counseling services are not covered.
Hearing Services See details
Hearing services include hearing exams with no copay. Routine hearing exams are covered once per year, and fitting/evaluation for a hearing aid is covered once every three years, with a copay between $0 and $35. Prescription hearing aids are covered, with a maximum plan benefit of $600 per ear every three years, while inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a copay of $0-$35, contact lenses, eyeglass lenses, and eyeglass frames. Eyewear has a combined maximum benefit of $150 per year, and eyeglass frames are limited to one frame per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for oral exams with a copay of $0-$200, and other dental services including oral exams (2 per year), dental x-rays (1 set of up to 4 bitewings or up to 6 periapical film every 2 years, or full mouth x-rays every 5 years), prophylaxis (cleaning) (2 per year), fluoride treatment (1 per year), and oral and maxillofacial surgery (2 per calendar year); however, maxillofacial prosthetics and orthodontics are not covered. The plan has a maximum benefit of $1,500 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay, and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0% and 20%.
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) with 0-20% coinsurance and no copay, Prosthetic Devices with 20% coinsurance and no copay, and Medical Supplies with 20% coinsurance and no copay. 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 by the BCN Advantage Elements (HMO-POS) plan, with prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $20, while Lab Services are not covered. Diagnostic Radiological Services have a copay up to $100, Therapeutic Radiological Services have a copay up to $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, but the specific services are not covered. There is a copay for some services, but the specific amount is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by BCN Advantage Elements (HMO-POS), with a $0 copay for days 1-20, and a $214 copay for days 21-100; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required.
Other Services See details
The BCN Advantage Elements (HMO-POS) plan covers Over-the-Counter (OTC) items with a maximum benefit of $50 every three months, and also covers a meal benefit for chronic illness. Other services include a $20 copay for Mobile Mental Health and a $90 copay for Ambulance No Transport, while 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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