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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 provides comprehensive medical coverage with highly predictable costs, featuring no copays or coinsurance for primary care doctor visits, telehealth services, and home health care. Inpatient hospital stays require a $250 daily copay for the first seven days followed by no copay for additional days, with no coinsurance. Outpatient hospital procedures, emergency room visits, and specialist consultations are also covered under clear, fixed copays with no coinsurance. In addition to core medical care, this plan includes valuable dental, vision, and hearing benefits, featuring no copays for routine exams and cleanings. Members benefit from a $1,500 annual dental maximum, a $100 vision eyewear allowance, and $50 every three months for over-the-counter items with no coinsurance. While specialized services like dialysis and durable medical equipment carry a 20% coinsurance, routine hearing and vision services are free from deductibles.
Inpatient Hospital See details
BCN Advantage Elements (HMO-POS) partially 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. Prior authorization is required, and while unlimited additional acute care days are covered with no copay, psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
BCN Advantage Elements (HMO-POS) covers outpatient services with no coinsurance, including outpatient hospital services for a $200 copay and observation services for a $130 copay per stay. Ambulatory surgical center and outpatient blood services are covered with no copays and no coinsurance, while outpatient substance abuse sessions require a $35 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by BCN Advantage Elements (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization is required for some of these services.
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, which is not waived if you are admitted to the hospital. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services are covered by BCN Advantage Elements (HMO-POS) 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 $50,000 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. Specialist visits, psychiatric care, chiropractic care, and physical, occupational, and speech therapies 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) offers partially covered preventive services with no copay and no coinsurance for covered options such as annual physical exams, kidney disease education, and fitness benefits. However, several additional services are not covered, including health education, in-home safety assessments, personal emergency response systems (PERS), and weight management programs.
Hearing Services See details
Hearing Services under BCN Advantage Elements (HMO-POS) are partially covered, offering routine hearing exams and fitting evaluations with no copay, no coinsurance, and no deductible. Prescription hearing aids are covered with no coinsurance and a copay ranging from $495 to $1,695, but OTC hearing aids and inner ear, outer ear, or over the ear prescription 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 eyewear with no copay, both with no coinsurance or deductibles and a $100 annual limit. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
BCN Advantage Elements (HMO-POS) offers partially covered dental services up to a $1,500 annual maximum, featuring no copay and no coinsurance for most preventive and comprehensive care, while Medicare-covered dental services require a $0 to $200 copay and no coinsurance. Covered services include exams, cleanings, x-rays, and fillings, but other diagnostic services, other preventive services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
BCN Advantage Elements (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while covered insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under BCN Advantage Elements (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
BCN Advantage Elements (HMO-POS) partially covers medical equipment with no copay, though prior authorization is required and diabetic therapeutic shoes and inserts are not covered. Covered durable medical equipment (DME) and diabetic supplies range from no coinsurance to 20% coinsurance, while prosthetic devices and medical supplies require a 20% coinsurance.
Diagnostic and Radiological Services See details
BCN Advantage Elements (HMO-POS) partially covers diagnostic and radiological services with no coinsurance, although prior authorization is required. Diagnostic procedures and tests require a copay ranging from no copay to $20, outpatient X-rays and diagnostic radiological services have a minimum $20 copay, and therapeutic radiological services require a minimum $25 copay, while lab services are not covered.
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
Cardiac rehabilitation services are covered by BCN Advantage Elements (HMO-POS) with no coinsurance and required prior authorization, though only some services are covered in practice while standard cardiac ($15 copay), intensive cardiac ($15 copay), pulmonary ($10 copay), and SET for PAD ($15 copay) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by BCN Advantage Elements (HMO-POS) with no coinsurance and do not require a prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though prior authorization is required and additional days beyond the 100-day Medicare limit are not covered.
Other Services See details
BCN Advantage Elements (HMO-POS) partially covers other services, which include over-the-counter items with no copay and no coinsurance up to $50 every three months, mobile mental health services for a $20 copay and no coinsurance, and ambulance no transport for a $90 copay and no coinsurance. Acupuncture and meal benefits are not covered.
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