A non-government entity
BCN Advantage HMO-POS Classic (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BCN Advantage HMO-POS Classic (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 HMO-POS Classic (HMO-POS) in 2025, please refer to our full plan details page.
BCN Advantage HMO-POS Classic (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 HMO-POS Classic (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about BCN Advantage HMO-POS Classic (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 HMO-POS Classic (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $75.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $3800.00 (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 $3800.00 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:
Sign up for BCN Advantage HMO-POS Classic (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The BCN Advantage HMO-POS Classic (HMO-POS) plan has an "Enhanced Alternative" drug benefit type with a $0 deductible. During the initial coverage phase, you will pay a copay for generic drugs and coinsurance for brand name and non-preferred drugs. For example, you will pay a $7.00 copay at a preferred pharmacy for preferred generic drugs. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The BCN Advantage HMO-POS Classic (HMO-POS) plan offers a wide range of benefits, including inpatient hospital stays with a $225 copay for the first seven days, and no copay for days 8-90. Outpatient services, such as outpatient hospital services, have a $225 copay, and there are no copays for preventive services. The plan also covers emergency services with a $125 copay, and includes coverage for hearing, vision, and dental services, as well as home health services with no copay. This plan provides coverage for a variety of services with varying cost-sharing. Primary care, specialist visits, and therapies have copays ranging from $15 to $30, while ambulance services have a $250 copay. Diagnostic and radiological services have copays between $0 and $75. The plan also includes coverage for prescription hearing aids up to $600 every three years, and offers an over-the-counter allowance of $65 every three months.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a $225 copay 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 stays and upgrades are not covered for Inpatient Hospital-Acute. Additional days and non-Medicare covered stays are not covered for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a $225 copay, Observation Services, and Ambulatory Surgical Center (ASC) Services with no copay. Outpatient Substance Abuse Services, including both Individual and Group Sessions, have a copay of $30.00, and Outpatient Blood Services are covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the BCN Advantage HMO-POS Classic (HMO-POS) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the BCN Advantage HMO-POS Classic (HMO-POS) plan. Ground and Air Ambulance Services have a $250 copay, while Transportation Services to a plan-approved health-related location are not covered, but transportation to any health-related location is covered for one round trip per year.
Emergency Services See details
Emergency Services are covered by the BCN Advantage HMO-POS Classic (HMO-POS) plan with a $125 copay and no coinsurance, and the copay is waived if admitted to the hospital within 3 days. Urgently Needed Services have a copay between $0 and $40 with no coinsurance. Worldwide Emergency Services are covered with a $125 copay for Worldwide Emergency Coverage, a $40 copay for Worldwide Urgent Coverage, and a $250 copay for Worldwide Emergency Transportation, with a maximum plan benefit of $50,000.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic Services have a $15 copay, Routine Chiropractic Care has a $30 copay, and Other Chiropractic Services have a $20 copay. Occupational Therapy Services, Physical Therapy, and Speech-Language Pathology Services have a $30 copay. Physician Specialist Services have a $30 copay. Mental Health and Psychiatric Services individual and group sessions have a $20 copay. Other Health Care Professional services have a copay between $0 and $30.
Preventive Services See details
The BCN Advantage HMO-POS Classic (HMO-POS) plan covers preventive services, including no copay for Medicare-covered preventive services, annual physical exams, and additional preventive services. Other covered services include health education, a personal emergency response system, nutritional/dietary benefits, additional sessions of smoking and tobacco cessation counseling, fitness benefits, remote access technologies, home and bathroom safety devices and modifications, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit.
Hearing Services See details
Hearing Services include routine hearing exams with a copay between $0 and $30, and fitting/evaluation for hearing aids. Prescription hearing aids are covered up to $600 every three years, and Prescription Hearing Aids (all types) are covered. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, Prescription Hearing Aids - Over the Ear, and OTC hearing aids are not covered.
Vision Services See details
The BCN Advantage HMO-POS Classic (HMO-POS) plan covers vision services including eye exams with a copay of $0-$30. The plan also covers eyewear, including contact lenses, eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $150 per year. However, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, with a yearly maximum of $1,500. Oral exams have a copay between $0 and $225 and are limited to two visits per year, while dental X-rays are covered once every two years. Other services, such as oral and maxillofacial surgery, have visit limits and may require additional costs. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the BCN Advantage HMO-POS Classic (HMO-POS) plan, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the BCN Advantage HMO-POS Classic (HMO-POS) plan, with a coinsurance of 20%.
Medical Equipment See details
Medical equipment benefits include Durable Medical Equipment (DME) with no copay and 0-20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance; however, Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
The BCN Advantage HMO-POS Classic (HMO-POS) plan covers diagnostic and radiological services, though lab services are not covered. Diagnostic Procedures/Tests have a minimum copay of $0 and a maximum copay of $20, while Diagnostic Radiological Services have a copay of at most $75 (minimum $20), Therapeutic Radiological Services have a copay of at most $15 (minimum $15), and Outpatient X-Ray Services have a $20 copay.
Home Health Services See details
Home Health Services are covered by the BCN Advantage HMO-POS Classic (HMO-POS) plan with no copay and no coinsurance, but prior authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. There is a copay for some Cardiac and Pulmonary Rehabilitation Services, but the specific cost is not detailed in the provided information.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the BCN Advantage HMO-POS Classic (HMO-POS) plan, with a $0 copay for days 1-20 and a $214 copay per day for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items with a maximum benefit of $65 every three months, and a meal benefit for a chronic illness, but 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. Other services such as Mobile Mental Health have a $20 copay, and Ambulance No Transport have a $90 copay.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved