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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 $106.00. 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:
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Drug Coverage
The BCN Advantage HMO-POS Classic (HMO-POS) plan has an enhanced alternative drug benefit. The plan has no deductible. In the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, you will pay a $7 copay at preferred pharmacies and a $12 copay at standard pharmacies. For standard generic drugs, you will pay a $38 copay at preferred pharmacies and a $43 copay at standard pharmacies. For preferred brand drugs, you will pay 50% coinsurance, and for non-preferred drugs, you will pay 33% coinsurance. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The BCN Advantage HMO-POS Classic (HMO-POS) plan offers a range of benefits including inpatient and outpatient hospital services, with varying copays. You'll find coverage for emergency services, primary care, and preventive services, often with no copay. This plan also includes hearing and vision benefits, such as hearing exams, hearing aids, eye exams, and eyewear, subject to certain limits. Dental services are covered with a maximum annual benefit, and the plan covers home infusion, dialysis, medical equipment, and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered. For Inpatient Hospital-Acute, you will pay a $225 copay for days 1-7, and no copay for days 8-90, while Inpatient Hospital Psychiatric services also have a $225 copay for days 1-7, and no copay for days 8-90. Additional days for Inpatient Hospital Psychiatric are not covered, and the plan does not cover non-Medicare stays or upgrades for Inpatient Hospital-Acute and Psychiatric.
Outpatient Services See details
Outpatient services include outpatient hospital services with a $225 copay, observation services, and ambulatory surgical center services with no copay. Outpatient substance abuse services include individual and group sessions, both with a copay between $30 and $30. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the BCN Advantage HMO-POS Classic (HMO-POS) plan, but requires prior authorization. You will have a $55 copay for this service.
Ambulance and Transportation Services See details
The BCN Advantage HMO-POS Classic (HMO-POS) plan covers ambulance services with a $250 copay for both ground and air ambulance services and no coinsurance. Transportation services to any health-related location are covered for one round trip per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay and no coinsurance, while Urgently Needed Services have a copay between $0 and $40 and no coinsurance. Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a $40 copay, and Worldwide Emergency Transportation has a $250 copay, and all have no coinsurance.
Primary Care See details
The BCN Advantage HMO-POS Classic (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 $30 copay, mental health specialty services with a $20 copay for individual and group sessions, other health care professional services with a copay between $0 and $30, psychiatric 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. This plan does not cover podiatry services.
Preventive Services See details
The BCN Advantage HMO-POS Classic (HMO-POS) plan covers preventive services, including Medicare-covered services, annual physical exams, health education, nutritional/dietary benefits, additional smoking cessation counseling sessions, fitness benefits, remote access technologies, home and bathroom safety devices and modifications (up to $100 per year), kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. The plan does not cover in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, 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 services, or counseling services.
Hearing Services See details
Hearing Services include hearing exams with no copay, and prescription hearing aids with a maximum plan benefit coverage of $600 every three years. Routine hearing exams have a copay of $0-$30 every year, while fitting and evaluation for hearing aids has no copay every three years. Prescription Hearing Aids (all types) are covered every three years. OTC hearing aids, prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include eye exams with a copay of $0 - $30, and routine eye exams once per year. Eyewear is covered up to a combined maximum of $150 per year, while contact lenses are covered, but eyeglass lenses and frames are not covered.
Dental Services See details
The BCN Advantage HMO-POS Classic (HMO-POS) plan offers dental services with a maximum benefit of $1500 per year. Oral exams, dental x-rays, cleaning, and fluoride treatments are covered with varying limits on the number of visits allowed, and costs ranging from no copay to $225. Orthodontic Services and Restorative Services are also covered, and other services such as Maxillofacial Prosthetics and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the BCN Advantage HMO-POS Classic (HMO-POS) plan. The coinsurance for this benefit is 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, Medical Supplies with 20% coinsurance, and Diabetic Equipment. 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
Diagnostic and Radiological Services include diagnostic procedures/tests, with a copay between $0 and $20, and outpatient X-ray services with a $20 copay. Diagnostic Radiological Services have a copay of at most $75, and Therapeutic Radiological Services have a copay of at most $15. Lab Services are not covered.
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 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, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. This plan does not specify the copay or coinsurance information for covered Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The "Other Services" benefit covers over-the-counter items with a $65 maximum benefit every three months, meals for chronic illness, mobile mental health with a $20 copay, and ambulance with no transport with a $90 copay. Acupuncture, Dual Eligible SNPs, 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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