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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 $115.00. 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 for prescription drugs. During the initial coverage phase, you will pay a copay for generic drugs, and coinsurance for brand name and non-preferred drugs. After your total drug costs reach $2,000, you will enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The BCN Advantage HMO-POS Classic (HMO-POS) plan offers a wide array of benefits with varying costs. This plan covers inpatient hospital stays with a $225 copay for the first 7 days, and no copay after that, as well as outpatient services, emergency services, primary care, preventive services, and home health services, all with varying copays. The plan also includes coverage for hearing, vision, and dental services, with routine exams and cleanings often having no copay. Additional benefits include coverage for ambulance services, partial hospitalization, and home infusion services, and covers over-the-counter items with a quarterly allowance. The plan also covers a range of services, including skilled nursing facility stays, and diagnostic and radiological services. However, it is important to note that certain services like additional home health care hours, dental services, and some other services may not be covered.
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; for Inpatient Hospital Psychiatric, you will also pay a $225 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 for Inpatient Hospital-Acute are not covered, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are also not covered.
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 are covered, including individual and group sessions with a copay between $30 and $30. Outpatient Blood Services are also covered, including services not usually covered by Medicare plans.
Partial Hospitalization See details
Partial Hospitalization is covered under the BCN Advantage HMO-POS Classic (HMO-POS) plan, but requires prior authorization. You will pay a $55 copay for this benefit.
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, but transportation services to plan-approved health-related locations are not covered. The plan covers round trip transportation services to any health-related location, with a limit of one 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 Urgently Needed Services have a copay between $0 and $40. Worldwide Emergency Services has a $125 copay for Worldwide Emergency Coverage, a $40 copay for Worldwide Urgent Coverage, and a $250 copay for Worldwide Emergency Transportation.
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, additional telehealth benefits, and opioid treatment program services. Podiatry services are not covered.
Preventive Services See details
Preventive services, including Medicare-covered services, annual physical exams, and additional preventive services are covered. Additional preventive services may have a copay, and other services like in-home safety assessments, medical nutrition therapy, and counseling services are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with a $0 copay, and fitting/evaluation for hearing aids with a copay between $0 and $30, and prescription hearing aids, with a maximum plan benefit of $600 every three years. Prescription hearing aids (all types) are covered, but prescription hearing aids for the inner, outer, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a copay of $0-$30, and routine eye exams are covered once per year. Eyewear is covered with a combined maximum benefit of $150 per year, while contact lenses and eyeglass lenses are covered. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The BCN Advantage HMO-POS Classic (HMO-POS) plan covers dental services, including oral exams with no copay for 2 visits per year, dental x-rays, prophylaxis (cleaning) with no copay for 2 visits per year, and fluoride treatment with no copay for 1 visit per year. The plan also covers orthodontic services with a maximum plan benefit of $1500 per year. However, maxillofacial prosthetics and orthodontics are not covered, and some other services are offered as optional supplemental benefits.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, with a coinsurance between 20% and 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. 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 HMO-POS Classic (HMO-POS) plan. Diagnostic Procedures/Tests have a minimum copay of $0 and a maximum copay of $20, while Lab Services are not covered. Diagnostic Radiological Services have a copay of at most $75, Therapeutic Radiological Services have a copay of at most $15, and Outpatient X-Ray Services have a $20 copay.
Home Health Services See details
Home Health Services are covered with no copay and no 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, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. The plan has a copay for Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, and Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, but the exact amount is not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with no copay for days 1-20 and a $214 copay per day for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for over-the-counter items, with a maximum benefit of $65 every three months, and a meal benefit for a chronic illness. 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 2 includes coverage for Ambulance No Transport with a $90 copay.
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