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BCN Advantage Classic (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BCN Advantage 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 Classic (HMO-POS) in 2026, please refer to our full plan details page.
BCN Advantage 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 2026.
It's important to know that BCN Advantage 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 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 Classic (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $123.60. 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 $4400.00 (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 $4400.00 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 Classic (HMO-POS) plan features a $0 drug deductible, meaning your prescription coverage begins immediately. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at preferred pharmacies and through preferred mail order, while standard locations charge a $5 copay for a 1-month supply. Tier 2 generic drugs require a $7 copay for a 1-month supply at preferred pharmacies, but you can avoid this cost entirely with no copay for a 3-month supply. For higher-tier medications, your costs are based on coinsurance at both standard and preferred pharmacies. Tier 3 preferred brand drugs require a 20% coinsurance, and Tier 4 non-preferred drugs carry a 25% coinsurance for both 1-month and 3-month fills. Specialty medications in Tier 5 are limited to a 1-month supply and require a 33% coinsurance.
Additional Benefits
The BCN Advantage Classic (HMO-POS) Medicare plan offers robust coverage for core medical services, featuring no copay and no coinsurance for primary care visits, telehealth, and home health services. For inpatient hospital stays, members pay a $250 daily copay for days one through seven and no copay thereafter, while outpatient hospital services carry a $225 copay. Emergency care is available with a $130 copay, which is waived upon hospital admission, and specialist visits require a copay ranging from $15 to $35. This plan also includes valuable supplemental benefits, such as dental coverage up to $1,500 annually and routine hearing exams with no copay. Vision care is covered with a routine exam copay of up to $30 and a $100 annual allowance for eyewear. Additionally, skilled nursing facility care requires no copay for the first 20 days, while medical equipment and dialysis services generally feature no copay with up to 20 percent coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by BCN Advantage Classic (HMO-POS) with no coinsurance, requiring a $250 daily copay for days 1 through 7 and no copay for days 8 through 90 per stay. Unlimited additional acute care days are covered with no copay, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
BCN Advantage Classic (HMO-POS) offers outpatient services with no coinsurance, featuring a $225 copay for outpatient hospital services and a $130 copay per stay for observation services. Outpatient substance abuse sessions require a $30 copay, while ambulatory surgical center and blood services are covered with no copay.
Partial Hospitalization See details
BCN Advantage Classic (HMO-POS) covers partial hospitalization services 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 Classic (HMO-POS) partially covers ambulance and transportation services, offering Medicare-covered ground and air ambulance services for a $250 copay and no coinsurance. Routine transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
BCN Advantage Classic (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within three days. Urgently needed services are covered with no coinsurance and a copay ranging from no copay to $40, while worldwide emergency services are covered up to $50,000 with no coinsurance and copays ranging from $40 to $250.
Primary Care See details
Primary care services under BCN Advantage Classic (HMO-POS) are partially covered, offering primary care visits, telehealth, and opioid treatment with no copay and no coinsurance. Specialist visits, physical therapy, and mental health services require copays ranging from $15 to $35 with no coinsurance, while podiatry services are not covered.
Preventive Services See details
BCN Advantage Classic (HMO-POS) preventive services are partially covered with no copay and no coinsurance for covered benefits like annual physicals, kidney education, and fitness programs. However, sub-services such as health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety modifications, and counseling are not covered.
Hearing Services See details
BCN Advantage Classic (HMO-POS) hearing services include one routine hearing exam per year and unlimited fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $495 to $1,695 for up to two devices per year, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
BCN Advantage Classic (HMO-POS) offers partially covered vision services, including one routine eye exam per year with a $0 to $30 copay and no coinsurance. Eyewear is covered with no copay and no coinsurance up to a $100 annual limit for contacts, lenses, and frames, but other eye exam services and upgrades are not covered.
Dental Services See details
Dental services are partially covered by BCN Advantage Classic (HMO-POS), offering up to $1,500 yearly for preventive and comprehensive care with no copay and no coinsurance, while Medicare-covered dental services require between no copay and a $225 copay with no coinsurance. Orthodontics, maxillofacial prosthetics, other diagnostic dental services, and other preventive dental services are not covered.
Home Infusion bundled Services See details
BCN Advantage Classic (HMO-POS) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Covered Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance, while chemotherapy and other Part B drugs have a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the BCN Advantage Classic (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
BCN Advantage Classic (HMO-POS) partially covers medical equipment with no copays, featuring no coinsurance to 20% coinsurance for durable medical equipment and diabetic supplies, and 20% coinsurance for prosthetics and medical supplies. Prior authorization is required for these benefits, and diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by BCN Advantage Classic (HMO-POS) with no coinsurance, though lab services are not covered and prior authorization is required. Covered services include outpatient X-rays and diagnostic radiology starting at a $20 copay, therapeutic radiology starting at a $15 copay, and diagnostic procedures ranging from no copay to a $20 copay.
Home Health Services See details
Home Health Services are covered by BCN Advantage Classic (HMO-POS) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under BCN Advantage Classic (HMO-POS) with no coinsurance, though prior authorization is required. While some services are covered, specific sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered in practice and carry copayments ranging from $10 to $15.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by BCN Advantage Classic (HMO-POS) with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by BCN Advantage Classic (HMO-POS), excluding acupuncture. Covered benefits include over-the-counter items up to $50 every three months and chronic illness meals with no copay and no coinsurance, mobile mental health with a $20 copay and no coinsurance, and non-transport ambulance services with a $90 copay and no coinsurance.
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