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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 $122.00. 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 with no deductible. During the initial coverage phase, you'll pay a copay for generic drugs, ranging from $7.00 to $43.00 depending on the pharmacy. For preferred and non-preferred brand drugs, you will pay 50% and 33% coinsurance, respectively. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your monthly premium will be $16.80.
Additional Benefits
The BCN Advantage HMO-POS Classic (HMO-POS) plan offers a wide range of benefits. This plan includes coverage for inpatient and outpatient hospital services, with varying copays. It also covers emergency services, primary care, preventive services, hearing, vision, and dental services. Additional benefits include ambulance and transportation services, home health services, and skilled nursing facility care. The plan offers coverage for home infusion, dialysis, medical equipment, and diagnostic and radiological services. However, it's important to note that certain services like cardiac rehabilitation, podiatry, and some other specialized services are not covered.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $225 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 both are not covered.
Outpatient Services See details
Outpatient services include outpatient hospital services with a $225 copay, observation services, ambulatory surgical center services with no copay, outpatient substance abuse services with a $30 copay for individual and group sessions, and outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered by the BCN Advantage HMO-POS Classic (HMO-POS) plan. The plan has a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $250 copay for both ground and air ambulance services. Transportation services to a plan-approved health-related location are covered, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the BCN Advantage HMO-POS Classic (HMO-POS) plan. Emergency Services have a $125 copay and no coinsurance, while Urgently Needed Services have a copay between $0 and $40 with no coinsurance. Worldwide Emergency Services have 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 coverage of $50,000.
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 from $0 to $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
The BCN Advantage HMO-POS Classic (HMO-POS) plan covers a variety of preventive services, including Medicare-covered services, annual physical exams, health education, nutritional/dietary benefits (6 visits), additional sessions of smoking and tobacco cessation counseling, fitness benefits (memory fitness), remote access technologies, home and bathroom safety devices and modifications (up to $100 per year), kidney disease education, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visit. In-home safety assessment, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission 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 of enrollees, enhanced disease management, telemonitoring services, and counseling services are not covered.
Hearing Services See details
Hearing Services includes coverage for hearing exams with no copay, and fitting/evaluation for hearing aids with a $0 - $30 copay. Prescription hearing aids are covered, with a maximum plan benefit of $600 per ear every three years, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a copay between $0 and $30, routine eye exams (1 per year), contact lenses, eyeglass lenses (1 pair per year), and eyeglass frames (1 frame per year), with a combined maximum benefit of $150 per year. 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, with a maximum benefit of $1500 per year. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and oral and maxillofacial surgery are covered with varying limits on visits and periodicity. Restorative services are covered with limits on fillings, crowns, and crown repairs. Maxillofacial prosthetics and orthodontics are not covered.
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 with 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 under 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
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $20, while Lab Services are not covered. Diagnostic Radiological Services have a copay up to $75 with a minimum copay of $20, Therapeutic Radiological Services have a copay up to $15 with a minimum copay of $15, and Outpatient X-Ray Services have a $20 copay.
Home Health Services See details
Home Health Services are covered by BCN Advantage HMO-POS Classic (HMO-POS) with no copay or coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the BCN Advantage HMO-POS Classic (HMO-POS) plan. This includes 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.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the BCN Advantage HMO-POS Classic (HMO-POS) plan, but require prior authorization. There is no copay for days 1-20, but there is a $214 copay per day for days 21-100.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and Meal Benefits. 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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