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BCN Advantage ConnectedCare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BCN Advantage ConnectedCare (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on BCN Advantage ConnectedCare (HMO) in 2026, please refer to our full plan details page.
BCN Advantage ConnectedCare (HMO) is a HMO plan offered by Blue Cross Blue Shield of Michigan Mutual Ins. Co. available for enrollment in 2025 to people living in Kalamazoo, Metro Detroit Area and Bay Region. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that BCN Advantage ConnectedCare (HMO) 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 ConnectedCare (HMO).
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 ConnectedCare (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $41.00. 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 a $125.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $4400.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 ConnectedCare (HMO) plan features a drug deductible of $125. For Tier 1 preferred generic drugs, you pay no copay for a 1-month or 3-month supply at preferred pharmacies and preferred mail order, or a $5 copay for a 1-month supply at standard pharmacies. Tier 2 generic drugs require a $2 copay for a 1-month supply and no copay for a 3-month supply at preferred locations. Brand-name and specialty medications require coinsurance rather than flat copays. Tier 3 preferred brand drugs carry a 20% coinsurance, and Tier 4 non-preferred drugs require a 25% coinsurance for both 1-month and 3-month supplies. Tier 5 specialty drugs require a 31% coinsurance for a 1-month supply at all pharmacy types.
Additional Benefits
The BCN Advantage ConnectedCare (HMO) plan offers robust coverage with no copay or coinsurance for primary care visits, telehealth, routine preventive services, and home health care. For specialist visits, physical therapy, and mental health sessions, members will pay flat copays ranging from $20 to $40 with no coinsurance. Inpatient hospital stays require a $275 daily copay for the first seven days and no copay thereafter, while outpatient hospital services feature a $225 copay. This plan also includes key dental, hearing, and vision benefits, highlighted by no copay for preventive dental care up to a $1,500 annual limit and no copay for routine hearing exams. Members can access emergency services with a $130 copay, which is waived upon hospital admission, and enjoy extra perks like an over-the-counter allowance of up to $50 every three months with no copay. However, certain services like cardiac rehabilitation and routine eyewear are not covered under this plan.
Inpatient Hospital See details
BCN Advantage ConnectedCare (HMO) covers inpatient hospital services with no coinsurance, requiring a $275 daily copay for days 1 through 7 and no copay for days 8 through 90. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
BCN Advantage ConnectedCare (HMO) covers outpatient services with no coinsurance, featuring a $225 copay for outpatient hospital services and a $130 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 copay with no coinsurance.
Partial Hospitalization See details
BCN Advantage ConnectedCare (HMO) covers partial hospitalization services with a $55 copay and no coinsurance, though prior authorization may be required.
Ambulance and Transportation Services See details
BCN Advantage ConnectedCare (HMO) covers Medicare-approved ground and air ambulance services with a $230 copay and no coinsurance. For transportation services, some services are covered but trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
Emergency services under BCN Advantage ConnectedCare (HMO) are covered with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within three days. Urgently needed services feature no coinsurance and a copay ranging from no copay to $45, while worldwide emergency services are covered up to a $50,000 maximum limit with no coinsurance and copays of $45 for urgent care, $130 for emergency care, and $230 for emergency transportation.
Primary Care See details
BCN Advantage ConnectedCare (HMO) provides primary care, telehealth, and opioid treatment with no copay and no coinsurance, while podiatry services are not covered. Covered specialist visits require a $35 copay, physical and occupational therapies require a $40 copay, and mental health or psychiatric sessions have a $20 copay, all with no coinsurance.
Preventive Services See details
Preventive services are partially covered by BCN Advantage ConnectedCare (HMO) with no copay and no coinsurance for covered services like annual physicals, kidney disease education, fitness benefits, and nutritional counseling. However, several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management programs, and alternative therapies.
Hearing Services See details
Hearing services are covered by BCN Advantage ConnectedCare (HMO), offering one routine hearing exam and unlimited fitting evaluations per year with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $495.00 to $1,695.00 for up to two devices per year, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
BCN Advantage ConnectedCare (HMO) partially covers vision services, which include one routine eye exam per year with a copay ranging from no copay to $35 and no coinsurance. Other eye exams and all eyewear—including contacts, eyeglasses, lenses, frames, and upgrades—are not covered under this plan.
Dental Services See details
BCN Advantage ConnectedCare (HMO) partially covers dental services with a $1,500 annual limit, offering no copay and no coinsurance for preventive and comprehensive care like exams, cleanings, fillings, root canals, and oral surgery. Medicare-covered dental services require a $0 to $225 copay and no coinsurance. Some sub-services, including orthodontics, maxillofacial prosthetics, other diagnostic dental, and other preventive dental services, are not covered.
Home Infusion bundled Services See details
BCN Advantage ConnectedCare (HMO) covers home infusion bundled services with no copay, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy and other drugs require no copay and no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
BCN Advantage ConnectedCare (HMO) covers dialysis services with no copay and 20% coinsurance.
Medical Equipment See details
BCN Advantage ConnectedCare (HMO) partially covers medical equipment with no copay, though coinsurance ranges from no coinsurance to 20% and diabetic therapeutic shoes or inserts are not covered. Covered items, including durable medical equipment, prosthetics, medical supplies, and diabetic supplies, feature no copay and require either no coinsurance or 20% coinsurance depending on the service.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by BCN Advantage ConnectedCare (HMO) with no coinsurance, though prior authorization is required. Covered services include diagnostic procedures with no copay up to $20, diagnostic radiology starting at a $20 copay, therapeutic radiology starting at a $25 copay, and outpatient X-rays with a $20 copay, while lab services are not covered.
Home Health Services See details
Home health services are covered by BCN Advantage ConnectedCare (HMO) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the BCN Advantage ConnectedCare (HMO) plan. This includes standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services, which are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
BCN Advantage ConnectedCare (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not needed for admission, additional days beyond the standard 100 days are not covered.
Other Services See details
Other services are partially covered by BCN Advantage ConnectedCare (HMO), featuring over-the-counter items (up to $50 every three months) and chronic illness meals with no copay or coinsurance. Non-Medicare-covered mobile mental health services require a $20 copay and ambulance no-transport services require a $90 copay, both with no coinsurance, while acupuncture is not covered.
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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.
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