BCN Advantage HMO-POS Elements (HMO-POS)


Medicare Plan Details

2020 Plan
Monthly Premium
(select county for price)

 

by Blue Care Network
Additional Coverage
Vision Dental
Overall Government Star Rating
 4.0
out of 5 stars

State: Michigan

Select your county to view the price for this plan

 


Plan Type

Medicare Advantage (Part C)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B

 

$34
$34
$0
$160 In-network
$4,500 In-network
No
No
Yes
Yes

Medical Benefits

Doctor Services

In-network: $10 per visit
Out-of-network: $40 per visit
In-network: $40 per visit
Out-of-network: $40 per visit

Tests, labs, & imaging

In-network: $20
Out-of-network: $20
In-network: $0 copay
Out-of-network: $0 copay
In-network: $20-100
Out-of-network: $20-100
In-network: $20-100
Out-of-network: $20-100
$90 per visit (always covered)
$45 per visit (always covered)

Hospital Services

In-network: $205 per day for days 1 through 6
$0 per day for days 7 through 90
Out-of-network: $205 per day for days 1 through 6
$0 per day for days 7 through 90
In-network: $0-200 per visit
Out-of-network: $0-200 per visit

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$178 per day for days 21 through 100
Out-of-network: $0 per day for days 1 through 20
$178 per day for days 21 through 100

Preventive services

In-network: $0 copay
Out-of-network: $0 copay

Ambulance

In-network: $230
Out-of-network: $230

Therapy services

In-network: $30
Out-of-network: $30
In-network: $30
Out-of-network: $30

Mental health services

In-network: $40
Out-of-network: $40
In-network: $40
Out-of-network: $40
In-network: $40
Out-of-network: $40
In-network: $40
Out-of-network: $40

Opioid treatment services

Covered

Other services

In-network: 20% per item
Out-of-network: 20% per item
In-network: 20% per item
Out-of-network: 20% per item
In-network: $0 copay
Out-of-network: $0 copay

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

In-network: 0-20%
Out-of-network: 0-20%
In-network: 0-20%
Out-of-network: 0-20%

Extra Benefits

Hearing

In-network: $10-40
Out-of-network: $40
Not covered
Not covered
Not covered
Not covered

Preventive Dental

In-network: $0 copay
Out-of-network: No Data
In-network: $0 copay
Out-of-network: No Data
Not covered
In-network: $0 copay
Out-of-network: No Data

Comprehensive dental

Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered

Vision

In-network: $0 copay
Out-of-network: No Data
Not covered
Not covered
Not covered
Not covered
Not covered

Other benefits

Limited coverage
Limited coverage
Not covered
Limited coverage
Not covered
Limited coverage
Limited coverage
 4
 4
 4
 3
 5
 4

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