BCN Advantage Elements (HMO-POS) H5883-001-5 Plan Details
BCN Advantage Elements (HMO-POS) H5883-001-5 Plan Details
When selecting a Medicare Advantage plan for 2025, it's important to compare all your options. BCN Advantage Elements (HMO-POS) is among the plans you can review side-by-side with others, ensuring you find the coverage that suits your needs. You can easily enroll online or reach out to a licensed agent for personalized guidance.
BCN Advantage Elements Overview
Plan ID H5883-001-5 Overview | |
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Health Plan ID: | H5883-001-5 |
Medicare Advantage Plan Type: | Local HMO |
Plan Year: | 2024 |
Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Annual Out-of-Pocket Maximum: | $4,500 |
Part B Give Back: | $0.00/mo |
Part D Drug Plan Benefit: | Not Included |
Part D Gap Coverage: | No |
Supplemental Benefits: | Vision, Hearing |
Availability: | See List |
Insured By: | Blue Care Network |
Explore BCN Advantage Elements Benefits
BCN Advantage Elements is a Medicare Advantage Health Maintenance Organization - Point of Service (HMO-POS) plan that provides comprehensive coverage with the added flexibility of out-of-network care. With a monthly premium of $0.00, this plan covers all the essential benefits of Medicare Part A and Part B, giving you access to vital healthcare services. As an HMO-POS plan, BCN Advantage Elements allows you to choose providers both within and outside the network, although in-network services generally cost less.
Keep in mind that BCN Advantage Elements does not include a Medicare prescription drug plan. If you require drug coverage, you can explore standalone Part D plans. BCN Advantage Elements also offers financial protection through its annual maximum out-of-pocket (MOOP) limit of $4,500. Once you reach this limit, your in-network healthcare costs are fully covered for the remainder of the year. This feature makes BCN Advantage Elements a solid option for those who value both flexibility and comprehensive coverage.
We're Here to Help You Enroll |
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Out-of-Pocket Costs
BCN Advantage Elements includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H5883-001-5.
Service | Enrollee Cost |
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Doctor's Office Visit (In-Network) | |
Primary: | $0 |
Specialist: | $35 Copay Prior Authorization Required |
Wellness & Preventive Programs: | None |
Preventive care: | $0 |
Foot Care (In-Network) | |
Foot Exams and Treatments (Medicare-covered): | $35 Copay Prior Authorization Required |
Routine Foot Care: | Not Covered |
Chiropractic Treatment (In-Network) | |
Medicare-covered chiropractic: | $15 Copay Prior Authorization Required |
Routine chiropractic: | Not Covered |
Emergency and Urgent Care | |
Emergency room care: | $90 Copay |
Urgent care: | $45 Copay |
Ground ambulance: | $250 Copay |
Inpatient hospital care: | $205.00 per day for days 1 through 6 $0.00 per day for days 7 and beyond |
Outpatient hospital care: | $100 Copay Prior Authorization Required |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $188.00 per day for days 21 and beyond |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy: | $20 Copay |
Outpatient group therapy: | $20 Copay |
Inpatient psychiatric hospital care: | $205.00 per day for days 1 through 6 $0.00 per day for days 7 and beyond |
Outpatient group therapy: | $20 Copay |
Outpatient individual therapy: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy: | $30 Copay Prior Authorization Required |
Occupational therapy: | $30 Copay Prior Authorization Required |
Medical Equipment and Supplies (In-Network) | |
Diabetes supplies: | $0 |
Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
Prosthetics: | 20% Coinsurance |
Diagnostics, Lab Services, and Imaging (In-Network) | |
Diagnostic radiology services: | $100 Copay Prior Authorization Required |
Lab services: | $0 |
Outpatient x-rays: | $100 Copay Prior Authorization Required |
Diagnostic tests and procedures: | $20 Copay Prior Authorization Required |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Most preventive services are covered 100% by BCN Advantage Elements as a Part B benefit.
Supplemental Benefits
Here’s an overview of the additional benefits that Blue Care Network offers with this plan:
Supplemental Healthcare Service | Member Cost |
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Preventive Dental | |
Oral exam (In-Network) | Not Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Not Covered |
Cleaning (In-Network) | Not Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Not Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Not Covered |
Extractions (In-Network) | Not Covered |
Endodontics (In-Network) | Not Covered |
Restorative services (In-Network) | Not Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Not Covered |
Hearing Aids | |
Fitting/evaluation (In-Network) | Covered Limits may apply |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | $35 Copay |
Vision | Maximum vision benefit: | $150.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | Not Covered |
Routine eye exam (In-Network) | Covered Limits may apply |
Contact lenses (In-Network) | Covered Limits may apply |
Additional Benefits
None specified.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Rating Overview
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
CMS Measure | Star Rating |
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2024 Overall Rating | |
Staying Healthy: Screenings, Tests, Vaccines | |
Managing Chronic (Long Term) Conditions | |
Member Experience with Health Plan | |
Complaints and Changes in Plans Performance | |
Health Plan Customer Service | |
Drug Plan Customer Service | |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | |
Drug Safety and Accuracy of Drug Pricing |
Plan Availability
BCN Advantage Elements (H5883-001-5) is available in the following locations (click to open):
Who Can Enroll in BCN Advantage Elements?
To qualify for enrollment in BCN Advantage Elements, you must:
- Be entitled to Medicare Part A and enrolled in Medicare Part B.
- Live within the plan’s designated service area.
- Not have End-Stage Renal Disease (ESRD), except under certain conditions.
If you fulfill these criteria, you can enroll in BCN Advantage Elements and enjoy the extensive healthcare benefits it offers.
When Should You Enroll in BCN Advantage Elements?
To ensure you don’t miss your chance to enroll in BCN Advantage Elements, be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711) to get assistance from a licensed insurance agent.
Steps to Enroll in BCN Advantage Elements
Enrolling in BCN Advantage Elements is easy. Choose the option that works best for you:
- Online through MedicareEnrollment.com: Visit the enrollment page and complete your enrollment through their Secure Online Enrollment Form.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711). A licensed insurance agent can assist you with the enrollment process and provide answers to any questions.
- Through Medicare.gov: Go to Medicare.gov, log in or create an account, and follow the instructions to join BCN Advantage Elements through the official Medicare website.
- Directly with BCN Advantage Elements: You can also enroll directly with the plan. The necessary contact details are provided below in the "Contact" section.
Remember to enroll during the correct enrollment period to ensure your coverage starts on time.
Contact Blue Care Network
Website: | http://www.bcbsm.com/medicare |
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Formulary: | http://www.bcbsm.com/pharmaciesmedicare |
Pharmacy: | Blue Care Network Pharmacy Page |
New Members: | (855)425-7720 |
TTY Users: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, you can do so on the Social Security Administration website. For more information about the Medicare Part C program, visit the official Medicare website or call 1-800-MEDICARE.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
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