BCN Advantage Elements (HMO-POS) Medicare Advantage Plan H5883-017 • 2027
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $4500.00In-network
- Part B Giveback
- −$20.00 reduction
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 0 beneficiaries
BCN Advantage Elements (HMO-POS) Introduction
This Medicare Advantage HMO-POS plan, BCN Advantage Elements, is offered by Blue Care Network and uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network. It comes without prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $4500.00. The plan is identified by CMS Plan ID H5883-017.
Plan Benefits
BCN Advantage Elements includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H5883-017.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: $0 copay Out-of-network: $0-$35 copay |
Coming soon |
| Specialist | In-network: $35 copay Out-of-network: $0-$35 copay |
Coming soon |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
Coming soon |
| Telehealth benefit | In-network: $0 copay | Coming soon |
| Routine chiropractic | In-network: $35 copay Out-of-network: $15-$35 copay |
Coming soon |
| Fitness benefits | Coming soon | Coming soon |
| Health education | Not covered | Coming soon |
| Counseling services | Not covered | Coming soon |
| Over-the-counter drug benefits | In-network: $0 copay | Coming soon |
| Health transportation (non-emergency) | Coming soon | Coming soon |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: $20-$100 copay Out-of-network: $0-$100 copay |
Coming soon |
| Lab services | In-network: $0 copay Out-of-network: $0-$100 copay |
Coming soon |
| Outpatient x-rays | In-network: $20-$100 copay Out-of-network: $0-$100 copay |
Coming soon |
| Diagnostic tests and procedures | In-network: $0-$20 copay Out-of-network: $0-$100 copay |
Coming soon |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $130 copay | Coming soon |
| Worldwide emergency care | Coming soon | Coming soon |
| Urgent care | $0-$45 copay | Coming soon |
| Inpatient hospital care | In-network: Tier 1 $250 per day for days 1-7 $0 per day for days 8-90 $0 per stay Out-of-network: $325 per day for days 1-7 $0 per day for days 8-90 $0 per stay |
Coming soon |
| Skilled Nursing Facility | In-network: Tier 1 $0 per day for days 1-20 $221 per day for days 21-100 Out-of-network: $0 per day for days 1-20 $221 per day for days 21-100 $0 per stay |
Coming soon |
| Ground ambulance | In-network: $300 copay Out-of-network: $90-$300 copay |
Coming soon |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: $20 copay Out-of-network: $35 copay |
Coming soon |
| Outpatient group therapy | In-network: $20 copay Out-of-network: $35 copay |
Coming soon |
| Inpatient psychiatric hospital care | In-network: Tier 1 $250 per day for days 1-7 $0 per day for days 8-90 $0 per stay Out-of-network: $325 per day for days 1-7 $0 per day for days 8-90 $0 per stay |
Coming soon |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $35 copay Out-of-network: $35 copay |
Coming soon |
| Occupational therapy | In-network: $35 copay Out-of-network: $35 copay |
Coming soon |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: 0%-20% coinsurance Out-of-network: 0%-40% coinsurance |
Coming soon |
| Durable medical equipment | In-network: 0%-20% coinsurance Out-of-network: 0%-40% coinsurance |
Coming soon |
| Prosthetics | In-network: 20% coinsurance Out-of-network: 0%-40% coinsurance |
Coming soon |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | In-network: 0%-20% coinsurance Out-of-network: $0-$35 copay, 0%-20% coinsurance |
Coming soon |
| Other Part B drugs (Medicare-covered) | In-network: 0%-20% coinsurance Out-of-network: $0-$35 copay, 0%-20% coinsurance |
Coming soon |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Dental x-rays | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Cleaning | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Periodontics | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Endodontics | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Restorative services | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Implant services | Not covered | Coming soon |
| Orthodontics | Not covered | Coming soon |
| Oral/Maxillofacial surgery | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | In-network: $0 copay | Coming soon |
| Contact lenses | In-network: $0 copay | Coming soon |
| Eyeglass frames only | In-network: $0 copay | Coming soon |
| Eyeglass lenses only | In-network: $0 copay | Coming soon |
| Eyeglasses (frames & lenses) | Not covered | Coming soon |
| Upgrades | Not covered | Coming soon |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | In-network: $0 copay | Coming soon |
| Fitting/evaluation | In-network: $0 copay | Coming soon |
| Prescription hearing aids | In-network: $495-$1695 copay | Coming soon |
| OTC hearing aids | Not covered | Coming soon |
Additional and Special Needs Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Adult day health services | Not covered | Coming soon |
| Home-based palliative care | Not covered | Coming soon |
| Personal emergency response system | Coming soon | Coming soon |
| Weight management programs | Not covered | Coming soon |
| Wigs for chemotherapy-related hair loss | Coming soon | Coming soon |
| Alternative therapies | Not covered | Coming soon |
| Massage therapy | Not covered | Coming soon |
| Home/bathroom safety devices | Not covered | Coming soon |
Certain preventive services are covered 100% by BCN Advantage Elements as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Performance Ratings (Contract ID: H5883)
CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 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 |
Contact Information for Blue Care Network
- Website
- Blue Care Network Plan Page
- Providers
- Blue Care Network Providers Page
- Formulary
- Blue Care Network Formulary Page
- Pharmacy
- Blue Care Network Pharmacy Page
- New Member Health Plan Help
- (855)425-7720
- New Member Health Plan TTY
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Plan Availability
BCN Advantage Elements (H5883-017-0) is available in the following locations:
Michigan Counties Served
- Alcona
- Allegan
- Alpena
- Antrim
- Arenac
- Barry
- Bay
- Benzie
- Berrien
- Branch
- Calhoun
- Charlevoix
- Cheboygan
- Clare
- Clinton
- Crawford
- Eaton
- Emmet
- Genesee
- Gladwin
- Grand Traverse
- Gratiot
- Hillsdale
- Huron
- Ingham
- Ionia
- Iosco
- Isabella
- Jackson
- Kalamazoo
- Kalkaska
- Kent
- Lake
- Lapeer
- Leelanau
- Lenawee
- Livingston
- Luce
- Mackinac
- Macomb
- Manistee
- Mason
- Mecosta
- Midland
- Missaukee
- Monroe
- Montcalm
- Montmorency
- Muskegon
- Newaygo
- Oakland
- Oceana
- Ogemaw
- Osceola
- Oscoda
- Otsego
- Ottawa
- Presque Isle
- Roscommon
- Saginaw
- Saint Clair
- Saint Joseph
- Sanilac
- Schoolcraft
- Shiawassee
- Tuscola
- Van Buren
- Washtenaw
- Wayne
- Wexford
Frequently Asked Questions
Here are some of the most frequently asked questions about this plan (click to open).
Frequently Asked Questions About BCN Advantage Elements (HMO-POS)
Is there a monthly premium for this plan in 2027?
For 2027, the monthly premium is $0.00. Medicare Part B premiums apply in addition to this amount.
What is the in-network MOOP for plan H5883-017?
For 2027, the in-network maximum out-of-pocket is $4500.00. The plan pays 100% of covered in-network services beyond this amount.
What is the total enrollment for plan H5883-017?
Total enrollment is 0 beneficiaries based on the latest CMS data.
Is there a Part D deductible for this plan?
The Part D deductible is $0.00.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Blue Care Network (official source) | http://www.bcbsm.com/medicare | October 4, 2026 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
MedicarePlans.com is an independent informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.