BCN Advantage HMO and HMO-POS

With BCN Advantage, you can choose from four HMO-POS plans (Elements, Basic, Classic, and Prestige), as well as two HMO plans for selected geographic areas.

BCN Advantage HMO-POS plans include three that include drug benefits and a medical-only option that’s popular with people such as veterans who already have drug coverage. You can choose from plan options with preventive dental, vision and hearing coverage, and added benefits such as coverage for bathroom safety bars, access to fitness facilities and transportation to medical appointments. HMO-POS plans start as low as $0 monthly premiums (for our Basic plan) and many plans have out-of-pocket maximums so you can anticipate your expenses.

You can add our optional supplemental dental, vision and hearing plan benefit to your base BCN Advantage plan and enjoy more comprehensive coverage for these important health items.

BCN Advantage^SM HMO ConnectedCare is uniquely designed for residents of Genesee, Kalamazoo, Livingston, Macomb, Oakland, St. Clair, Washtenaw and Wayne counties, in consultation with local health care providers who will oversee treatment. With a low monthly premium, the ConnectedCare plan includes prescription drug coverage and preventive dental and vision benefits, as well as some of the same added benefits as our HMO-POS plans. There are no medical deductible or prescription drug deductibles and no cost for primary care office visits, so you pay less when you need care.

BCN Advantage ^SM HMO MyChoice Wellness is a specially designed plan open to residents of Kent, Muskegon and Oceana counties. Member care is overseen by health care providers from Mercy Health System who work closely with one another to understand and treat all your health risk factors and medical needs. MyChoice Wellness has no medical or prescription drug deductibles and no copay for primary care office visits, so you pay less when you need care.

Financial safeguards when you're ill

BCN Advantage plans combine hospital and doctor coverage with extra benefits. Plans include built-in safeguards to ensure that a medical need is more easily managed:

Our network doctors accept our payments as payment in full. You pay only your copayment or coinsurance.
Out-of-pocket maximums for medical care help limit your annual expenses.

Help when you're healthy

Dental discounts: Some network dentists will discount your care for services that aren't covered by your BCN Advantage plan.
Savings: Our Blue365^® program offers discounts on weight-loss programs and sporting goods. And we've arranged for additional discounts, especially for our BCN Advantage members.
Quit the Nic: This free telephone-based program supports members' efforts to quit smoking.

Features for 2015

BCN Advantage service area has expanded
You can now enroll in a BCN Advantage HMO-POS plan if you live in one of these additional six counties: Alpena, Benzie, Charlevoix, Emmet, Leelanau, Lenawee and portions of St. Joseph*. Our service area now covers 65 counties and portions of St. Joseph* county in the Lower Peninsula.
All-in-one coverage that can save you money
With BCN Advantage plans:
- Hospital, medical and other services have costs you can predict
- Out-of-pocket spending is capped, unlike Original Medicare
- Part D prescription drug coverage is usually included, so you know your share of the cost for drugs

Your agent can help you choose the plan that's best for you

For more information about BCN Advantage plans, contact your local, independent agent today.

*The service area St. Joseph county includes only these ZIP codes: 49011, 49030, 49052, 49072, 49093 and 49097.

BCN Advantage is an HMO-POS and HMO plan with a Medicare contract. Enrollment in BCN Advantage depends on contract renewal.

This is not a complete list of plans available in your service area. For a complete list, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day, seven days a week, or consult www.medicare.gov.

Important information about this plan

The benefit information provided is a brief summary, not a complete description of benefits. Limitations, copayments and restrictions may apply. For more information, contact the plan. Benefits, formulary, pharmacy, network, premium, and copayments or coinsurance may change on Jan. 1 of each year. You must continue to pay your Medicare Part B premium.

BCN Advantage HMO-POS is available in these counties: Alcona, Allegan, Alpena, Antrim, Arenac, Barry, Bay, Benzie, 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, Macomb, Manistee, Mason, Mecosta, Midland, Missaukee, Monroe, Montcalm, Montmorency, Muskegon, Newaygo, Oakland, Oceana, Ogemaw, Osceola, Oscoda, Otsego, Ottawa, Presque Isle, Roscommon, Saginaw, Sanilac, Shiawassee, St. Clair, in portions of St. Joseph* , Tuscola, Van Buren, Washtenaw, Wayne and Wexford.

*The service area in St. Joseph county includes only these ZIP codes: 49011, 49030, 49052, 49072, 49093 and 49097.

Premiums vary by county.

BCN Advantage HMO MyChoice Wellness is available in Kent, Muskegon and Oceana counties. BCN Advantage HMO ConnectedCare is available in Genesee, Kalamazoo, Livingston, Macomb, Oakland, St. Clair, Washtenaw and Wayne counties.

You must use plan providers, except in emergency or urgent care situations, or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers, neither Medicare nor BCN Advantage will be responsible for the costs, and your care may cost more than in-network pricing.

If you are enrolled in BCN Advantage HMO-POS Basic, Classic or Prestige or BCN Advantage HMOConnectedCare or MyChoice Wellness, you must use a network pharmacy to access your prescription drug benefit, except under non-routine circumstances when you cannot reasonably use a network pharmacy. Quantity limitations and restrictions may apply. Our pharmacy network includes the majority of chain pharmacies, mail order through Express Scripts Pharmacy^® (formerly Medco Mail Order Pharmacy) or Walgreens, as well as long-term care and home infusion pharmacies. For additional information on network pharmacies, please call Customer Service at the number on the back of your Blues ID card, 8 a.m. to 8 p.m., Monday through Friday, with weekend hours Oct. 1 through Feb. 14. You may also write to:
BCN Advantage
2311 Green Road
Ann Arbor, MI 48105

If you decide to have your BCN Advantage premium withheld from your Social Security check or deducted from your checking or savings account, it may take up to three months for the automatic deduction to begin. If your premium amount is currently withheld from your Social Security check or deducted from your checking or savings account and you wish to receive a monthly bill instead, the change may also take up to three months to become effective. During this time, you will be responsible for paying your premium.

Medicare beneficiaries may enroll in BCN Advantage through the CMS Medicare Online Enrollment Center. For more information, please contact Blue Cross Blue Shield of Michigan and Blue Care Network at 1-888-563-3307 from 8 a.m. to 8 p.m., seven days a week. There are extended service hours Oct. 15 through Feb. 14, 8 a.m. to 8 p.m. Eastern time, seven days a week, including holidays. TTY users should call 711. Beneficiaries may only enroll during specific times of the year.

*The service area in St. Joseph county includes only these ZIP codes: 49011, 49030, 49052, 49072, 49093 and 49097.

Premiums vary by county.

Medicare beneficiaries may enroll in BCN Advantage through the CMS Medicare Online Enrollment Center located at www.medicare.gov. For more information, please contact Blue Cross Blue Shield of Michigan and Blue Care Network at 1-888-563-3307 from 8 a.m. to 8 p.m., seven days a week. There are extended service hours Oct. 15 through Feb. 14, 8 a.m. to 8 p.m. Eastern time, seven days a week, including holidays. TTY users should call 711. Beneficiaries may only enroll during specific times of the year.

H5883_W_BCNAAgentlink5 CMS Approved 11072014