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Blue Cross Blue Shield of Illinois – Plan Descriptions

BlueCross BlueShield of Illinois is the largest health insurance company in the state with over 6.5 million members.

Blue Cross Blue Shield of Illinois announced a significant network change for its individual Preferred Provider Network (PPO) health plans. The broad PPO network plans will no longer be available, effective January 1, 2016. This means that if you purchased one of these plans on or after January 1, 2014 as part of the Affordable Care Act (ACA), your choices will now be limited to the narrower Blue Choice Preferred PPO network or Blue Precision HMO network plans.

Key Hospitals NOT accepting the Blue Choice Preferred PPO Plans in 2016:
  • Northshore Hospital Systems
  • Northwestern Hospital Systems – (with the exception of Northwestern Memorial Central DuPage Hospital)
  • Rush Hospital Systems
  • University of Illinois Chicago
  • University of Chicago
Hospitals accepting the Blue Choice Preferred PPO Plans in 2016:
  • Edwards Memorial
  • Alexian Brothers
  • Loyola Hospital Systems
  • Elmhurst Memorial
  • Central Dupage Hospital (formerly Cadence)

The BCBSIL 2016 health plan options include HMO Plans, Health Savings Accounts, PPO Plans, short-term plans, Medicare Supplements, Medicare Advantage Plans, and Medicare Part D prescription drug plans. The different plans are described below.

Blue Precision HMO Plans

Our Rating:

Blue Precision Gold HMO 101 Plan features:
  • $1,750 single/$5,250 family deductible and 80% coinsurance
  • $25 doctor visit / $50 specialist copayment
  • $25 urgent care copayment
  • No charge for Tier 1 formulary generic drugs
Blue Precision Silver HMO 102 Plan features:
  • $2,000 single/$6,000 family deductible and 80% coinsurance
  • $30 doctor visit / $50 specialist copayment
  • $30 urgent care copayment
  • No charge for Tier 1 formulary generic drugs
Blue Precision Bronze HMO 103 Plan features:
  • $3,000 single/$13,700 family deductible and 80% coinsurance
  • $50 doctor visit / $100 specialist copayment
  • $50 urgent care copayment
  • No charge for Tier 1 formulary generic drugs
HMO Network

The Blue Precision HMO Plans use the Blue Precision HMO network, one the largest HMO networks in Illinois. You must select a network primary care physician (PCP), who coordinates your care within the network and referrals are required from your PCP to see a specialists.

Key Blue Precision HMO® Plan features include:
  • Lower out-of-pocket costs than PPO plans
  • You must select a network primary care physician (PCP), who coordinates your care within the network
  • Referral required to see a specialist
  • $25 doctor visit / $50 specialist copayment for Gold HMO Plan 101
  • Prescription drug coverage
  • Maternity Coverage
  • Well-adult care
  • Well-child care
  • Diagnostic testing
  • Hospital services
  • Optional dental coverage
Blue Precision HMO® Plans may be right for you if you are an individual or family who:
  • Are willing to have a primary care physician (PCP) coordinate your care
  • Prefers fixed doctor visit copayments
  • Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
  • Requires regular prescription medication

Learn more about valuable member services and features you get when you join the Blue Cross and Blue Shield of Illinois family.


BCBSIL HMO Deductibles
$1,750 single / $5,250 family
$2,000 single / $6,000 family
$6,000 single / $13,700 family

Blue PPO Gold Plans

Blue PPO Gold Plans will be discontinued January 1, 2016

Our Rating:

There are 3 Blue PPO Gold Plan Options:
Key Blue PPO Gold® plan features include:
  • $30 doctor visit copayment for Gold Plan 001 and Gold Plan 012
  • $10 doctor visit copayment for Gold Plan 002
  • Prescription drug coverage
  • Maternity Coverage
  • Well-adult care covered at 100%
  • Well-child care covered at 100%
  • Diagnostic testing
  • Hospital services
  • Access to the BlueCard PPO network when traveling out-of-state
  • Optional dental coverage


Blue PPO Gold Deductibles
$1,000 single / $3,000 family
$1,500 single / $4,500 family
$3,250 single / $9,750 family

Blue Choice Preferred PPO Gold Plans

Our Rating:

Blue Choice Preferred Gold Plans offer the smaller but respectable Blue Choice Preferr3ed PPO network of doctors and hospitals and the convenience of never needing a referral to see a specialist. Blue Choice Preferred PPO Plans are coupled with the Blue Choice Preferred PPO network, a smaller version of the “standard” Blue Cross Blue Shield of Illinois PPO network that is being discontinued beginning January 1st, 2016. If you can accept some reduced hospital and physician choices, Blue Choice Preferred Gold PPO may be a great option for you.

The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are. Blue Choice Preferred Gold PPO Plans have a higher monthly premium and often lower out-of-pocket costs than Blue Choice Preferred Silver plans.

There is only 1 Blue Choice Preferred Gold PPO Plan:
Blue Choice Preferred Gold®PPO Plan 101 features include:

Use the Provider Finder to search for physicians and hospitals in the Blue Choice Preferred PPO network.

Blue Choice Gold® may be right for you if you are an individual or family who:
      • Seeks coverage comparable to what is offered by employers
      • Prefers fixed doctor visit copayments
      • Regularly visits a doctor
      • Requires regular prescription medication


Blue Choice Preferred Gold PPO Deductibles
$500 single / $1,500 family

Blue PPO Silver Plans

Blue PPO Silver Plans will be discontinued January 1, 2016

Our Rating:
Blue PPO Silver Plans are the second most popular BCBSIL individual plans. Blue Silver PPO Plans include access to the Blue Advantage Entrepreneur (BAE) PPO network, the largest PPO network in Illinois that includes over 90% of Illinois doctors and 96% of hospitals.

All Silver plans offer the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are. Silver Plans have a higher monthly premium and often lower out-of-pocket costs than bronze plans. In most cases, Silver plans cover 80% of costs, while you cover 20%.

There are 2 Blue PPO Silver Plan Options:
Key Blue PPO Silver® plan features include:
      • $30 primary office visit copay and $50 specialist copay for Silver Plan 003 and Silver Plan 004 Plans
      • Prescription drug coverage
      • Maternity Coverage
      • Well-adult care
      • Well-child care
      • Diagnostic testing
      • Hospital services
      • Access to the BlueCard PPO network when traveling out-of-state
      • Optional dental coverage


Blue PPO Silver Deductibles
$3,000 single / $9,000 family
$6,000 single / $12,700 family

Blue Choice Preferred PPO Silver Plans

Blue Choice Preferred Silver PPO Plans offers a respectable PPO network of doctors and hospitals and the convenience of never needing a referral to see a specialist. Blue Choice Preferred PPO Plans are coupled with the Blue Choice Preferred PPO network, a smaller version of the “standard” Blue Cross Blue Shield of Illinois PPO network and the largest PPO network BCBSIL offers to individual health lans. If you can accept some reduced hospital and physician choice, Blue Choice Preferred Silver PPO may be a great option for you. All Blue Choice Preferred Silver PPO plans offer the same set of essential health benefits, quality and amount of care.

The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are. Blue Choice Preferred Silver PPO Plans have a higher monthly premium and often lower out-of-pocket costs than Blue Choice Preferred Silver plans.

There are 3 Blue Choice Preferred Silver PPO Plans:
Blue Choice Preferred PPO Network

The Blue Choice Preferred PPO Silver Plans use the Blue Choice Preferred PPO network, a smaller PPO network that includes about 50% of doctors and hospitals in Illinois.

Key Blue Choice Preferred Silver PPO® plan features include:
Blue Choice Preferred Silver PPO Plans may be right for you if you are an individual or family who:
      • Seeks coverage comparable to what is offered by employers
      • Prefers fixed doctor visit copayments
      • Regularly visits a doctor
      • Requires regular prescription medication

Compare the features, options and costs of Blue Choice Preferred Silver® PPO plans to find the one that’s right for you.

Learn more about valuable member services and features you get when you join the Blue Cross and Blue Shield of Illinois family.


Blue Choice Preferred Silver Deductibles
$2,000 single / $6,000 family
$3,200 single / $9,700 family
$3,500 single / $10,500 family

Blue PPO Bronze Plans 

Blue PPO Bronze Plans will be discontinued January 1, 2016

Our Rating:
Bronze PPO Plans are catastrophic plans that are health savings account (HSA) eligible. Bronze Plans have a higher monthly premium and often lower out-of-pocket costs than silver plans. In most cases, Bronze plans cover 80% of costs, while you cover 20%. Blue PPO Bronze Plans include access to the Blue Advantage Entrepreneur (BAE) PPO network, the largest PPO network in Illinois that includes over 90% of Illinois doctors and 96% of hospitals.

There are 2 Blue PPO Bronze Plan Options:
      • Bronze Plan 005 – $5,000 individual deductible and 80% coinsurance
      • Bronze Plan 006 (HSA Compatible) – $6,000 individual deductible and 100% coinsurance
Key Blue PPO Bronze® plan features include:
      • $30 primary / $60 specialist copay for first 3 visits per calendar year, then 80% 80% coinsurance after deductible for the Bronze Plan 005
      • 100% coinsurance after deductible for the Bronze Plan 006
      • Prescription drug coverage after deductible is met
      • Maternity Coverage
      • Well-adult care covered at 100%, no deductible
      • Well-child care, covered at 100%, no deductible
      • Diagnostic testing
      • Hospital services
      • Access to the BlueCard PPO network when traveling out-of-state
      • Optional dental coverage
Blue PPO Bronze® may be right for you if you are an individual or family who:
      • Seeks lower cost coverage
      • Does not regularly have doctor visits
      • Would like an HSA compatible plan (Bronze Plan 006 only)


Blue PPO Bronze Deductibles
$5,000 single / $12,700 family
$6,000 single / $12,700 family

Blue Choice Preferred Bronze PPO Plans

Our Rating:

Blue Choice Preferred PPO Bronze Plans offer a respectable PPO network of doctors and hospitals and the convenience of never needing a referral to see a specialist. Blue Choice Preferred PPO Plans are coupled with the Blue Choice Preferred PPO network, a smaller version of the “standard” Blue Cross Blue Shield of Illinois PPO network. If you generally in good health and can accept some reduced hospital and physician choice, Blue Choice Preferred Bronze PPO may be a great option for you.

There are 3 Blue Choice Preferred Bronze Plan Options:

Blue Choice Preferred Bronze Plans 105 and 106 are HSA compatible plans, which combined with tax-favored savings account combined allows you to fund health care expenses with pre-tax money.

Blue Choice Preferred Bronze Plan 107 is not HSA compatible, but offers one additional free office visit at no cost in addition to the the free annual office visit check up. Additionally, it offers a $75 urgent care copay and $12 generic drugs without needing to reach your deductible.

To find if your doctor or hospital is part of the Blue Choice Network Provider Finder.

Blue Choice Preferred PPO Bronze® Plans may be right for you if you are an individual or family who:


Blue Choice Preferred Bronze Deductibles
$4,500 single / $13,500 family
$6,000 single / $13,100 family
$6,850 single / $13,700 family

Blue Precision Bronze HMO Plan

Our Rating:
The Blue Precision Bronze HMO Plan 103 is the least expensive HMO plan, but also includes comprehensive benefits. Bronze Plans have a lower monthly premium and often higher out-of-pocket costs than Platinum, Gold, and Silver plans. This is an HMO plan. You must select a Blue Precision HMO Network Primary Care Physician (PCP) when enrolling in this plan.

There are is only 1 BCBSIL Bronze HMO Plan Option:
HMO Network

The Blue Precision Bronze HMO Plan 103 uses the Blue Precision HMO network, one the largest HMO network in Illinois. You must select a network primary care physician (PCP), who coordinates your care within the network and referrals are required from your PCP to see a specialists.

Bronze HMO ® Plan 103 features include:
      • No charge for Tier 1 formulary generic drugs
      • You must select a network primary care physician (PCP), who coordinates your care within the network
      • Referral required to see a specialist
      • $50 doctor visit copayment for primary care physicians (PCPs)
      • $100 office visit copayment for specialists
      • $50 urgent care copayment
      • Maternity Coverage
      • Well-adult care
      • Well-child care
      • Diagnostic testing
      • Hospital services
      • Optional dental coverage
Bronze® HMO 103 may be right for you if you are an individual or family who:
      • Are willing to have a primary care physician (PCP) coordinate your care
      • Prefers fixed doctor visit copayments
      • Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
      • Requires regular prescription medication


Bronze HMO Deductibles
$6,250 single / $12,700 family

SelectTemp PPO (short-term medical)

Our Rating:

SelectTEMP PPO is an affordable short-term individual health plan that provides basic protection against unexpected accident or illness.
Individuals who are temporarily without health insurance because COBRA is too expensive, are in-between jobs, or waiting for employer coverage to begin find SelectTEMP PPO to be an affordable alternative.

SelectTEMP PPO offers various benefit periods and deductibles to allows you the control to tailor coverage, premium rates and out-of-pocket expenses according to your own needs.

You are able to choose:

      • The date you want coverage to begin
      • The coverage period – 1 to 11 months
      • The deductible – from $500 to $5,000
      • From over 200 Illinois hospitals


SelectTemp PPO Deductibles
$500 single / $1,000 family
$1,000 single / $2,000 family
$1,500 single / $3,000 family
$2,000 single / $4,000 family
$5,000 single / $10,000 family

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