Blue Choice Silver PPO Plans


Blue Cross BlueShield of Illinois
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Blue Choice – Silver PPO Plans Overview

Our Rating:

Blue Choice Silver PPO Plans offer the same benefits as Blue PPO Silver Plans, but are coupled with the Blue Choice PPO network, a smaller version of the “standard” Blue Cross Blue Sheild of Illinois PPO network. If you can accept some reduced hospital and physician choice, BlueChoice Select may be a great option for you. All Blue Choice 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. Blue Choice Silver Plans have a higher monthly premium and often lower out-of-pocket costs than Blue Choice Bronze plans. Blue Choice Silver Plans cover cover 80% or 100% of the costs after your deductible, depending on the plan.

There are 2 Blue Choice Silver PPO Plan Options:

Blue Choice PPO Network

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

Key Blue Choice Silver® plan features include:
Blue Choice Silver® PPO Plans may be right for you if you are an individual or family who:
  • Prefers fixed doctor visit copayments
  • Regularly visits a doctor and does not have expected major medical procedures or surgeries
  • Requires regular prescription medication

Compare the features, options and costs of Blue Choice Silver® 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 Silver Plan Costs

Health insurance costs include monthly premium payments, individual/family deductibles, out-of-pocket expenses, copayments, and coinsurance. Here is what you can expect with Blue Choice Silver® plans:

  • Individual in-network deductibles ranging from $3,000 to $6,000
  • $30 or $35 office visit copayments
  • $0 or $10 copayments for generic prescription drugs
  • Coinsurance of 100% to 80% percent of services provided in-network, after deductible and copayments are met
  • Annual out-of-pocket maximum of $6,000 and $6,350 for individuals and $9,750 or $12,700 for families, depending on the plan

By using a contracting BCBS PPO hospital, doctor or specialist you are able to save on premiums and the cost of covered services. You do not need to select a primary care physician or obtain a referral to see a specialist.

For more information on costs, get a quick quote or see the benefit summary.

What’s Included with Blue Choice Silver PPO Plans®

  • Coverage for major hospital, medical and surgical expenses incurred as a result of a covered accident or sickness
  • Coverage for daily hospital room and board, miscellaneous hospital services, surgical services, anesthesia services, in-hospital medical services, and out-of-hospital care
  • Although you can go to the hospital or doctor of your choice, your benefits under a Blue Choice Silver® plan will be higher, and your costs lower, when you use the services of participating PPO BlueChoice® providers.
  • Maternity Coverage
  • As with all individual Blue Cross and Blue Shield of Illinois plans, the freedom of not having to select a primary care doctor or obtain a referral to see a specialist

More Plan Details

It’s important to know the critical features of the health plan you are considering. Each plan’s Outline of Coverage provides brief descriptions of the basic provisions the Blue Choice Silver plans, as well as details on policy renewability, benefit exclusions and coverage limitations.

Prescription Drug Coverage

For the Blue Choice Silver Plans, there is a prescription drug card benefit that includes a $0 or $10 copay for generic, $50 or $100 copay for formulary drugs, and a $150 copay for specialty medications. This benefit is immediately available and not subject to a deductible.

There is a also a Home Delivery prescription benefit available with these 3 deductible options where you can receive a 90 day supply in the mail for the cost of a 60 day supply and is subject to a maximum cost of $300 per prescription.

Outpatient Prescription Drug Benefit Blue Choice Silver Plan 003 Blue Choice Silver Plan 004
Preferred Generics $0 copay $0 copay
Non-Preferred Generics $10 copay $10 copay
Preferred Formulary $50 copay $50 copay
Non-Preferred Formulary $100 copay $100 copay
Specialty $150 copay $150 copay

Plan Renewals

Your BCBSIL policy can ONLY be terminated for the following reasons:

  • Failure to pay
  • The plan is discontinued (90 days notice given with an option to convert to any plan we offer)
  • Discovery of fraud or an intentional misrepresentation of facts (30 days prior written notice given)
  • If you no longer reside, live or work in an area where we are authorized to do business

Add-ons and Plan Options

You can customize any Blue Choice Silver plan to add-on dental insurance.

Optional Dental Coverage

  • Covers cleanings, check-ups and other preventive procedures immediately – no waiting period
  • One of the highest maximum benefit amounts available – up to $1,500 per person per year
  • Up to 20% discount for orthodontic services at participating providers
  • Learn more about optional dental coverage

Blue Choice – Silver Plan 003

Our Rating:

Benefit Highlight Blue Choice PPO Silver 003
Plan Features
Lifetime Maximum Unlimited
Participating providers BlueChoice PPO Network
Smaller PPO Network
Individual Deductible $6,000
Family Deductible $12,700
Coinsurance 100%
Out of Pocket Maximum
Includes deductible
$6,000
Family Out of Pocket Maximum
Includes deductible
$12,700
Office Visit Copay (Primary Care/Specialist) $30 / $50 specialist
Medical Coverage Details
Inpatient Hospital Medical / Surgical Services
Hospital Services and Hospital Diagnostic Testing
$250 copay then 100% after deductible
Outpatient Surgery $200 copay then 100% after deductible
Emergency Room / Outpatient Emergency Care
Physician and Hospital
$500 copay then 100% after deductible
Outpatient Hospital Diagnostic Testing 100% after deductible
Mental Illness & Substance Abuse Rehab
(Outpatient Hospital/ Physician Care)
$30 copay
Mental Illness & Substance Abuse Treatment
(Inpatient Hospital Care)
$250 copay then 100% coinsurance after deductible
Mental Illness & Substance Abuse Treatment
(Inpatient Physician Care)
100% after deductible
Preventive Care Covered at 100%, no copay
Maternity Coverage $250 copay then 100% after deductible
Prescription Drugs
Preferred Generics $0 copay
Non Preferred Generics $10 copay
Preferred Formulary $50 copay
Non-Preferred Formulary $100 copay
Specialty $150 copay
Prescription Drug Formulary Standard
Cost Reductions
Tax Credit Eligible Yes
Cost Sharing Eligible No
HSA Eligibile No
Outline of Coverage PDF icon

Blue Choice Silver Plan 004

Our Rating:

Benefit Highlight Blue Choice PPO Silver 004
Plan Features
Lifetime Maximum Unlimited
Participating providers BlueChoice PPO Network
Smaller PPO Network
Individual Deductible $3,000
Family Deductible $9,000
Coinsurance 80%
Out of Pocket Maximum
Includes deductible
$6,350
Family Out of Pocket Maximum
Includes deductible
$12,700
Office Visit Copay (Primary Care/Specialist) $30 / $50 specialist
Medical Coverage Details
Outpatient Surgery $200 copay then 80% after deductible
Inpatient Hospital Medical / Surgical Services
Hospital Services and Hospital Diagnostic Testing
$250 copay then 80% after deductible
Emergency Room / Outpatient Emergency Care
Physician and Hospital
$500 copay then 80% after deductible
Outpatient Hospital Diagnostic Testing 80% after deductible
Mental Illness & Substance Abuse Rehab
(Outpatient Hospital/ Physcian Care)
$30 copay
Mental Illness & Substance Abuse Treatment
(Inpatient Hospital Care)
$250 copay then 80% coinsurance after deductible
Mental Illness & Substance Abuse Treatment
(Inpatient Physician Care)
80% coinsurance after deductible
Preventive Care Covered at 100%, no copay
Maternity Coverage $200 copay then 80% after deductible
Prescription Drugs
Preferred Generics $0 copay
Non Preferred Generics $10 copay
Preferred Formulary $50 copay
Non-Preferred Formulary $100 copay
Specialty $150 copay
Prescription Drug Formulary Standard
Cost Reductions
Tax Credit Eligible Yes
Cost Sharing Eligible No
HSA Eligibile No
Outline of Coverage PDF icon