BlueChoice Value Plans
BlueChoice Value Overview
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BlueChoice Value gives you major medical coverage at a reduced premium cost by utilizing the money-saving BlueChoice Network and eliminating office visit and prescription co-payments. With the exception of well-child care, all claims are subject to the deductible and coinsurance.
BlueChoice Value is a smart choice for reliable health insurance coverage at rates to fit your budget. BlueChoice Value is a great combination of benefits and price.
Key BlueChoice Value® plan features include:
- Access to the BlueChoice PPO Network, a smaller version of the largest BCBS PPO network in Illinois
- Well-child care
- 80% coinsurance
- Family deductible is only 2x the individual deductible
- Diagnostic testing
- Hospital services
- Prescription drug coverage
- Access to the BlueCard PPO network when traveling out-of-state
- Optional dental coverage
- Unlimited lifetime maximum
Learn more about valuable member services and features you get when you join the Blue Cross and Blue Shield of Illinois family.
BlueChoice Value 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 BlueChoice Value® plans:
- Individual in-network deductibles ranging from $250 to $5000 – customize your plan by choosing a deductible amount that works best for your situation
- You pay 20% coinsurance on prescription drugs after deductible is met
- You pay 20% coinsurance of major services provided in-network, after deductible and copayments are met
- Annual out-of-pocket maximum of $3,000 for individuals and $6,000 for families
By using a contracting BlueChoice Value 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 BlueChoice Value®
- 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 BlueChoice Value® plan will be higher, and your costs lower, when you use the services of participating BlueChoice® providers.
- 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
Prescription Drug Coverage
For the BlueChoice Value plans, there is a prescription drug benefit of 80% coinsurance after the deductible is satisfied for all BlueChoice Value plans.
| Outpatient Prescription Drug Benefit | You Pay | BlueChoice Value Pays |
| Retail After deductible |
||
| Generic | 20% | 80% |
| Brand formulary & Insulin and Insulin syringes | 20% | 80% |
| Brand non-formulary | 20% | 80% |
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
BlueChoice Value® Limits
Every insurance plan has limitations. These limits are there to keep health care costs down for everyone. A pre-existing condition is just one example of a plan limitation. For example:
- A pre-existing condition may limit or exclude your participation in a plan.
- There is a waiting period of 365 days for pre-existing conditions, including optional maternity coverage.
- This means your health care expenses related to that specific condition will not be covered by the plan during the specified time.
It's important to know the limitations of your health plan. For a list of exclusions and limitations, see the benefit summary.
Add-ons and Plan Options
You can customize any BlueChoice Value plan with add-on coverage and insurance.
Optional Maternity Coverage
- Covers inpatient and outpatient hospital services
- Includes coverage for medical and surgical services
- Maternity benefits begin 365 days after the effective date of the maternity coverage
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 percent discount for orthodontic services at participating providers
- Learn more about optional dental coverage