BlueCross BlueShield of IL


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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 is offering 4 different individual plan networks for plans effective January 1st, 2023: Blue Choice Preferred PPO network, Blue Precision HMO network, BlueCare Direct Advocate, or Blue FocusCare plans.

New BCBSIL Plans: 

Plan NamePlan TierDeductibleMax Out-of-PocketPrimary CareSpecialist
Blue Precision: 
703 – rx Copays
Gold HMO$95030%$20$40
Blue Precision : 707Gold HMO$2,00025%$30$60
Blue Choice Preferred: 707Gold PPO$2,000$8,700$30$60
Blue Choice Preferred: 706Silver PPO$5,800$8,900$40$80
Blue Precision:
704 – rx Copays
Silver HMO$7,500$9,100$70$95
Blue Precision: 706Silver HMO$5,800$8,900$40$80
Blue Choice Preferred: 701Bronze PPO$8,600$9,10050%50%
Blue Choice Preferred: 705Bronze PPO$9,100 $9,1000%0%
Blue Choice Preferred: 708Bronze PPO$7,500$9,000$50$100
Blue Precision: 701 – rx copaysBronze HMO$9,100$9,100$150$160
Blue Precision: 708Bronze HMO$7,500$9,000$50$100

Why BCBSIL? 

Access

  • Health plans on and off exchange in every county
  • Comprehensive, year-round coverage
  • High-quality, efficient networks with focus on preventive care

Affordability

  • Affordable plan options to fit every budget
  • Monthly payments as low as $0 for qualified on-exchange applicants

Stability

  • Serving Illinois communities for 85 years.
  • In the nine years of ACA open enrollment, BCBSIL has been proud to offer multiple qualified health plans in every county across Illinois.

Helpful Resources 24/7

  • Virtual Visits for Blue Choice Preferred PPO members
  • 24/7 Nurseline (English and Spanish) for PPO members
  • Cost Estimator Tool on Blue Access for Members
  • SmartER Care Options – member education campaign on choices for non-emergency care

Mobile App

  • Easy to use – find a doctor, see payment options, access electronic member ID card and more

Blue365®

  • Blue365 member discount program – members save on health club and gym memberships, weight loss programs, dental products and much more
Key Hospitals NOT accepting the Blue Choice Preferred PPO Plans in 2023:
  • Northshore Hospital Systems (accepting BluePrecision HMO Plans, Ambetter, United Healthcare, Aetna marketplace plans only)
  • Rush Hospital Systems
  • University of Chicago – accepted by 2022 Oscar Health plans
Key Hospitals accepting the Blue Choice Preferred PPO Plans in 2023:
  • Amita Health Hospitals
  • Edwards Memorial
  • Alexian Brothers
  • Loyola Hospital Systems
  • Elmhurst Memorial
  • Galesburg Cottage Hospital
  • Northwestern Hospital Systems
  • Swedish Covenant Hospital
  • OSF Hospital System
  • Presence Hospital Systems
  • University of Illinois Chicago
  • St. Francis Medical Center
  • St. Mary Medical Center (OSF Hospital Systems)
  • UnityPoint Health Methodist

Effective Jan. 1, 2020: Methodist First Choice #457 will participate in the Blue Precision HMOSM provider network.

The details: Current members of Methodist First Choice will be able to choose doctors that are in the Blue Precision HMO network. Review a list of participating providers  for members impacted by this change.

Chicago BCBSIL Hospital Network Guide

 BCBSIL Plan Network
Network NameBlue Preferred PPOBlue Precision HMOBlueCare Direct AdvocateBlue Focus
Network Hospital ListsHospital ListHospital ListHospital ListHospital List
NorthwesternXX
    
LoyolaXX
    
RushXXXX
    
AdvocateX
    
NorthshoreXXX
    
Presence HospitalsXX
    
U of CX ✓**XX
    
UICXX
    
Edward/ElmhurstXX

**Specialty care only with referral; No primary care

The BCBSIL 2023 individual health plan options include HMO Plans, Health Savings Accounts, and PPO Plans. The different plans are described below.

Illinois Plans Overview:

Blue FocusCare HMO: 1 Bronze, 1 Silver 1 Gold

  • Network: BlueFocus CareSM (BFC)
  • Approximately 15 hospitals, 1,806 providers*
  • Micro network for Cook County
  • Lower-cost HMO plan

BlueCare Direct w/ Advocate: 1 Bronze, 1 Silver, 1 Gold

  • Network: BlueCare DirectSM (BHD)
  • Approximately 11 hospitals, 4,083 providers*
  • In collaboration with Advocate Health Care1
  • Competitive HMO plan with low out-of-pocket costs
  • Call today, be seen today by primary care doctors

Blue Precision HMO: 1 Bronze, 2 Silver, 1 Gold

  • Network: Blue Precision HMOSM (BAV)
  • Approximately 66 hospitals, 17,467 providers*
  • Helps keep costs low and predictable
  • Personalized with a primary care physician (PCP), who coordinates health care
  • Flexibility to change medical group

Blue Choice Preferred PPO: 5 Bronze, 2 Silver, 1 Gold, 1 Catastrophic

  • Network: Blue Choice Preferred PPO (BCE)
  • Approximately 176 hospitals, 73,027 providers*
  • New bronze plan –
    • Blue Choice Preferred Bronze PPO 601
  • New plan –
    • Blue Choice Preferred Security PPOSM 200 (Catastrophic)
  • Greater flexibility and array of product options
  • Available in all counties
  • Virtual Visits available via phone, video or mobile app
  • Electronic prescriptions, when appropriate, can be sent to member’s pharmacy of choice

Dental

BlueCare Dental

  • Coverage for cleanings, preventive services and much more
  • Preventive dental services deductible waived

Prescription and Pharmacy

  • Six prescription payment level tiers for all ACA plans – generic, brand and specialty have preferred and non-preferred benefit levels
  • All plans include a drug list. PPO includes Preferred Pharmacy Network – Walgreens, Walmart, Sam’s Club, Albertsons and select Independent Pharmacies
*Estimates as of 6/1/2021 
1. An independently contracted provider. 
2. A “preferred” or “participating” pharmacy has a contract with BCBSIL’s pharmacy benefit manager (Prime Therapeutics) to provide pharmacy services at a negotiated rate. A pharmacy benefit  manager administers prescription drug benefits for a health plan. The terms “preferred” and “participating” should not be construed as a recommendation, referral or any other statement as 

Blue Precision HMO Plans

Our Rating:

Blue Precision Gold HMO 207 Plan features:
  • $750 single/$2,250 family deductible and 30% coinsurance
  • $20 doctor visit / $40 specialist copayment
  • $40 urgent care copayment
  • 10% for Tier 1 formulary generic drugs
Blue Precision Silver HMO 206 Plan features:
  • $3,100 single/$9,300 family deductible and 50% coinsurance
  • $35 doctor visit / $75 specialist copayment
  • $75 urgent care copayment
  • 0% for Tier 1 formulary generic drugs
Blue Precision Bronze HMO 205 Plan features:
  • $7,400 single/$17,100 family deductible and 50% coinsurance
  • $65 doctor visit / $105 specialist copayment
  • $85 urgent care copayment
  • 10% 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
  • $20 doctor visit / $40 specialist copayment for Gold HMO Plan 207
  • 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.

Blue Precision HMO Deductibles
$750 single / $2,550 family
$3,000 single / $9,000 family
$3,300 single / 9,900 family
$7,400 single / 17,100 family

Blue Choice Preferred PPO Plans

Blue Choice Preferred 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 plans. If you can accept some reduced hospital and physician choice, Blue Choice Preferred PPO  plans 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.

There are 7 Blue Choice Preferred PPO Plans:

Bronze

There are 4 Blue Choice Preferred Bronze Plan Options:
BlueChoice Bronze® may be right for you if you are an individual or family who:

Compare the features, options and costs of Bronze® plans to find the one that’s right for you.

Silver

There are 2 Blue Choice Preferred Silver Plan Options:
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
  • Qualifies for a cost sharing reduction (CSR) on-exchange (Blue Choice Preferred Silver Plan 203 only)

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.

Gold

There is 1 Blue Choice Preferred Gold Plan Option:

Blue Precision Bronze HMO Plan

Our Rating:
The Blue Precision Bronze HMO Plan 205 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 205 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 205 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
  • $65 doctor visit copayment for primary care physicians (PCPs)
  • $105 office visit copayment for specialists
  • $105 urgent care copayment
  • Maternity Coverage
  • Well-adult care
  • Well-child care
  • Diagnostic testing – $150 copay X-rays & Imaging
  • $300 copay – Outpatient Imaging (CT/PET Scans/MRIs)
  • Optional dental coverage
Bronze® HMO 205 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
$7,400 single / $17,100 family

BlueCare Direct with Advocate HMO Plans

Blue Care Direct HMO

Our Rating:
The Chicago-area residents now have a new choice for health care coverage. Blue Cross and Blue Shield of Illinois (BCBSIL) has teamed up with Advocate Health Care* to offer a new, more affordable health plan — BlueCare Direct.

There are 3 BCBSIL BlueCare Direct Plan Options:
HMO Network

BlueCare Direct combines the strength, expertise and reputation of two of the state’s most respected leaders in the health industry. Advocate is the largest health system in Illinois, and BCBSIL is the largest health insurer in the state. Advocate is uniquely positioned to deliver quality patient outcomes, while working to manage overall health care costs, with the goal of delivering value to our members.

BlueCare Direct ® Plan 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
  • Lower monthly premiums and lower out-of-pocket costs than most other HMO plans available to individual plan members
  • Access to Advocate’s network of over 250 sites of care, including:
    • 4,000+ Advocate doctors
    • 11 Advocate community hospitals
    • The state’s largest integrated children’s network
    • The state’s largest home health and hospice companies
    • One of the region’s largest medical groups
  • $65 urgent care copayment
  • Maternity Coverage
  • Well-adult care
  • Well-child care
  • Diagnostic testing
  • Hospital services
  • Optional dental coverage
BlueCare Direct 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 or lives near an Advocate hospital (Cook, Dupage, Kane, Lake, and Will Counties
  • Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
  • Requires regular prescription medication

  • Overview
  • BlueCare Direct Gold 409 – $750 individual / $2,250 family deductible and 30% coinsurance
  • BlueCare Direct Silver 212 – $3,200 individual / $9,600 family deductible and 50% coinsurance
  • BlueCare Direct Bronze 401 – $7,400 individual / $17,100 deductible and 50% coinsurance
BlueCare Direct Deductibles
$750 single / $2,250 family
$3,200 single / $9,600 family
$7,400 single / $17,100 family

Blue FocusCare Plans

Our Rating:
Blue FocusCare is a new HMO plan offered in Cook County starting in 2017. It includes a narrower HMO network and reduced costs compared to the Blue Precision HMO and BlueCare Direct HMO plans.
Blue FocusCare Plans are good for individuals that don’t mind limited networks. If you do not make frequent hospital visits and only need to have your basic needs covered this may be the cost efficient choice for you. If you can accept some reduced hospital and physician choice, Blue FocusCare may be a great option for you. All Blue FocusCare plans offer the same set of essential health benefits, quality and amount of care..

There are 3 BCBSIL BlueCare Direct Plan Options:
  • Blue FocusCare Gold 211 – $750 individual deductible and 30% coinsurance
  • Blue FocusCare Silver 210 – $4,150 individual deductible and 30% coinsurance
  • Blue FocusCare Bronze 209 – $7,400 individual deductible and 50% coinsurance
HMO Network

The new Blue FocusCare Network is a narrow network plan designed around several physician organizations in Cook County. The plan designs are identical to the Blue Precision HMO plans. The only difference is a small subset of hospitals are available compared to the Blue Precision HMO plan.

Blue FocusCare Plan 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
  • Lower monthly premiums and lower out-of-pocket costs than most other HMO plans available to individual plan members
  • $50 urgent care copayment
  • Maternity Coverage
  • Well-adult care
  • Well-child care
  • Diagnostic testing
  • Hospital services
  • Optional dental coverage
Blue FocusCare 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
  • Lives in Cook County and want an affordable plan
  • Are flexible with their doctor or hospital preferences
  • Generally in good health and don’t take several brand name prescriptions

  • Overview
  • Blue FocusCare Gold 211 – $750 individual deductible and 30% coinsurance
  • Blue FocusCare Silver 210 – $4,150 individual deductible and 30% coinsurance
  • Blue FocusCare Bronze 209 – $7,400 individual deductible and 50% coinsurance
Blue FocusCare Deductibles
$750 single / $2,250 family
$4,150 single / $12,450 family
$7,400 single / $17,000 family

SelectTemp PPO (short-term medical)

SelectTemp PPO plans are not available at this time – United HealthOne short term plans are an available alternative.

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 (6 month limitation in IL)
  • 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

2017 Discontinued Plans

BlueChoice Preferred Gold Plan 101 was discontinued January 1, 2017

The BCBSIL 2017 individual health plan options include HMO Plans, Health Savings Accounts, and PPO 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:
  • $2,600 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:
  • $7,100 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.

Blue Precision HMO Deductibles
$1,750 single / $5,250 family
$2,600 single / $6,000 family
$7,100 single / $13,700 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
$3,000 single / $9,000 family
$3,250 single / $9,700 family
$3,500 single / $10,500 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
$5,000 single / $13,500 family
$6,000 single / $13,100 family
$6,750 single / $13,700 family

Blue Precision Bronze HMO Plan

Our Rating:
The Blue Precision Bronze HMO Plan 205 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 205 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 205 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 205 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
$6,000 single / $14,700 family

BlueCare Direct with Advocate HMO Plans

Blue Care Direct HMO

Our Rating:
The Chicago-area residents now have a new choice for health care coverage. Blue Cross and Blue Shield of Illinois (BCBSIL) has teamed up with Advocate Health Care* to offer a new, more affordable health plan — BlueCare Direct.

There are 4 BCBSIL BlueCare Direct Plan Options:
HMO Network

BlueCare Direct combines the strength, expertise and reputation of two of the state’s most respected leaders in the health industry. Advocate is the largest health system in Illinois, and BCBSIL is the largest health insurer in the state. Advocate is uniquely positioned to deliver quality patient outcomes, while working to manage overall health care costs, with the goal of delivering value to our members.

BlueCare Direct ® Plan 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
  • Lower monthly premiums and lower out-of-pocket costs than most other HMO plans available to individual plan members
  • Access to Advocate’s network of over 250 sites of care, including:
    • 4,000+ Advocate doctors
    • 11 Advocate community hospitals
    • The state’s largest integrated children’s network
    • The state’s largest home health and hospice companies
    • One of the region’s largest medical groups
  • $50 urgent care copayment
  • Maternity Coverage
  • Well-adult care
  • Well-child care
  • Diagnostic testing
  • Hospital services
  • Optional dental coverage
BlueCare Direct 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 or lives near an Advocate hospital
  • Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
  • Requires regular prescription medication

BlueCare Direct Deductibles
$1,750 single / $5,250 family
$2,600 single / $7,800 family
$5,500 single / $14,300 family
$7,100 single / $14,300 family

Blue FocusCare Plans

Our Rating:
Blue FocusCare is an HMO plan offered in Cook County only. It includes a narrower HMO network and reduced costs compared to the Blue Precision HMO and BlueCare Direct HMO plans.
Blue FocusCare Plans are good for individuals that don’t mind limited networks. If you do not make frequent hospital visits and only need to have your basic needs covered this may be the cost efficient choice for you. If you can accept some reduced hospital and physician choice, Blue FocusCare may be a great option for you. All Blue FocusCare plans offer the same set of essential health benefits, quality and amount of care..

There are 4 BCBSIL Blue FocusCare Plan Options:
HMO Network

The new Blue FocusCare Network is a narrow network plan designed around several physician organizations in Cook County. The plan designs are identical to the Blue Precision HMO plans. The only difference is a small subset of hospitals are available compared to the Blue Precision HMO plan.

Blue FocusCare Plan 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
  • Lower monthly premiums and lower out-of-pocket costs than most other HMO plans available to individual plan members
  • $50 urgent care copayment
  • Maternity Coverage
  • Well-adult care
  • Well-child care
  • Diagnostic testing
  • Hospital services
  • Optional dental coverage
Blue FocusCare 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
  • Lives in Cook County and want an affordable plan
  • Are flexible with their doctor or hospital preferences
  • Generally in good health and don’t take several brand name prescriptions

BlueCare Direct Deductibles
$1,750 single / $5,250 family
$2,600 single / $6,000 family
$5,500 single / $14,300 family
$7,100 single / $14,300 family

2016 Plans (Discontinued)

BlueChoice Preferred Gold Plan 101 was discontinued January 1, 2017

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

2015 Plans (Discontinued)

Blue PPO Gold Plans

Blue PPO Gold Plans were 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 PPO Silver Plans

Blue PPO Silver Plans were 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 PPO Bronze Plans 

Blue PPO Bronze Plans were 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