Blue Choice Preferred Bronze PPO

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Blue Choice Preferred PPO Bronze Plans

Our Rating: Blue Choice Preferred Bronze PPO

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 and the largest PPO network BCBSIL offers to individual health plans. If you can accept some reduced hospital and physician choice, a Blue Choice Preferred Bronze PPO plan may be a great option for you.

All Blue Choice Bronze plans offer the same set of essential health benefits, quality and amount of care. If you’re not planning on needing much care, Bronze level plan premiums could offer your most affordable health care option. You can expect BCBSIL to cover roughly 60% of health care bills while you cover 40%. The Blue PPO Bronze Plans use the Blue Choice Preferred PPO network, a PPO network that includes over half of doctors and hospitals in Illinois.

Below is a summary of the four Blue Choice Preferred Bronze Plan Options. See toggles below for each plan detail or download the available plan summaries.

    Compare the features, options and costs of Bronze® 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.

    See toggles below for plan comparisons. Information is based on Participating Providers. For Non-Participating Provider information, please download the plan summaries listed above. 

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    Deductibles

    201 202 701 Standard – Select Rx
    Overall Deductible Individual/Family $7,000/ $14,000 $4,500 / $9,000 $8,600 / $17,200 $7,500 / $15,000
    Are there services covered before you meet deductible Yes. Yes. Yes. Yes.
    Are there other deductibles for specific services No. No. No. No.
    Out-of-pocket limit Individual/Family** $10,150 / $20,300 $8,300 / $16,600 $10,600 / $21,200 $10,000 / $20,000
    Will you pay less if you use network provider? Yes. Yes. Yes. Yes.
    Referral to see a specialist? No. No. No. No.

    **Premiums, balance billing & health care this plan doesn’t cover are not included in the out-of-pocket limit

    Office Visit / Testing

    201 202 701 Standard – Select Rx
    Primary Care for injury/illness $45/visit 40% 50% $50/visit
    Specialist visit 50% 40% 50% $100/visit
    Preventative care/screening No Charge No Charge No Charge No Charge
    Diagnostic test (xray, blood) Freestanding / Hospital 40% / 50% 30% / 50% 40% / 50% 50%
    Imaging (CT/PET/MRI) Freestanding / Hospital 40% / 50% 30% / 50% 40% / 50% 50%

     

    Generic / Brand / Specialty Drug Comparison

    If you need Drugs to treat your illness or condition. For information on whether or not deductibles apply, please download the plan summaries

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    201 202 701 Standard – Select Rx
    Generic Drugs (Preferred) $10/$20/$30 20% / 25% $25 / $35 / $75 $25 / $75
    Generic Drugs (Non Preferred) $20/$30/$60 25% / 30% $175 / $525 NA
    Brand drugs (Preferred) 30% / 35% 30% / 35% 30% / 30% $50 / $150
    Brand Drugs Non Preferred 35% / 40% 35% / 40% 40% / 40% $100 / $300
    Specialty Drugs Preferred 45% 45% 45% $500
    Specialty Drugs Non Preferred 50% 50% 50% NA

    Outpatient Surgery / Emergency Comparison

    201 202 701 Standard – Select Rx
    Facility Fee Freestanding $600/visit + 40% $600/visit + 30% $600/visit +
    40%
    50% coinsurance
    Facility fee Hospital $600/visit + 40% $600/visit + 30% $600/visit + 40% NA
    Physician/surgeon Fee $200/visit + 50% $200/visit + 40% $200/visit + 50% 50% coinsurance
    Emergency Room Care 50% coinsurance 40% coinsurance 50% coinsurance 50% coinsurance
    Emergency Medical Transportation 50% coinsurance 40% coinsurance 50% coinsurance 50% coinsurance
    Urgent Care $60/visit 40% coinsurance 50% coinsurance $75/visit

     

    Hospital Stay / Health Services / Pregnancy

    201 202 701 Standard – Select Rx
    Facility Fee for hospital stay 50% coinsurance 50% coinsurance 50% coinsurance 50% coinsurance
    Physician/surgeon Fees 50% coinsurance 50% coinsurance 50% coinsurance 50% coinsurance
    Mental health, behavioral health, or substance abuse services: Outpatient 50% office / 40% other 40% for office visits / 30% other 50% for office visits / 40% other 50% for office visits / 50% other
    Mental health, behavioral health, or substance abuse services: Inpatient 50% coinsurance 40% coinsurance  50% coinsurance 50% coinsurance
    If you are pregnant – office visit Primary: $45 / Specialist: 50% 40% coinsurance 50% coinsurance Primary: $50 / Specialist: $100
    Childbirth/delivery/professional services 50% coinsurance 40% coinsurance 50% coinsurance 50% coinsurance
    Childbirth/delivery facility services 50% coinsurance 40% coinsurance 50% coinsurance 50% coinsurance

     

    Help recovering / other special needs

    201 202 701 Standard – Select Rx
    Home Health Care 50% 40% 50% 50%
    Rehabilitation Services 50% 40% 50% $50/visit
    Habilitation services 50% 40% 50% $50/visit
    Skilled nursing care 50% 40% 50% 50%
    Durable medical equipment 50% 40% 50% 50%
    Hospice services 50% 40% 50% 50%

    Childrens Dental / Eye care

     

    201 202 701 Standard – Select Rx
    Children’s eye exam No Charge No Charge No Charge No Charge
    Children’s Glasses No Charge No Charge No Charge No Charge
    Children’s Dental check-up Not Covered Not Covered Not Covered Not Covered

     

    Excluded & Other Covered Services

    Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.)

    201 202 701 Standard – Select Rx
    Acupuncture  ✓  ✓  ✓  ✓
    Dental Care (Adult)  ✓  ✓  ✓  ✓
    Long-term Care  ✓  ✓  ✓  ✓
    Non-emergency care when traveling outside of US  ✓  ✓  ✓  ✓
    Routine eye care (adult)  ✓  ✓  ✓
    Weight loss programs  ✓  ✓  ✓  ✓

    Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)

    201 202 701 Standard – Select Rx
    Abortion care  ✓  ✓  ✓  ✓
    Bariatric surgery  ✓  ✓  ✓  ✓
    Chiropractic care  ✓  ✓  ✓  ✓
    Cosmetic surgery  ✓  ✓  ✓  ✓
    Hearing aids  ✓  ✓  ✓  ✓
    Infertility treatment  ✓  ✓  ✓  ✓
    Private-duty nursing  ✓  ✓  ✓  ✓
    Routine Foot Care  ✓  ✓  ✓  ✓

     

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