Blue Precision Gold HMO Plan

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2025 Blue Precision Gold HMO Plans

Our Rating: Blue Precision Gold HMO Plan

The plans below 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. Gold plans may be for you if you have more health care needs than most, require regular prescription medication, have a spouse/children on your plan or want to grow your family soon, or prefer to pay more each month but have lower out-of-pocket expenses.

There are 3 Gold HMO plans:

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

Blue Precision Gold 207  Blue Precision Gold 703 Blue Precision Gold Standard – Rx Copays
Overall Deductible Individual/Family $750 / $1,500 $1,600 / $3,200 $2,000/ $4,000
Are there services covered before you meet deductible Yes. Yes. Yes.
Are there other deductibles for specific services No. No. No.
Out-of-pocket limit Individual/Family** $10,150/ $20,300 $10,600/ $21,200 $8,200/ $16,400
Will you pay less if you use network provider? Yes. Yes. Yes.
Referral to see a specialist? Yes Yes. Yes.

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

Office Visit / Testing

Blue Precision Gold 207  Blue Precision Gold 703 Blue Precision Gold Standard – Rx Copays
Primary Care for injury/illness $20/visit $15/visit $30/visit
Specialist visit $40/visit $60/visit $60/visit
Preventative care/screening No Charge No Charge No Charge
Diagnostic test (xray, blood) $40/test $30/test 25%
Imaging (CT/PET/MRI) $250/test $250/test 25%

 

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

Blue Precision Gold 207  Blue Precision Gold 703 Blue Precision Gold Standard – Rx Copays
Generic Drugs (Preferred) 10% No Charge $15 / $45
Generic Drugs (Non Preferred) 15% $20 / $60 $15 / $45
Brand drugs (Preferred) 20% 20% $30 / $90
Brand Drugs Non Preferred 30% 30% $60 / $180
Specialty Drugs Preferred 40% 40% $250
Specialty Drugs Non Preferred 50% 50% $250

Outpatient Surgery / Emergency Comparison

Blue Precision Gold 207  Blue Precision Gold 703 Blue Precision Gold Standard – Rx Copays
Facility Fee Freestanding $300/visit + 30% $300/visit + 30% 25%
Facility fee Hospital NA NA NA
Physician/surgeon Fee $40/visit $30/visit 25%
Emergency Room Care 30% 30% 25%
Emergency Medical Transportation 30% 30% 25%
Urgent Care $40/visit $60/visit $45/visit

 

Hospital Stay / Health Services / Pregnancy

Blue Precision Gold 207  Blue Precision Gold 703 Blue Precision Gold Standard – Rx Copays
Facility Fee for hospital stay 30% 30% 25%
Physician/surgeon Fees No Charge No Charge No Charge
Mental health, behavioral health, or substance abuse services: Outpatient $20 office / 30% other $15 office / 30% other $30 office / 25% other
Mental health, behavioral health, or substance abuse services: Inpatient 30% 30% 25%
If you are pregnant – office visit Primary: $20 / Specialist: $40 Primary: $15 / Specialist: $60 Primary: $30 / Specialist: $60
Childbirth/delivery/professional services No Charge No Charge No Charge
Childbirth/delivery facility services 30% 30% 25%

 

Help recovering / other special needs

Blue Precision Gold 207  Blue Precision Gold 703 Blue Precision Gold Standard – Rx Copays
Home Health Care No Charge No Charge No Charge
Rehabilitation Services $20/visit $15/visit $30/visit
Habilitation services $20/visit $15/visit $30/visit
Skilled nursing care $500/day $500/day 25%
Durable medical equipment No Charge No Charge No Charge
Hospice services 30% 30% 25%

Childrens Dental / Eye care

 

Blue Precision Gold 207  Blue Precision Gold 703 Blue Precision Gold Standard – Rx Copays
Children’s eye exam No Charge No Charge No Charge
Children’s Glasses No Charge No Charge No Charge
Children’s Dental check-up 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.)

Blue Precision Gold 207  Blue Precision Gold 703 Blue Precision Gold Standard – Rx Copays
Acupuncture  ✓  ✓  ✓
Dental Care (Adult)  ✓  ✓  ✓
Long-term Care  ✓  ✓  ✓
Non-emergency care when traveling outside of US  ✓  ✓  ✓
Weight loss programs  ✓  ✓  ✓

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

Blue Precision Gold 207  Blue Precision Gold 703 Blue Precision Gold Standard – Rx Copays
Abortion care  ✓  ✓  ✓
Bariatric surgery  ✓  ✓  ✓
Chiropractic care  ✓  ✓  ✓
Cosmetic surgery  ✓  ✓  ✓
Hearing aids  ✓  ✓  ✓
Infertility treatment  ✓  ✓  ✓
Private-duty nursing  ✓  ✓  ✓
Routine eye care  ✓  ✓  ✓
Routine Foot Care  ✓  ✓  ✓

 

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