- Preventive Services List
- No-Cost Preventive Drug List – included on all BCBSIL ACA plans
- 2025 6-Tier formulary (all plans)
*BCBSIL Launches NEW Plan Network in 2025*
MyBlue Plus, launching 1/1/2025, will be the new low-cost option for members in the metro Chicago area replacing Blue FocusCare HMO.
New BCBSIL Plans Effective 2025 (Other than MyBlue Plus)
| Plan Name | Deductible | Max Out-of-Pocket |
| Blue Choice Preferred Gold PPO 901 | $1,000 | $9,200 |
*Discontinued BCBSIL Plans*
| Discontinued Plan Name | Deductible | Max Out-of-Pocket |
| Blue Choice Preferred Bronze PPO 601 | $7,500 | $9,450 |
| Blue FocusCare Bronze 209 (Replaced by MyBlue Plus) | $7,400 | $9,450 |
| Blue FocusCare Silver 210 (Replaced by MyBlue Plus) | $2,500 | $9,450 |
| Blue FocusCare Gold 211 (Replaced by MyBlue Plus) | $750 | $9,450 |
| BlueCare Direct Bronze 410 with Advocate Rx Copays | $0 | $9,450 |
| BlueCare Direct Silver 212 with Advocate Rx Copays | $7,500 | $9,450 |
| BlueCare Direct Gold 409 with Advocate Rx Copays | $2,000 | $9,450 |
*Renamed BCBSIL Plans: These plans are still active, but have a new name for 2025.
| Renamed Plans | Plan name in 2025 |
| Blue Choice Preferred Bronze PPO 708 | Blue Choice Preferred Bronze PPO℠ Standard – Select Rx |
| Blue Choice Preferred Silver PPO 706 | Blue Choice Preferred Silver PPO℠ Standard – Select Rx |
| Blue Choice Preferred Gold PPO 707 | Blue Choice Preferred Gold PPO℠ Standard – Rx Copays |
| Blue Precision Bronze HMO 708 | Blue Precision Bronze HMO℠ Standard – Select Rx Copays |
| Blue Precision Silver HMO 706 | Blue Precision Silver HMO℠ Standard – Select Rx Copays |
| Blue Precision Gold HMO 707 | Blue Precision Gold HMO℠ Standard – Rx Copays |
Individual Health Insurance Plans
Blue Cross Blue Shield of Illinois is offering 4 different individual plan networks for plans effective January 1st, 2024: Blue Choice Preferred PPO network, Blue Precision HMO network, BlueCare Direct w/ Advocate, or Blue FocusCare plans.
What is the difference between PPO and HMO?
PPO, or Preferred Provider Organization, plans usually carry a higher monthly premium while having access to a larger network of doctors and hospitals to choose from.
HMO, or Health Maintenance Organization, plans usually have lower monthly premiums than PPO’s and may help keep your costs lower and more predictable. A Primary Care Physician (PCP) will coordinate your health care.
Individual / Family Plans
Group / Medicare / Dental
Additional Resources
Why Choose BlueCross BlueShield of Illinois?
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
Hospital Network Guide
Key Hospitals accepting the Blue Choice Preferred PPO Plans in 2025:
- Amita Health Hospitals
- Edwards Memorial
- Alexian Brothers
- Loyola Hospital Systems
- Elmhurst Memorial
- Galesburg Cottage Hospital
- Northwestern Hospital Systems
- Northshore Hospital
- Swedish Covenant Hospital
- OSF Hospital System
- Presence Hospital Systems
- University of Illinois Chicago
- Rush University Hospital
- St. Francis Medical Center
- St. Mary Medical Center (OSF Hospital Systems)
- UnityPoint Health Methodist
Key Hospitals NOT accepting the Blue Choice Preferred PPO Plans in 2025:
- Northshore Hospital Systems (accepting BluePrecision HMO Plans, Ambetter, United Healthcare, Aetna marketplace plans only)
- University of Chicago – accepted by Aetna Health PPO plans and MyBlue Plus POS
Effective Jan. 1, 2020: Methodist First Choice #457 will participate in the Blue Precision HMO 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.
for members impacted by this change.Hospital Network Guide
| BCBSIL Plan Network | ||||
| Network Name | Blue Preferred PPO | Blue Precision HMO | BlueCare Direct Advocate | Blue Focus |
| Network Hospital Lists | Hospital List | Hospital List | Hospital List | Hospital List |
| Northwestern | ✓ | ✓ | X | X |
| Loyola | ✓ | ✓ | X | X |
| Rush | ✓ | X | X | X |
| Advocate | ✓ | ✓ | ✓ | X |
| Northshore | ✓ | ✓ | X | X |
| Presence Hospitals | ✓ | ✓ | X | X |
| U of C | X | ✓** | X | X |
| UIC | ✓ | ✓ | X | X |
| Edward/Elmhurst | ✓ | ✓ | X | X |
**Specialty care only with referral; No primary care
The BCBSIL 2024 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: 2 Bronze, 2 Silver, 2 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: 3 Bronze, 4 Silver, 3 Gold
- Network: Blue Precision HMO SM (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, 4 Silver, 2 Gold
- Network: Blue Choice Preferred PPO (BCE)
- Approximately 176 hospitals, 73,027 providers*
- New Silver plan –
- Blue Choice Preferred Silver PPO 801 – Rx Copays
- 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
Discontinued Plans
SelectTemp PPO plans are not available at this time – United HealthOne short term plans are an available alternative.
BlueChoice Preferred Gold Plan 101 (Discontinued January 1, 2017)
Blue PPO Gold Plans (Discontinued January 1, 2016)