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Blue Precision – Bronze HMO Plans – 2024
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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. Bronze plans may be for you if you have fewer medical needs, would rather have a low monthly payment, and don’t take prescription drugs regularly.
Below is a summary of the five Blue Choice Preferred Bronze Plan Options. Please visit the tabs above to see plan information in detail.
There are 3 Bronze HMO plans:
- Blue Precision Bronze HMO 205 – $7,400 individual deductible and 50% coinsurance
- Blue Precision Bronze HMO 701 Rx Copays – $0 individual deductible and 50% coinsurance
- Blue Precision Bronze HMO 708 – $7,500 individual deductible and 50% coinsurance
Learn more about valuable member services and features you get when you join the Blue Cross and Blue Shield of Illinois family.
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Deductibles
205 | 701 Rx Copays | 708 | |
Overall Deductible Individual/Family | $7,400 / $14,800 | $0 | $7,500 / $15,000 |
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** | $9,450 / $18,900 | $9,450 / $18,900 | $9,400 / $18,800 |
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
205 | 701 Rx Copays | 708 | |
Primary Care for injury/illness | $65/visit | $150/visit | $50/visit |
Specialist visit | $105/visit | $160/visit | $100/visit |
Preventative care/screening | No Charge | No Charge | No Charge |
Diagnostic test (xray, blood) | $100/lab, $150/xray | $250/test | 50% |
Imaging (CT/PET/MRI) | $300/test | $450/test | 50% |
**Premiums, balance billing & health care this plan doesn’t cover are not included in the out-of-pocket limit
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
205 | 701 Rx Copays | 708 | |
Generic Drugs (Preferred) | 10% | $100 / $300 | $25 / $75 |
Generic Drugs (Non Preferred) | 15% | $110 / $330 | $25 / $75 |
Brand drugs (Preferred) | 20% | $120 / $360 | $50 / $150 |
Brand Drugs Non Preferred | 30% | $175 / $525 | $100 / $300 |
Specialty Drugs Preferred | 40% | $275 | $500 |
Specialty Drugs Non Preferred | 50% | $500 | $500 |
Outpatient Surgery / Emergency Comparison
205 | 701 Rx Copays | 708 | |
Facility Fee Freestanding | $300/visit + 50% | $750/visit + 50% | 50% |
Facility fee Hospital | NA | NA | N/A |
Physician/surgeon Fee | $150/visit | $400/visit | 50% |
Emergency Room Care | $1,000/visit + 50% | $2,000/visit + 50% | 50% |
Emergency Medical Transportation | 50% | 50% | 50% |
Urgent Care | $105/visit | $160/visit | $75/visit |
Hospital Stay / Health Services / Pregnancy
205 | 701 Rx Copays | 708 | |
Facility Fee for hospital stay | $850/day | $1,500/day + 50% | 50% |
Physician/surgeon Fees | No Charge | No Charge | No Charge |
Mental health, behavioral health, or substance abuse services: Outpatient | $65 office, 50% other | $150 office, 50% other | $50 office, 50% other |
Mental health, behavioral health, or substance abuse services: Inpatient | $850/day | $1,500/day + 50% | 50% |
If you are pregnant – office visit | Primary: $65 / Specialist: $105 | Primary: $150 / Specialist: $160 | Primary: $50 / Specialist: $100 |
Childbirth/delivery/professional services | No Charge | No Charge | No Charge |
Childbirth/delivery facility services | $850/day | $1,500/day + 50% | 50% |
Help recovering / other special needs
205 | 701 Rx Copays | 708 | |
Home Health Care | No Charge | No Charge | No Charge |
Rehabilitation Services | $65/visit | $150/visit | $50/visit |
Habilitation services | $65/visit | $150/visit | $50/visit |
Skilled nursing care | $500/day | $800/day | 50% |
Durable medical equipment | No Charge | No Charge | No Charge |
Hospice services | 50% | 50% | 50% |
Childrens Dental / Eye care
205 | 701 Rx Copays | 708 | |
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.)
205 | 701 Rx Copays | 708 | |
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.)
205 | 701 Rx Copays | 708 | |
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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