Blue Precision – Silver HMO Plans – 2024
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. Silver plans may be for you if you want to pay less out-of-pocket for care, qualify for a premium tax credit (also known as a subsidy), have a spouse/children on your health plan, or have regular medical needs.
Below is a summary of the five Blue Precision Silver Plan Options. Please visit the tabs above to see plan information in detail.
There are 4 Silver HMO plans:
- Blue Precision Silver HMO 206– $2,250 individual deductible and 50% coinsurance, $35 PCP copays
- Blue Precision Silver HMO 306 – $6,000 individual deductible and 50% coinsurance, $15 PCP copays
- Blue Precision Silver HMO 704 Rx Copays – $7,500 individual deductible and 50% coinsurance, $100 PCP copays
- Blue Precision Silver HMO 706 – $5,900 individual deductible and 40% coinsurance, $40 PCP copays
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
| 206 | 306 | 704 Rx Copays | 706 | |
| Overall Deductible Individual/Family | $4,400 / $8,800 | $6,000 / $12,00 | $7,500 / $15,000 | $5,900 / $11,800 |
| 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** | $9,450 / $18,900 | $9,450 / $18,900 | $9,450 / $18,900 | $9,100 / $18,200 |
| Will you pay less if you use network provider? | Yes. | Yes. | Yes. | Yes. |
| Referral to see a specialist? | Yes. | 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
| 206 | 306 | 704 Rx Copays | 706 | |
| Primary Care for injury/illness | $35/visit | $15/visit | $100/visit | $40/visit |
| Specialist visit | $65/visit | $40/visit | $130/visit | $80/visit |
| Preventative care/screening | No Charge | No Charge | No Charge | No Charge |
| Diagnostic test (xray, blood) | $20/test | $35/test | $90/test | 40% |
| Imaging (CT/PET/MRI) | $350/test | $250/test | $250/test | 40% |
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
| 206 | 306 | 704 Rx Copays | 706 | |
| Generic Drugs (Preferred) | No Charge | $10 / $30 | $25 / $75 | $20 / $60 |
| Generic Drugs (Non Preferred) | 10% | $20 / $60 | $70 / $210 | $20 / $60 |
| Brand drugs (Preferred) | 20% | 30% | $85 / $255 | $40 / $120 |
| Brand Drugs Non Preferred | 30% | 40% | $120 / $360 | $80 / $240 |
| Specialty Drugs Preferred | 40% | 45% | $250 | $350 |
| Specialty Drugs Non Preferred | 50% | 50% | $500 | $350 |
Outpatient Surgery / Emergency Comparison
| 206 | 306 | 704 Rx Copays | 706 | |
| Facility Fee Freestanding | 50% | $600/visit + 50% | $350/visit + 50% | 40% |
| Facility fee Hospital | NA | NA | NA | NA |
| Physician/surgeon Fee | $35/visit | $200/visit | $90/visit | 40% |
| Emergency Room Care | $1,000/visit + 50% | $1,000/visit + 50% | $1,200/visit + 50% | 40% |
| Emergency Medical Transportation | 50% | 50% | 50% | 40% |
| Urgent Care | $65/visit | $40/visit | $130/visit | $60/visit |
Hospital Stay / Health Services / Pregnancy
| 206 | 306 | 704 Rx Copays | 706 | |
| Facility Fee for hospital stay | $500/visit + 50% | $850/visit + 50% | $500/visit + 50% | 40% |
| Physician/surgeon Fees | No Charge | No Charge | No Charge | No Charge |
| Mental health, behavioral health, or substance abuse services: Outpatient | $35 office, 50% other | $15 office, 30% other | $100 office, 50% other | $40 office, 40% other |
| Mental health, behavioral health, or substance abuse services: Inpatient | $500/visit + 50% | $850/visit + 50% | $500/visit + 50% | 40% |
| If you are pregnant – office visit | Primary: $35 / Specialist: $65 | Primary: $15 / Specialist: $40 | Primary: $100 / Specialist: $130 | Primary: $40 / Specialist: $80 |
| Childbirth/delivery/professional services | No Charge | No Charge | No Charge | No Charge |
| Childbirth/delivery facility services | $500/visit + 50% | $850/visit + 50% | $500/visit + 50% | 40% |
Help recovering / other special needs
| 206 | 306 | 704 Rx Copays | 706 | |
| Home Health Care | No Charge | No Charge | No Charge | No Charge |
| Rehabilitation Services | $35/visit | $15/visit | $100/visit | $40/visit |
| Habilitation services | $35/visit | $15/visit | $100/visit | $40/visit |
| Skilled nursing care | 50% | 50% | 50% | 40% |
| Durable medical equipment | No Charge | No Charge | No Charge | No Charge |
| Hospice services | 50% | 50% | 50% | 40% |
Childrens Dental / Eye care
| 206 | 306 | 704 Rx Copays | 706 | |
| 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.)
| 206 | 306 | 704 Rx Copays | 706 | |
| 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.)
| 206 | 306 | 704 Rx Copays | 706 | |
| 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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