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Blue Precision Silver HMO Plan

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2026 Blue Precision Silver HMO Plans

Our Rating: Blue Precision Silver 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. 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.

There are 4 Silver HMO plans:

Compare the features, options and costs of Silver 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

206 306 704 Silver HMO Standard – Select Rx Copays
Overall Deductible Individual/Family $3,000/ $6,000 $6,000 / $12,000 $7,000 / $14,000 $6,000 / $12,000
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** $10,600/ $21,200 $10,150/ $20,300 $8,200/ $16,400 $8,900 / $17,800
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 Silver HMO Standard – Select Rx Copays
Primary Care for injury/illness $35/visit $15/visit $65/visit $40/visit
Specialist visit $90/visit $40/visit $90/visit $80/visit
Preventative care/screening No Charge No Charge No Charge No Charge
Diagnostic test (xray, blood) $40/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 Silver HMO Standard – Select Rx Copays
Generic Drugs (Preferred) No Charge $10 / $30 $5/$15 $20 / $60
Generic Drugs (Non Preferred) 10% $20 / $60 $15 / $45 $20 / $60
Brand drugs (Preferred) 20% 30% 35% $40 / $120
Brand Drugs Non Preferred 30% 40% 40% $80 / $240
Specialty Drugs Preferred 40% 45% 45% $350
Specialty Drugs Non Preferred 50% 50% 50% $350

Outpatient Surgery / Emergency Comparison

206 306 704 Silver HMO Standard – Select Rx Copays
Facility Fee Freestanding 50% $600/visit + 50% $350/visit + 50% 40%
Facility fee Hospital NA NA NA NA
Physician/surgeon Fee $40/visit $200/visit $90/visit 40%
Emergency Room Care 50% 50% 50% 40%
Emergency Medical Transportation 50% 50% 50% 40%
Urgent Care $90/visit $40/visit $90/visit $60/visit

 

Hospital Stay / Health Services / Pregnancy

206 306 704 Silver HMO Standard – Select Rx Copays
Facility Fee for hospital stay 50% 50% 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 $65 office, 50% other $40 office, 40% other
Mental health, behavioral health, or substance abuse services: Inpatient 50% 50% 50% 40%
If you are pregnant – office visit Primary: $35 / Specialist: $90 Primary: $15 / Specialist: $40 Primary: $65 / Specialist: $90 Primary: $40 / Specialist: $80
Childbirth/delivery/professional services No Charge No Charge No Charge No Charge
Childbirth/delivery facility services 50% 50% 50% 40%

 

Help recovering / other special needs

206 306 704 Silver HMO Standard – Select Rx Copays
Home Health Care No Charge No Charge No Charge No Charge
Rehabilitation Services $35/visit $15/visit $65/visit $40/visit
Habilitation services $35/visit $15/visit $65/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 Silver HMO Standard – Select Rx Copays
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.)

Not Covered 206 306 704 Silver HMO Standard – Select Rx Copays
Acupuncture Not Covered Not Covered Not Covered Not Covered
Dental Care (Adult) Not Covered Not Covered Not Covered Not Covered
Long-term Care Not Covered Not Covered Not Covered Not Covered
Non-emergency care when traveling outside of US Not Covered Not Covered Not Covered Not Covered
Weight loss programs Not Covered Not Covered Not Covered Not Covered

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

206 306 704 Silver HMO Standard – Select Rx Copays
Abortion care Covered Covered Covered Covered
Bariatric surgery Covered Covered Covered Covered
Chiropractic care Covered (25 visits per calendar year) Covered (25 visits per calendar year) Covered (25 visits per calendar year) Covered (25 visits per calendar year)
Cosmetic surgery Covered when medically necessary Covered when medically necessary Covered when medically necessary Covered when medically necessary
Hearing aids Covered (1 per ear every 24 months) Covered (1 per ear every 24 months) Covered (1 per ear every 24 months) Covered (1 per ear every 24 months)
Infertility treatment Covered (4 procedures per benefit period) Covered (4 procedures per benefit period) Covered (4 procedures per benefit period) Covered (4 procedures per benefit period)
Private-duty nursing Covered, except inpatient private-duty nursing Covered, except inpatient private-duty nursing Covered, except inpatient private-duty nursing Covered, except inpatient private-duty nursing
Routine eye care Covered (1 visit per benefit period) Covered (1 visit per benefit period) Covered (1 visit per benefit period) Covered (1 visit per benefit period)
Routine Foot Care Covered when medically necessary Covered when medically necessary Covered when medically necessary Covered when medically necessary

 

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