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Blue PPO Silver Plan 003
Our Rating: 
| Benefit Highlight | Blue PPO Silver 003 |
|---|---|
| Plan Features | |
| Lifetime Maximum | Unlimited |
| Participating providers | PPO Network 90% of IL doctors; over 200 IL hospitals |
| Individual Deductible | $6,000 |
| Family Deductible | $12,700 |
| Coinsurance | 100% |
| Out of Pocket Maximum Includes deductible | $6,000 |
| Family Out of Pocket Maximum Includes deductible | $12,700 |
| Office Visit Copay (Primary Care/Specialist) | $30 / $50 specialist |
| Medical Coverage Details | |
| Inpatient Hospital Medical / Surgical Services Hospital Services and Hospital Diagnostic Testing | $250 copay then 100% after deductible |
| Outpatient Surgery | $200 copay then 100% after deductible |
| Emergency Room / Outpatient Emergency Care Physician and Hospital | $500 copay then 100% after deductible |
| Outpatient Hospital Diagnostic Testing | 100% after deductible |
| Mental Illness & Substance Abuse Rehab (Outpatient Hospital/ Physician Care) | $30 copay |
| Mental Illness & Substance Abuse Treatment (Inpatient Hospital Care) | $250 copay then 100% coinsurance after deductible |
| Mental Illness & Substance Abuse Treatment (Inpatient Physician Care) | 100% after deductible |
| Preventive Care | Covered at 100%, no copay |
| Maternity Coverage | $250 copay then 100% after deductible |
| Prescription Drugs | |
| Preferred Generics | $0 copay |
| Non Preferred Generics | $10 copay |
| Preferred Formulary | $50 copay |
| Non-Preferred Formulary | $100 copay |
| Specialty | $150 copay |
| Prescription Drug Formulary | Standard |
| Cost Reductions | |
| Tax Credit Eligible | Yes |
| Cost Sharing Eligible | No |
| HSA Eligibile | No |
Outline of Coverage  | |
Blue PPO Silver Plan 004
Our Rating:
| Benefit Highlight | Blue PPO Silver 004 |
|---|---|
| Plan Features | |
| Lifetime Maximum | Unlimited |
| Participating providers | PPO Network 90% of IL doctors; over 200 IL hospitals |
| Individual Deductible | $3,000 |
| Family Deductible | $9,000 |
| Coinsurance | 80% |
| Out of Pocket Maximum Includes deductible | $6,350 |
| Family Out of Pocket Maximum Includes deductible | $12,700 |
| Office Visit Copay (Primary Care/Specialist) | $30 / $50 specialist |
| Medical Coverage Details | |
| Outpatient Surgery | $200 copay then 80% after deductible |
| Inpatient Hospital Medical / Surgical Services Hospital Services and Hospital Diagnostic Testing | $250 copay then 80% after deductible |
| Emergency Room / Outpatient Emergency Care Physician and Hospital | $500 copay then 80% after deductible |
| Outpatient Hospital Diagnostic Testing | 80% after deductible |
| Mental Illness & Substance Abuse Rehab (Outpatient Hospital/ Physcian Care) | $30 copay |
| Mental Illness & Substance Abuse Treatment (Inpatient Hospital Care) | $250 copay then 80% coinsurance after deductible |
| Mental Illness & Substance Abuse Treatment (Inpatient Physician Care) | 80% coinsurance after deductible |
| Preventive Care | Covered at 100%, no copay |
| Maternity Coverage | $200 copay then 80% after deductible |
| Prescription Drugs | |
| Preferred Generics | $0 copay |
| Non Preferred Generics | $10 copay |
| Preferred Formulary | $50 copay |
| Non-Preferred Formulary | $100 copay |
| Specialty | $150 copay |
| Prescription Drug Formulary | Standard |
| Cost Reductions | |
| Tax Credit Eligible | Yes |
| Cost Sharing Eligible | No |
| HSA Eligibile | No |
| Outline of Coverage | |