NEW POS Overview: MyBlue Plus
Due to CMS limits on the number of products offered by insurance carriers, BCBSIL will be discontinuing BlueFocus Care HMO and will instead launch a new POS product offering, MyBlue Plus.
PCP & REFERRALS: PCP Election is necessary & Referrals are required
PRODUCT FEATURES: Well onTarget & Blue Points, 24/7 Nurseline, Learn to Live, MDLIVE (Urgent care, Behavioral Health, Virtual primary care, Dermatology), and Mental Health Hub
MyBlue Plus Will Replace Blue FocusCare HMO
| Blue FocusCare HMO | MyBlue Plus | |
| Service Area | Cook | Cook, DuPage, Kane, Kankakee, and Will |
| Potential Anchor Facilities | Ascension | Ascension – Endeavor Health – UChicago Medicine AdventHealth |
| Provider Assignment | Assigned at Medical Group Level | Assigned at individual provider level |
| Value Add Benefits | Well onTarget & Blue Points | Well onTarget & Blue Points – Bilingual 24/7 Nurseline – Learn to Live – MDLIVE – Mental Health Hub |
| Offers CMS Standard Plans | No | Yes |
| Out-of-Service Area Benefits | No, members are limited to in-network care except for emergency and urgent care and other services required by law. | Members can receive non-emergency / non-urgent care outside of the service area and contiguous border counties by receiving approved waiver. If members are approved for non-emergency / non-urgent care outside of the service and contiguous border counties, it will be at the in-network benefit level. |
MyBlue Plus - What We Know
MyBlue Plus Plan Summaries:
Bronze Plans
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 quick summary of available plans and what we know so far.
All MyBlue Plus Bronze plans have $9,200 Out of Pocket Max, and 50% General Coinsurance.
- MyBlue Plus Bronze 903 – $4,900 individual deductible
- MyBlue Plus Bronze 912 – $1,500 individual deductible
- MyBlue Plus Bronze Standard – Rx Copays – $7,500 individual deductible
| Plan Name | PCP Office / Virtual Visit | HDHP / HSA Compatible | Prescription Drugs (Preferred) |
| MyBlue Plus Bronze 903 | $45 / $45 | No / No | 0% / 10% / 20% / 35% / 45% / 50% |
| MyBlue Plus Bronze 912 | $70 / $70 | No / No | $40 / $150 / 35% / 40% / 45% / 50% |
| MyBlue Plus Bronze Standard – Rx Copays | $50 / $50 | No / No | $25 / $50 / $100 / $500 |
Silver Plans
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 quick summary of available plans and what we know so far.
- MyBlue Plus Silver 907 (Off Exchange only) – $1,800 individual deductible, and 50% coinsurance
- MyBlue Plus Silver 905 – $5,000 individual deductible, and 50% coinsurance
- MyBlue Plus Silver 906– $3,850 individual deductible, and 40% coinsurance
- MyBlue Plus Silver Standard – Rx Copays– $5,000 individual deductible, and 40% coinsurance
| Plan Name | PCP Office / Virtual Visit | HDHP / HSA Compatible | Prescription Drugs (Preferred) |
| MyBlue Plus Silver 907 | $5 / $5 | No / No | $5 / $15 / 30% / 35% / 45% / 50% |
| MyBlue Plus Silver 905 | $65 / $65 | No / No | $15 / $15 / 15% / 40% / 45% / 50% |
| MyBlue Plus Silver 906 | $30 / $30 | No / No | 0% / 10% / 20% / 35% / 45% / 50% |
| MyBlue Plus Silver Standard – Rx Copays | $40 / $40 | No / No | $20 / $40 / $80 / $350 |
Gold Plans
Gold plans may be for you if you have more health care needs than most, have a spouse/children on your plan or want to grow your family soon, or prefer to pay more each month but have lower out-of-pocket expenses. Below is a quick summary of available plans and what we know so far.
- MyBlue Plus Gold 910 – $250 individual deductible, and 40% coinsurance
- MyBlue Plus Gold 909 – $1,500 individual deductible, and 30% coinsurance
- MyBlue Plus Gold Standard – Rx Copays – $1,500 individual deductible, $7,800 Out of Pocket Max, and 25% coinsurance
| Plan Name | PCP Office / Virtual Visit | HDHP / HSA Compatible | Prescription Drugs (Preferred) |
| MyBlue Plus Gold 910 | 40% / 40% | No / No | 10% / 20% / 30% / 35% / 45% / 50% |
| MyBlue Plus Gold 909 | $15 / $15 | No / No | $0 / 420 / 20% / 30% / 40% / 50% |
| MyBlue Plus Gold Standard – Rx Copays | $30 / $30 | No / No | $15 / $30 / $60 / $250 |