MyBlue Plus POS Bronze

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MyBlue Plus POS Bronze Plans

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. This new network offers a low-cost solution for cost-conscious members who purchase health insurance through state and federal marketplaces. Highlights of MyBlue Plus POS include:

Claims processing and health care management through Blue Cross and Blue Shield of Illinois
Primary care provider election assigned at the individual provider level
Referrals required to access in-network benefits, except for PCP services
Out-of-network benefit to provide additional access to care
Service area: Cook, DuPage, Kane, Kankakee and Will counties

All Bronze plans offer the same set of essential health benefits, quality and amount of care.

Below is a summary of the three MyBlue Plus POS Bronze Plan Options. See toggles below for each plan detail or download the available plan summaries.

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

Compare the features, options and costs of Bronze® 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

	903	912	Bronze Standard Select Rx Copays
Overall Deductible Individual/Family	$4,900 / $9,800	$1,500 / $3,000	$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**	$9,200 / $18,400	$9,200 / $18,400	$9,200 / $18,400
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

	903	912	Bronze Standard Select Rx Copays
Primary Care for injury/illness	$45/visit	$70/visit	$50/visit
Specialist visit	50%	$140/visit	$100/visit
Preventative care/screening	No Charge	No Charge	No Charge
Diagnostic test (xray, blood) Freestanding / Hospital	50%	$250/test	50%
Imaging (CT/PET/MRI) Freestanding / Hospital	50%	$450/test	50%

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

	903	912	Bronze Standard Select Rx Copays
Generic Drugs (Preferred)	No Charge	$40/$120	$25 / $75
Generic Drugs (Non Preferred)	10%	$150/$450	$25 / $75
Brand drugs (Preferred)	20%	35%	$50/$150
Brand Drugs Non Preferred	35%	40%	$100/$300
Specialty Drugs Preferred	45%	45%	$500
Specialty Drugs Non Preferred	50%	50%	$500

Outpatient Surgery / Emergency Comparison

	903	912	Bronze Standard Select Rx Copays
Facility Fee	$600/visit + 50%	$750/visit + 50%	50%
Facility fee Hospital	NA	NA	NA
Physician/surgeon Fee	$200/visit + 50%	$400/visit	50%
Emergency Room Care	$1,000/visit + 50%	$2,000/visit + 40%	50%
Emergency Medical Transportation	50%	50%	50%
Urgent Care	$60/visit	$150/visit	$75/visit

Hospital Stay / Health Services / Pregnancy

	903	912	Bronze Standard Select Rx Copays
Facility Fee for hospital stay	$850/visit plus 50% coinsurance	$1,500/visit + 50%	50%
Physician/surgeon Fees	50%	50%	50%
Mental health, behavioral health, or substance abuse services: Outpatient	50% office	$70 office / 50% other	50% office / 50% other
Mental health, behavioral health, or substance abuse services: Inpatient	$850/visit + 50%	$1,500 / visit + 50%	50%
If you are pregnant – office visit	Primary: $45 / Specialist: 50%	Primary: $70 / Specialist: $140	Primary: $50 / Specialist: $100
Childbirth/delivery/professional services	50%	50%	50%
Childbirth/delivery facility services	$850/visit + 50%	$1,500/visit + 50%	50%

Help recovering / other special needs

	903	912	Bronze Standard Select Tx Copays
Home Health Care	50%	40%	50%
Rehabilitation Services	50%	40%	50%
Habilitation services	50%	40%	50%
Skilled nursing care	50%	40%	50%
Durable medical equipment	50%	40%	50%
Hospice services	50%	40%	50%

Childrens Dental / Eye care

	903	912	Bronze Standard Select Tx Copays
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.)

	903	912	Bronze Standard Select Rx Copays
Acupuncture	✓	✓	✓
Dental Care (Adult)	✓	✓	✓
Long-term Care	✓	✓	✓
Non-emergency care when traveling outside of US	✓	✓	✓
Routine eye care (adult)	✓	✓	✓
Weight loss programs	✓	✓	✓

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

	903	912	Bronze Standard Select Rx Copays
Abortion care	✓	✓	✓
Bariatric surgery	✓	✓	✓
Chiropractic care	✓	✓	✓
Cosmetic surgery	✓	✓	✓
Hearing aids	✓	✓	✓
Infertility treatment	✓	✓	✓
Private-duty nursing	✓	✓	✓
Routine Foot Care	✓	✓	✓

MyBlue Plus POS Bronze