Select Page
CarriersBlueCross BlueShield of ILMyBlue Plus POS PlansGold | MyBlue Plus Plans

MyBlue Plus POS Gold

MyBlue Plus POS Gold plans keep your out-of-pocket costs lower when you need care most. Compare the 2026 Gold plan options below to find the right fit for you and your family.

Home » Carriers » BlueCross BlueShield of IL » MyBlue Plus POS Plans » Gold | MyBlue Plus Plans

Find Your 2026 ACA Health Plan

Compare Blue Cross Blue Shield of Illinois ACA plans available in your area. Enter your ZIP code to see plans and pricing - no contact info required.

MyBlue Plus POS Gold 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

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.

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

    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. 

    closed accordion

    keep this item to close accordion by default

    Deductibles

    909 910 Gold Standard – Rx Copays
    Overall Deductible Individual/Family $1,000/ $2,000 $250 / $500 $2,000 / $4,000
    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** $8,000/ $16,000 $7,000 / $14,000 $8,200 / $16,400
    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

    909 910 Gold Standard – Rx Copays
    Primary Care for injury/illness $10/visit 20% $30/visit
    Specialist visit $60/visit 40% $60/visit
    Preventative care/screening No Charge No Charge No Charge
    Diagnostic test (xray, blood) Freestanding / Hospital $30/test 40% 25%
    Imaging (CT/PET/MRI) Freestanding / Hospital $250/test 40% 25%

     

    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

    909 910 Gold Standard – Rx Copays
    Generic Drugs (Preferred) No charge 10% $15 / $45
    Generic Drugs (Non Preferred) $20 / $60 20% $15 / $45
    Brand drugs (Preferred) 20% 30% $30 / $90
    Brand Drugs Non Preferred 30% 35% $60 / $180
    Specialty Drugs Preferred 40% 45% $250/prescription
    Specialty Drugs Non Preferred 50% 50% $250/prescription

     

    Outpatient Surgery / Emergency Comparison

    909 910 Gold Standard – Rx Copays
    Facility Fee $300/visit + 30% $600/visit + 40% 25%
    Facility fee Hospital NA NA NA
    Physician/surgeon Fee $30/visit $200/visit + 40% 25%
    Emergency Room Care 30% 40% 25%
    Emergency Medical Transportation 30% 40% 25%
    Urgent Care $60/visit 40% $45/visit

     

    Hospital Stay / Health Services / Pregnancy

    909 910 Gold Standard – Rx Copays
    Facility Fee for hospital stay 30% 40% 25%
    Physician/surgeon Fees 30% 40% 25%
    Mental health, behavioral health, or substance abuse services: Outpatient $10 office / 30% other 20% office / 40% other $30/office / 25% other
    Mental health, behavioral health, or substance abuse services: Inpatient 30% 40% 25%
    If you are pregnant – office visit Primary: $10 / Specialist: $60 Primary: 20%/ Specialist: 40% Primary: $30 / Specialist: $60
    Childbirth/delivery/professional services 30% 40% 25%
    Childbirth/delivery facility services 30% 40% 25%

     

    Help recovering / other special needs

    909 910 Gold Standard – Rx Copays
    Home Health Care 30% 40% 25%
    Rehabilitation Services 30% 40% $30/visit
    Habilitation services 30% 40% $30/visit
    Skilled nursing care $500/day 40% 25%
    Durable medical equipment 30% 40% 25%
    Hospice services 30% 40% 25%

    Childrens Dental / Eye care

     

    909 910 Gold Standard – Rx 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.)

    909 910 Gold Standard – Rx Copays
    Acupuncture Not Covered Not Covered Not Covered
    Dental Care (Adult) Not Covered Not Covered Not Covered
    Long-term Care Not Covered Not Covered Not Covered
    Non-emergency care when traveling outside of US Not Covered Not Covered Not Covered
    Weight loss programs 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.)

    909 910 Gold Standard – Rx Copays
    Abortion care Covered Covered Covered
    Bariatric surgery Covered Covered Covered
    Chiropractic care Covered Covered Covered
    Cosmetic surgery Covered Covered Covered
    Hearing aids Covered Covered Covered
    Infertility treatment Covered Covered Covered
    Private-duty nursing Covered Covered Covered
    Routine Foot Care Covered Covered Covered
    Routine eye care (Adult) Covered Covered Covered

    Ready to Enroll or Have Questions?

    Illinois Health Agents - licensed, independent, and serving Illinois since 2007. No pressure, no spam - just expert guidance.