2018 BCBSIL Plan Comparison Chart
Preventive Services List
No-Cost Preventive Drug List – included on all BCBSIL ACA plans
2018 5-Tier Drug Formulary – (plan Blue Choice Preferred Silver Plan 102)
2018 6-Tier formulary – (all other plans)
Health Alliance Illinois – Plan Descriptions![Health Alliance - Illinois](/images/apply4.png)
BlueCross BlueShield of Illinois is the largest health insurance company in the state with over 6.5 million members.
Blue Cross Blue Shield of Illinois is offering 4 different individual plan networks for plans effective January 1st, 2018: Blue Choice Preferred PPO network, Blue Precision HMO network, BlueCare Direct Advocate, or Blue FocusCare plans.
Key Hospitals NOT accepting the Blue Choice Preferred PPO Plans in 2018:
- Northshore Hospital Systems (accepting BluePrecison HMO Plans only)
- Northwestern Hospital Systems (accepting BluePrecison HMO Plans only – more here)
- Rush Hospital Systems
- University of Chicago
Key Hospitals accepting the Blue Choice Preferred PPO Plans in 2018:
- Edwards Memorial
- Alexian Brothers
- Loyola Hospital Systems
- Elmhurst Memorial
- Swedish Covenant Hospital
- Presence Hospital Systems
- University of Illinois Chicago
Effective January 1, 2018: UnityPoint Health – Methodist in Peoria and Galesburg Cottage Hospital in Galesburg joined the BCBSIL Blue Choice Preferred PPO network
Effective January 1, 2018: BCBSIL reaches agreement with OSF Hospital System
Health Alliance Illinois Hospital Network Guide
BCBSIL Plan Network | ||||
Network Name | Blue Preferred PPO | Blue Precision HMO | BlueCare Direct Advocate | Blue Focus |
Network Hospital Lists | Hospital List | Hospital List | Hospital List | Hospital List |
Northwestern | X | ✓ * | X | X |
Loyola | ✓ | ✓ | X | X |
Rush | X | X | X | X |
Advocate | X | ✓ | ✓ | X |
Northshore | X | ✓ | X | X |
Presence Hospitals | ✓ | ✓ | X | X |
U of C | X | X | X | X |
UIC | ✓ | X | X | X |
Edward/Elmhurst | ✓ | ✓ | X | X |
*If you wish to continue receiving your care from Northwestern Medicine, Blue Precision HMO is the best option. You will need to select either Administrative Site 475 or 477 through a Northwestern Medicine primary care physician, you will be able to be referred to the appropriate Northwestern Medicine facility for services. – more information
The BCBSIL 2018 individual health plan options include HMO Plans, Health Savings Accounts, and PPO Plans. The different plans are described below.
Blue Precision HMO Plans
Our Rating:
Blue Precision Gold HMO 207 Plan features:
- $500 single/$1,500 family deductible and 80% coinsurance
- $20 doctor visit / $40 specialist copayment
- $40 urgent care copayment
- No charge for Tier 1 formulary generic drugs
Blue Precision Silver HMO 206 Plan features:
- $2,250 single/$6,750 family deductible and 80% coinsurance
- $30 doctor visit / $65 specialist copayment
- $65 urgent care copayment
- 10% for Tier 1 formulary generic drugs
Blue Precision Bronze HMO 205 Plan features:
- $6,000 single/$14,700 family deductible and 80% coinsurance
- $50 doctor visit / $85 specialist copayment
- $85 urgent care copayment
- No charge for Tier 1 formulary generic drugs
HMO Network
The Blue Precision HMO Plans 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.
Key Blue Precision HMO® Plan features include:
- Lower out-of-pocket costs than PPO plans
- You must select a network primary care physician (PCP), who coordinates your care within the network
- Referral required to see a specialist
- $20 doctor visit / $40 specialist copayment for Gold HMO Plan 207
- Prescription drug coverage
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Optional dental coverage
Blue Precision HMO® Plans may be right for you if you are an individual or family who:
- Are willing to have a primary care physician (PCP) coordinate your care
- Prefers fixed doctor visit copayments
- Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
- Requires regular prescription medication
Learn more about valuable member services and features you get when you join the Blue Cross and Blue Shield of Illinois family.
Blue Precision HMO Deductibles | |
---|---|
$500 single / $1,500 family | |
$3,250 single / $9,750 family | |
$2,250 single / 6,750 family | |
$6,000 single / 14,700 family |
Blue Choice Preferred PPO Silver Plans
Blue Choice Preferred Silver PPO Plans offers a respectable PPO network of doctors and hospitals and the convenience of never needing a referral to see a specialist. Blue Choice Preferred PPO Plans are coupled with the Blue Choice Preferred PPO network, a smaller version of the “standard” Blue Cross Blue Shield of Illinois PPO network and the largest PPO network BCBSIL offers to individual health lans. If you can accept some reduced hospital and physician choice, Blue Choice Preferred Silver PPO may be a great option for you. All Blue Choice Preferred Silver PPO plans offer the same set of essential health benefits, quality and amount of care.
The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are. Blue Choice Preferred Silver PPO Plans have a higher monthly premium and often lower out-of-pocket costs than Blue Choice Preferred Silver plans.
There are 2 Blue Choice Preferred Silver PPO Plans:
- Blue Choice Preferred Silver Plan 102 – $3,750 individual deductible and 70% coinsurance, $30 PCP and $60 specialist copays
- Uses the 5 tier formulary
- Blue Choice Preferred Silver Plan 203 – $1,450 individual deductible and 50% coinsurance, $10 PCP copays
- Uses the 6 tier formulary
Blue Choice Preferred PPO Network
The Blue Choice Preferred PPO Silver Plans use the Blue Choice Preferred PPO network, a smaller PPO network that includes about 50% of doctors and hospitals in Illinois.
Key Blue Choice Preferred Silver PPO® plan features include:
- $30 primary care/$60 specialist office visit copays for Blue Choice Preferred Silver Plan 102
- $10 PCP copays for Blue Choice Preferred Silver Plan 203
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Optional dental coverage
Blue Choice Preferred Silver PPO Plans may be right for you if you are an individual or family who:
- Seeks coverage comparable to what is offered by employers
- Prefers fixed doctor visit copayments
- Regularly visits a doctor
- Requires regular prescription medication
- Qualifies for a cost sharing reduction (CSR) on-exchange (Blue Choice Preferred Silver Plan 203 only)
Compare the features, options and costs of Blue Choice Preferred Silver® PPO 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.
Blue Choice Preferred Silver Deductibles | |
---|---|
$3,750 single / $11,250 family | |
$1,450 single / $4,350 family |
Blue Choice Preferred Bronze PPO Plans
Our Rating:
Blue Choice Preferred PPO Bronze Plans offer a respectable PPO network of doctors and hospitals and the convenience of never needing a referral to see a specialist. Blue Choice Preferred PPO Plans are coupled with the Blue Choice Preferred PPO network, a smaller version of the “standard” Blue Cross Blue Shield of Illinois PPO network. If you generally in good health and can accept some reduced hospital and physician choice, Blue Choice Preferred Bronze PPO may be a great option for you.
There are 2 Blue Choice Preferred Bronze Plan Options:
- Blue Choice Preferred Bronze Plan 201 – $5,500 individual deductible and 70% coinsurance, 2 $40 PCP visits/year
- Blue Choice Preferred Bronze Plan 202 – $2,850 individual deductible and 60% coinsurance, HSA compatible
To find if your doctor or hospital is part of the Blue Choice Network Provider Finder.
BlueChoice Bronze® may be right for you if you are an individual or family who:
- Seeks lower cost coverage
- Does not regularly have doctor visits
- Would like an HSA compatible plan (HSA Compatible plan with Blue Choice Preferred Bronze PPO 202 is HSA compatible.
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.
Blue Choice Preferred Bronze Deductibles | |
---|---|
$5,500 single / $14,700 family | |
$2,850 single / $6,550 family |
Blue Precision Bronze HMO Plan
Our Rating:
The Blue Precision Bronze HMO Plan 205 is the least expensive HMO plan, but also includes comprehensive benefits. Bronze Plans have a lower monthly premium and often higher out-of-pocket costs than Platinum, Gold, and Silver plans. This is an HMO plan. You must select a Blue Precision HMO Network Primary Care Physician (PCP) when enrolling in this plan.
There are is only 1 BCBSIL Bronze HMO Plan Option:
- Blue Precision Bronze HMO Plan 205 – $6,000 individual/$14,700 deductible and 80% coinsurance
HMO Network
The Blue Precision Bronze HMO Plan 205 uses the Blue Precision HMO network, one the largest HMO network 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.
Bronze HMO ® Plan 103 features include:
- No charge for Tier 1 formulary generic drugs
- You must select a network primary care physician (PCP), who coordinates your care within the network
- Referral required to see a specialist
- $50 doctor visit copayment for primary care physicians (PCPs)
- $85 office visit copayment for specialists
- $85 urgent care copayment
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Optional dental coverage
Bronze® HMO 103 may be right for you if you are an individual or family who:
- Are willing to have a primary care physician (PCP) coordinate your care
- Prefers fixed doctor visit copayments
- Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
- Requires regular prescription medication
Bronze HMO Deductibles | |
---|---|
$7,100 single / $14,300 family |
BlueCare Direct with Advocate HMO Plans
Our Rating:
The Chicago-area residents now have a new choice for health care coverage. Blue Cross and Blue Shield of Illinois (BCBSIL) has teamed up with Advocate Health Care* to offer a new, more affordable health plan — BlueCare Direct.
There is only 1 BCBSIL BlueCare Direct Plan Option:
HMO Network
BlueCare Direct combines the strength, expertise and reputation of two of the state’s most respected leaders in the health industry. Advocate is the largest health system in Illinois, and BCBSIL is the largest health insurer in the state. Advocate is uniquely positioned to deliver quality patient outcomes, while working to manage overall health care costs, with the goal of delivering value to our members.
BlueCare Direct ® Plan features include:
- No charge for Tier 1 formulary generic drugs
- You must select a network primary care physician (PCP), who coordinates your care within the network
- Referral required to see a specialist
- Lower monthly premiums and lower out-of-pocket costs than most other HMO plans available to individual plan members
- Access to Advocate’s network of over 250 sites of care, including:
- 4,000+ Advocate doctors
- 11 Advocate community hospitals
- The state’s largest integrated children’s network
- The state’s largest home health and hospice companies
- One of the region’s largest medical groups
- $65 urgent care copayment
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Optional dental coverage
BlueCare Direct may be right for you if you are an individual or family who:
- Are willing to have a primary care physician (PCP) coordinate your care
- Prefers or lives near an Advocate hospital (Cook, Dupage, Kane, Lake, and Will Counties
- Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
- Requires regular prescription medication
- Overview
- BlueCare Direct Silver 102 – $2,250 individual deductible and 50% coinsurance
BlueCare Direct Deductibles | |
---|---|
$2,250 single / 6,750 family |
Blue FocusCare Plans
Our Rating:
Blue FocusCare is a new HMO plan offered in Cook County starting in 2017. It includes a narrower HMO network and reduced costs compared to the Blue Precision HMO and BlueCare Direct HMO plans.
Blue FocusCare Plans are good for individuals that don’t mind limited networks. If you do not make frequent hospital visits and only need to have your basic needs covered this may be the cost efficient choice for you. If you can accept some reduced hospital and physician choice, Blue FocusCare may be a great option for you. All Blue FocusCare plans offer the same set of essential health benefits, quality and amount of care..
There are 4 BCBSIL BlueCare Direct Plan Options:
- Blue FocusCare Gold 101 – $1,750 individual deductible and 80% coinsurance
- Blue FocusCare Silver 103 – $2,600 individual deductible and 80% coinsurance
- Blue FocusCare Silver 102 – $5,500 individual deductible and 70% coinsurance
- Blue FocusCare Bronze 104 – $7,100 individual deductible and 50% coinsurance
HMO Network
The new Blue FocusCare Network is a narrow network plan designed around several physician organizations in Cook County. The plan designs are identical to the Blue Precision HMO plans. The only difference is a small subset of hospitals are available compared to the Blue Precision HMO plan.
Blue FocusCare Plan features include:
- No charge for Tier 1 formulary generic drugs
- You must select a network primary care physician (PCP), who coordinates your care within the network
- Lower monthly premiums and lower out-of-pocket costs than most other HMO plans available to individual plan members
- $50 urgent care copayment
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Optional dental coverage
Blue FocusCare may be right for you if you are an individual or family who:
- Are willing to have a primary care physician (PCP) coordinate your care
- Lives in Cook County and want an affordable plan
- Are flexible with their doctor or hospital preferences
- Generally in good health and don’t take several brand name prescriptions
- Overview
- Blue FocusCare Gold 101 – $1,750 individual deductible and 80% coinsurance
- Blue FocusCare Silver 103 – $2,600 individual deductible and 80% coinsurance
- Blue FocusCare Silver 102 – $5,500 individual deductible and 70% coinsuranceBlue FocusCare Bronze 104 – $7,100 individual deductible and 50% coinsurance
$2,250 single / $6,750 family
BlueCare Direct Deductibles |
---|
SelectTemp PPO (short-term medical)
SelectTemp PPO plans are not available at this time – United HealthOne short term plans are an available alternative.
Our Rating:
SelectTEMP PPO is an affordable short-term individual health plan that provides basic protection against unexpected accident or illness.
Individuals who are temporarily without health insurance because COBRA is too expensive, are in-between jobs, or waiting for employer coverage to begin find SelectTEMP PPO to be an affordable alternative.
SelectTEMP PPO offers various benefit periods and deductibles to allows you the control to tailor coverage, premium rates and out-of-pocket expenses according to your own needs.
You are able to choose:
- The date you want coverage to begin
- The coverage period – 1 to 11 months
- The deductible – from $500 to $5,000
- From over 200 Illinois hospitals
SelectTemp PPO Deductibles | |
---|---|
$500 single / $1,000 family | |
$1,000 single / $2,000 family | |
$1,500 single / $3,000 family | |
$2,000 single / $4,000 family | |
$5,000 single / $10,000 family |
2017 Discontinued Plans
BlueChoice Preferred Gold Plan 101 was discontinued January 1, 2017
The BCBSIL 2017 individual health plan options include HMO Plans, Health Savings Accounts, and PPO Plans. The different plans are described below.
Blue Precision HMO Plans
Our Rating:
Blue Precision Gold HMO 101 Plan features:
- $1,750 single/$5,250 family deductible and 80% coinsurance
- $25 doctor visit / $50 specialist copayment
- $25 urgent care copayment
- No charge for Tier 1 formulary generic drugs
Blue Precision Silver HMO 102 Plan features:
- $2,600 single/$6,000 family deductible and 80% coinsurance
- $30 doctor visit / $50 specialist copayment
- $30 urgent care copayment
- No charge for Tier 1 formulary generic drugs
Blue Precision Bronze HMO 103 Plan features:
- $7,100 single/$13,700 family deductible and 80% coinsurance
- $50 doctor visit / $100 specialist copayment
- $50 urgent care copayment
- No charge for Tier 1 formulary generic drugs
HMO Network
The Blue Precision HMO Plans 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.
Key Blue Precision HMO® Plan features include:
- Lower out-of-pocket costs than PPO plans
- You must select a network primary care physician (PCP), who coordinates your care within the network
- Referral required to see a specialist
- $25 doctor visit / $50 specialist copayment for Gold HMO Plan 101
- Prescription drug coverage
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Optional dental coverage
Blue Precision HMO® Plans may be right for you if you are an individual or family who:
- Are willing to have a primary care physician (PCP) coordinate your care
- Prefers fixed doctor visit copayments
- Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
- Requires regular prescription medication
Learn more about valuable member services and features you get when you join the Blue Cross and Blue Shield of Illinois family.
Blue Precision HMO Deductibles | |
---|---|
$1,750 single / $5,250 family | |
$2,600 single / $6,000 family | |
$7,100 single / $13,700 family |
Blue Choice Preferred PPO Silver Plans
Blue Choice Preferred Silver PPO Plans offers a respectable PPO network of doctors and hospitals and the convenience of never needing a referral to see a specialist. Blue Choice Preferred PPO Plans are coupled with the Blue Choice Preferred PPO network, a smaller version of the “standard” Blue Cross Blue Shield of Illinois PPO network and the largest PPO network BCBSIL offers to individual health lans. If you can accept some reduced hospital and physician choice, Blue Choice Preferred Silver PPO may be a great option for you. All Blue Choice Preferred Silver PPO plans offer the same set of essential health benefits, quality and amount of care.
The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are. Blue Choice Preferred Silver PPO Plans have a higher monthly premium and often lower out-of-pocket costs than Blue Choice Preferred Silver plans.
There are 3 Blue Choice Preferred Silver PPO Plans:
- Blue Choice Preferred Silver Plan 102 – $3,000 individual deductible and 70% coinsurance, $40 PCP copays
- Blue Choice Preferred Silver Plan 103 – $3,250 individual deductible and 80% coinsurance, up to 3 $0 PCP copays/year
- Blue Choice Preferred Silver Plan 109 – $3,500 individual deductible and 80% coinsurance, $30 PCP and $65 specialist copays
Blue Choice Preferred PPO Network
The Blue Choice Preferred PPO Silver Plans use the Blue Choice Preferred PPO network, a smaller PPO network that includes about 50% of doctors and hospitals in Illinois.
Key Blue Choice Preferred Silver PPO® plan features include:
- $40 primary care/$60 specialist office visit copays for Blue Choice Preferred Silver Plan 102
- First 3 primary care copays are $0 for Blue Choice Preferred Silver Plan 103
- Unlimited $0 primary care and specialist office visit copays for Blue Choice Preferred Silver Plan 109
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Optional dental coverage
Blue Choice Preferred Silver PPO Plans may be right for you if you are an individual or family who:
- Seeks coverage comparable to what is offered by employers
- Prefers fixed doctor visit copayments
- Regularly visits a doctor
- Requires regular prescription medication
Compare the features, options and costs of Blue Choice Preferred Silver® PPO 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.
- Overview
- Blue Choice Preferred Silver PPO 102
- Blue Choice Preferred Silver PPO 103
- Blue Choice Preferred Silver PPO 109
Blue Choice Preferred Silver Deductibles | |
---|---|
$3,000 single / $9,000 family | |
$3,250 single / $9,700 family | |
$3,500 single / $10,500 family |
Blue Choice Preferred Bronze PPO Plans
Our Rating:
Blue Choice Preferred PPO Bronze Plans offer a respectable PPO network of doctors and hospitals and the convenience of never needing a referral to see a specialist. Blue Choice Preferred PPO Plans are coupled with the Blue Choice Preferred PPO network, a smaller version of the “standard” Blue Cross Blue Shield of Illinois PPO network. If you generally in good health and can accept some reduced hospital and physician choice, Blue Choice Preferred Bronze PPO may be a great option for you.
There are 3 Blue Choice Preferred Bronze Plan Options:
- Blue Choice Preferred Bronze Plan 105 – $5,000 individual deductible and 60% coinsurance
- Blue Choice Preferred Bronze Plan 106 – $6,500 individual deductible and 100% coinsurance
- Blue Choice Preferred Bronze Plan 107 – $6,750 individual deductible and 80% coinsurance, 1 $0 office visit copay
Blue Choice Preferred Bronze Plans 105 and 106 are HSA compatible plans, which combined with tax-favored savings account combined allows you to fund health care expenses with pre-tax money.
Blue Choice Preferred Bronze Plan 107 is not HSA compatible, but offers one additional free office visit at no cost in addition to the the free annual office visit check up. Additionally, it offers a $75 urgent care copay and $12 generic drugs without needing to reach your deductible.
To find if your doctor or hospital is part of the Blue Choice Network Provider Finder.
Blue Choice Preferred PPO Bronze® Plans may be right for you if you are an individual or family who:
- Seeks lower cost coverage
- Does not regularly have doctor visits
- Would like an HSA compatible plan (Bronze Plan 105 and Bronze Plan 106 plans only)
- Overview
- Blue Choice Preferred Bronze 105 (HSA Compatible)
- Blue Choice Preferred Bronze 106 (HSA Compatible)
- Blue Choice Preferred Bronze 107
Blue Choice Preferred Bronze Deductibles | |
---|---|
$5,000 single / $13,500 family | |
$6,000 single / $13,100 family | |
$6,750 single / $13,700 family |
Blue Precision Bronze HMO Plan
Our Rating:
The Blue Precision Bronze HMO Plan 205 is the least expensive HMO plan, but also includes comprehensive benefits. Bronze Plans have a lower monthly premium and often higher out-of-pocket costs than Platinum, Gold, and Silver plans. This is an HMO plan. You must select a Blue Precision HMO Network Primary Care Physician (PCP) when enrolling in this plan.
There are is only 1 BCBSIL Bronze HMO Plan Option:
- Blue Precision Bronze HMO Plan 205 – $6,000 individual/$14,700 deductible and 80% coinsurance
HMO Network
The Blue Precision Bronze HMO Plan 205 uses the Blue Precision HMO network, one the largest HMO network 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.
Bronze HMO ® Plan 205 features include:
- No charge for Tier 1 formulary generic drugs
- You must select a network primary care physician (PCP), who coordinates your care within the network
- Referral required to see a specialist
- $50 doctor visit copayment for primary care physicians (PCPs)
- $100 office visit copayment for specialists
- $50 urgent care copayment
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Optional dental coverage
Bronze® HMO 205 may be right for you if you are an individual or family who:
- Are willing to have a primary care physician (PCP) coordinate your care
- Prefers fixed doctor visit copayments
- Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
- Requires regular prescription medication
Bronze HMO Deductibles | |
---|---|
$6,000 single / $14,700 family |
BlueCare Direct with Advocate HMO Plans
Our Rating:
The Chicago-area residents now have a new choice for health care coverage. Blue Cross and Blue Shield of Illinois (BCBSIL) has teamed up with Advocate Health Care* to offer a new, more affordable health plan — BlueCare Direct.
There are 4 BCBSIL BlueCare Direct Plan Options:
- BlueCare Direct Gold 101 – $1,750 individual deductible and 80% coinsurance
- BlueCare Direct Silver 102 – $2,600 individual deductible and 80% coinsurance
- BlueCare Direct Silver 104 – $5,500 individual deductible and 70% coinsurance
- BlueCare Direct Bronze 103 – $7,100 individual deductible and 50% coinsurance
HMO Network
BlueCare Direct combines the strength, expertise and reputation of two of the state’s most respected leaders in the health industry. Advocate is the largest health system in Illinois, and BCBSIL is the largest health insurer in the state. Advocate is uniquely positioned to deliver quality patient outcomes, while working to manage overall health care costs, with the goal of delivering value to our members.
BlueCare Direct ® Plan features include:
- No charge for Tier 1 formulary generic drugs
- You must select a network primary care physician (PCP), who coordinates your care within the network
- Referral required to see a specialist
- Lower monthly premiums and lower out-of-pocket costs than most other HMO plans available to individual plan members
- Access to Advocate’s network of over 250 sites of care, including:
- 4,000+ Advocate doctors
- 11 Advocate community hospitals
- The state’s largest integrated children’s network
- The state’s largest home health and hospice companies
- One of the region’s largest medical groups
- $50 urgent care copayment
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Optional dental coverage
BlueCare Direct may be right for you if you are an individual or family who:
- Are willing to have a primary care physician (PCP) coordinate your care
- Prefers or lives near an Advocate hospital
- Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
- Requires regular prescription medication
- Overview
- BlueCare Direct Gold 101 – $1,750 individual deductible and 80% coinsurance
- BlueCare Direct Silver 102 – $2,600 individual deductible and 80% coinsurance
- BlueCare Direct Silver 104 – $5,500 individual deductible and 70% coinsurance
- BlueCare Direct Bronze 103 – $7,100 individual deductible and 50% coinsurance
BlueCare Direct Deductibles | |
---|---|
$1,750 single / $5,250 family | |
$2,600 single / $7,800 family | |
$5,500 single / $14,300 family | |
$7,100 single / $14,300 family |
Blue FocusCare Plans
Our Rating:
Blue FocusCare is a new HMO plan offered in Cook County starting in 2017. It includes a narrower HMO network and reduced costs compared to the Blue Precision HMO and BlueCare Direct HMO plans.
Blue FocusCare Plans are good for individuals that don’t mind limited networks. If you do not make frequent hospital visits and only need to have your basic needs covered this may be the cost efficient choice for you. If you can accept some reduced hospital and physician choice, Blue FocusCare may be a great option for you. All Blue FocusCare plans offer the same set of essential health benefits, quality and amount of care..
There are 4 BCBSIL BlueCare Direct Plan Options:
- Blue FocusCare Gold 101 – $1,750 individual deductible and 80% coinsurance
- Blue FocusCare Silver 103 – $2,600 individual deductible and 80% coinsurance
- Blue FocusCare Silver 102 – $5,500 individual deductible and 70% coinsurance
- Blue FocusCare Bronze 104 – $7,100 individual deductible and 50% coinsurance
HMO Network
The new Blue FocusCare Network is a narrow network plan designed around several physician organizations in Cook County. The plan designs are identical to the Blue Precision HMO plans. The only difference is a small subset of hospitals are available compared to the Blue Precision HMO plan.
Blue FocusCare Plan features include:
- No charge for Tier 1 formulary generic drugs
- You must select a network primary care physician (PCP), who coordinates your care within the network
- Lower monthly premiums and lower out-of-pocket costs than most other HMO plans available to individual plan members
- $50 urgent care copayment
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Optional dental coverage
Blue FocusCare may be right for you if you are an individual or family who:
- Are willing to have a primary care physician (PCP) coordinate your care
- Lives in Cook County and want an affordable plan
- Are flexible with their doctor or hospital preferences
- Generally in good health and don’t take several brand name prescriptions
- Overview
- Blue FocusCare Gold 101 – $1,750 individual deductible and 80% coinsurance
- Blue FocusCare Silver 103 – $2,600 individual deductible and 80% coinsurance
- Blue FocusCare Silver 102 – $5,500 individual deductible and 70% coinsurance
- Blue FocusCare Bronze 104 – $7,100 individual deductible and 50% coinsurance
BlueCare Direct Deductibles | |
---|---|
$1,750 single / $5,250 family | |
$2,600 single / $6,000 family | |
$5,500 single / $14,300 family | |
$7,100 single / $14,300 family |
2016 Plans (Discontinued)
BlueChoice Preferred Gold Plan 101 was discontinued January 1, 2017
Blue Choice Preferred PPO Gold Plans
Our Rating:
Blue Choice Preferred Gold Plans offer the smaller but respectable Blue Choice Preferr3ed PPO network of doctors and hospitals and the convenience of never needing a referral to see a specialist. Blue Choice Preferred PPO Plans are coupled with the Blue Choice Preferred PPO network, a smaller version of the “standard” Blue Cross Blue Shield of Illinois PPO network that is being discontinued beginning January 1st, 2016. If you can accept some reduced hospital and physician choices, Blue Choice Preferred Gold PPO may be a great option for you.
The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are. Blue Choice Preferred Gold PPO Plans have a higher monthly premium and often lower out-of-pocket costs than Blue Choice Preferred Silver plans.
There is only 1 Blue Choice Preferred Gold PPO Plan:
Blue Choice Preferred Gold®PPO Plan 101 features include:
- $30 doctor visit copayment for Blue Choice Gold Plan 001 and Blue Choice Gold Plan 007
- $20 primary care copays
- $40 specialist copays
- $500 individual deductible
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Optional dental coverage
Use the Provider Finder to search for physicians and hospitals in the Blue Choice Preferred PPO network.
Blue Choice Gold® may be right for you if you are an individual or family who:
- Seeks coverage comparable to what is offered by employers
- Prefers fixed doctor visit copayments
- Regularly visits a doctor
- Requires regular prescription medication
Blue Choice Preferred Gold PPO Deductibles | |
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$500 single / $1,500 family |
2015 Plans (Discontinued)
Blue PPO Gold Plans
Blue PPO Gold Plans were discontinued January 1, 2016
Our Rating:
There are 3 Blue PPO Gold Plan Options:
- Blue PPO Gold Plan 001 – $3,250 individual deductible and 100% coinsurance
- Blue PPO Gold Plan 002 – $1,500 individual deductible and 80% coinsurance
- Blue PPO Gold Plan 012 – $1,000 individual deductible and 80% coinsurance
Key Blue PPO Gold® plan features include:
- $30 doctor visit copayment for Gold Plan 001 and Gold Plan 012
- $10 doctor visit copayment for Gold Plan 002
- Prescription drug coverage
- Maternity Coverage
- Well-adult care covered at 100%
- Well-child care covered at 100%
- Diagnostic testing
- Hospital services
- Access to the BlueCard PPO network when traveling out-of-state
- Optional dental coverage
Blue PPO Gold Deductibles | |
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$1,000 single / $3,000 family | |
$1,500 single / $4,500 family | |
$3,250 single / $9,750 family |
Blue PPO Silver Plans
Blue PPO Silver Plans were discontinued January 1, 2016
Our Rating:
Blue PPO Silver Plans are the second most popular BCBSIL individual plans. Blue Silver PPO Plans include access to the Blue Advantage Entrepreneur (BAE) PPO network, the largest PPO network in Illinois that includes over 90% of Illinois doctors and 96% of hospitals.
All Silver plans offer the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are. Silver Plans have a higher monthly premium and often lower out-of-pocket costs than bronze plans. In most cases, Silver plans cover 80% of costs, while you cover 20%.
There are 2 Blue PPO Silver Plan Options:
- Silver Plan 003 – $6,000 individual deductible and 100% coinsurance
- Silver Plan 004 – $3,000 individual deductible and 80% coinsurance
Key Blue PPO Silver® plan features include:
- $30 primary office visit copay and $50 specialist copay for Silver Plan 003 and Silver Plan 004 Plans
- Prescription drug coverage
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Access to the BlueCard PPO network when traveling out-of-state
- Optional dental coverage
Blue PPO Silver Deductibles | |
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$3,000 single / $9,000 family | |
$6,000 single / $12,700 family |
Blue PPO Bronze Plans
Blue PPO Bronze Plans were discontinued January 1, 2016
Our Rating:
Bronze PPO Plans are catastrophic plans that are health savings account (HSA) eligible. Bronze Plans have a higher monthly premium and often lower out-of-pocket costs than silver plans. In most cases, Bronze plans cover 80% of costs, while you cover 20%. Blue PPO Bronze Plans include access to the Blue Advantage Entrepreneur (BAE) PPO network, the largest PPO network in Illinois that includes over 90% of Illinois doctors and 96% of hospitals.
There are 2 Blue PPO Bronze Plan Options:
- Bronze Plan 005 – $5,000 individual deductible and 80% coinsurance
- Bronze Plan 006 (HSA Compatible) – $6,000 individual deductible and 100% coinsurance
Key Blue PPO Bronze® plan features include:
- $30 primary / $60 specialist copay for first 3 visits per calendar year, then 80% 80% coinsurance after deductible for the Bronze Plan 005
- 100% coinsurance after deductible for the Bronze Plan 006
- Prescription drug coverage after deductible is met
- Maternity Coverage
- Well-adult care covered at 100%, no deductible
- Well-child care, covered at 100%, no deductible
- Diagnostic testing
- Hospital services
- Access to the BlueCard PPO network when traveling out-of-state
- Optional dental coverage
Blue PPO Bronze® may be right for you if you are an individual or family who:
- Seeks lower cost coverage
- Does not regularly have doctor visits
- Would like an HSA compatible plan (Bronze Plan 006 only)
Blue PPO Bronze Deductibles | |
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$5,000 single / $12,700 family | |
$6,000 single / $12,700 family |