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. BlueCross BlueShield of Illinois is the largest health insurance company in the state with over 6.5 million members. Healthplanradar.com is owned and operated by a private company, Amabo LLC, and is not affiliated with the federal government health insurance marketplace healthcare.gov or state-based marketplaces. Those with incomes between 100% and 150% of the federal poverty level (FPL) may qualify for a zero-dollar premium silver plan (after tax credits). Ask to see the members BCBSIL ID card for current information. Central DuPage Hospital | Northwestern Medicine For official federal government information, please visit Healthcare.gov or Medicare.gov (1-800-MEDICARE). Choosing between an HMO or a PPO health plan doesn't have to be complicated. Provider | Blue Cross and Blue Shield of Illinois File is in portable document format (PDF). Not all agents are licensed to sell all products. 2021 HealthMarkets Insurance Agency. Provides basic medical care and medication. Blue Choice Preferred PPO SM Blue Choice Preferred Platinum PPOSM 119 P5E2BCE NA $250/$500 $750/$1,500 $1,250/Unlimited $3,750/Unlimited 80%/50% $30 $60 $60 DC $400 $200/$300 . Combined Medical and Drug Out of Pocket Maximum, CoInsurance: 50.00% Coinsurance after deductible, CoInsurance: 30.00% Coinsurance after deductible. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, Blue PPO Bronze Plans were discontinued January 1, 2016. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Chicago Metro counties: Cook, Lake, McHenry, Dupage, Kane, Grundy, Kankakee, Kendall and Will. Blue PPO Gold Plans were discontinued January 1, 2016, Blue PPO Silver Plans were discontinued January 1, 2016. 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. *Not available in Sangamon, Lawrence, and Wabash counties. It includes a narrower HMO network and reduced costs compared to the Blue Precision HMO and BlueCare Direct HMO plans. Health Savings Accounts and Health Care Accounts. The site may also contain non-Medicare related information. All of BCBSILs small business health plan options include comprehensive coverage under the Affordable Care Act (ACA), including: Regarding health plans, "metal" tiers easily identify how costs are split between the insurance company and the insured. 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. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. * Figures shown are only for in-network medical costs, ** Please check with insurance company if Copay and Coinsurance rates are before or after the deductible, Get advice from Licensed Insurance Agents. Northwestern Memorial Hospital | Northwestern Medicine See benefit book for details. Cost sharing (deductibles and coinsurance) may be higher. Copyright document.write(new Date().getFullYear()); Health Care Service Corporation. Remind your patients to call the number on their BCBSIL card if they have questions about their benefits. 2. The BCBSIL PPO network gives you flexible benefit design options at a price you can afford while giving your employees a wide range of benefits and the freedom to visit any doctor they choose. 2022 HealthMarkets Insurance Agency. Use the Provider Finder to search for physicians and hospitals in the Blue Choice Preferred PPO network. PDF PPO Networks - Blue Cross and Blue Shield of Illinois Get a Quote. One option is Adobe Reader which has a built-in reader. We are happy to announce that as of Jan. 1, 2021, the Blue Choice Select PPO plan will be available in 99 counties* throughout Illinois. Physicians: Regional Medical . Benefit Explanation: Certain generic drugs may have a higher cost share amount than is listed on this page. 155.260 to protect the privacy and security of personally identifiable information. The network service area for Blue Choice PPO includes the following counties: The Blue Choice PPO network provides access to over 15,000 participating physicians and 62 participating hospitals. In addition, some sites may require you to agree to their terms of use and privacy policy. Offers a choice of primary care providers with coverage for preventive health services. In most cases, Bronze plans cover 80% of costs, while you cover 20%. HMO Illinois: Blue Advantage HMO: Site 475 (Hospitals: Kishwaukee, Valley West, Delnor, Central DuPage, McHenry, Huntley . Selection Required. A preferred or participating pharmacy has a contract with BCBSILs pharmacy benefit manager (Prime Therapeutics) to provide pharmacy services at a negotiated rate. Keep in mind that an employer can customize the benefit levels for each tier. The Blue Choice PPO network provides access to over 15,000 participating physicians and 62 participating hospitals. You are leaving this website/app (site). This new site may be offered by a vendor or an independent third party. Benefit Booklets provide further information to help determine if members are within the network service area. Typically the insurance carrier will cover 60% of the cost of services. In most cases, Silver plans cover 80% of costs, while you cover 20%. The only difference is a small subset of hospitals are available compared to the Blue Precision HMO plan. Illinois Valley Community Hosp 925 West St Peru, IL 61354 (815) 223-3300 NPI:1164403622 PONTIAC General Acute Care Hospital St James Hospital 2500 W Reynolds St Tier 3 benefits, if offered, typically address the use of out-of-network providers as the highest cost option for covered services. Blue Choice Select PPOSM includes all the features of a PPO plan, such as a wide range of benefits and the flexibility for members to help control their care there are no referrals required. All rights reserved. Find the right short term coverage for your needs. ( Note: See Medicaid page for BCCHP and MMAI Provider Finder links.) Serving Illinois communities for 85 years. New BCBSIL Plans: Why BCBSIL? Blue Choice Opt PPO SM Network Expanding Throughout Illinois October 26, 2021 We're happy to announce that as of Jan. 1, 2022, the Blue Choice Opt PPO network, which includes Blue Choice Options SM and Blue Options SM plans will be available throughout the State of Illinois. At Duly Health and Care, we proudly accept plans from the following insurance providers: This listing reflects current contracts between Duly's physician practice, DuPage Medical Group, and health plans. To see all available data on Qualified Health Plan options in your state, go to the Health Insurance Marketplace website at, HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. BlueCare Direct combines the strength, expertise and reputation of two of the states most respected leaders in the health industry. Blue Cross/Blue Shield Beech Street Cigna Corvel Coventry Fox Valley Medicine Great-West Healthcare Healthcare's Finest Network - HFN HealthChoice Illinois Managed Medicaid (BCBS Community, Meridian) HMO Illinois Humana Kane County IPA Medicare Part B Medicare Advantage (BCBSPPO, AetnaPPO and HMO) MultiPlan Preferred Plan It would be especially helpful if you travel a lot, since you would not need to see a primary care physician. Members choose a contracting medical group or independent practice association from one of the largest HMO networks in the state with no annual deductible and generally no claim forms. If you can accept some reduced hospital and physician choice, Blue Choice Preferred PPO plans may be a great option for you. gsbrady over 7 years ago Are there hospitals outside of Illinois that are in-network for the Blue Choice Preferred PPO through BCBSIL? Chicago, Illinois 60601-5099. Blue Choice Preferred PPO is a comprehensive PPO network of doctors and hospitals with higher monthly premium and often lower out-of-pocket costs. **Specialty care only with referral; No primary care. Service and product availability varies by state. Compare the features, options and costs of Bronze plans to find the one thats right for you. No obligation to enroll. To view this file, you may need to install a PDF reader program. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces. Our Rating: Blue FocusCare is a new HMO plan offered in Cook County starting in 2017. HMO Illinois: Blue Advantage HMO: Site 475 (Hospitals: Kishwaukee, Valley West, Delnor, Central DuPage, McHenry, Huntley, Woodstock, Palos. If youre currently contracted with Blue Cross and Blue Shield of Illinois (BCBSIL) for the Blue Choice PPOSM network, as of Jan. 1, 2021, you will also be an in-network provider for members who have the Blue Choice Select PPO benefit plan. 3. Review a list ofparticipating providers for members impacted by this change. Mental health and substance use disorder services, including behavioral health treatment, Rehabilitative and habilitative services and devices, Preventive and wellness services and chronic disease management, Pediatric services, including dental and vision. By expanding the Tier 1 service area for the Blue Choice Options and Blue Options benefit plans throughout Illinois, we are providing a lower-cost tiered PPO option to members in Illinois. One option is Adobe Reader which has a built-in reader. Cost sharing (deductibles and coinsurance) may be higher. PPO includes Preferred Pharmacy Network Walgreens, Walmart, Sams Club, Albertsons and select Independent Pharmacies, $750 single/$2,250 family deductible and 30% coinsurance, $20 doctor visit / $40 specialist copayment, $3,100 single/$9,300 family deductible and 50% coinsurance, $35 doctor visit / $75 specialist copayment, $7,400 single/$17,100 family deductible and 50% coinsurance, $65 doctor visit / $105 specialist copayment, You must select a network primary care physician (PCP), who coordinates your care within the network, $20 doctor visit / $40 specialist copayment for, Are willing to have a primary care physician (PCP) coordinate your care, Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs, Seeks coverage comparable to what is offered by employers, Qualifies for a cost sharing reduction (CSR) on-exchange (, $65 doctor visit copayment for primary care physicians (PCPs), $105 office visit copayment for specialists, Diagnostic testing $150 copay X-rays & Imaging, $300 copay Outpatient Imaging (CT/PET Scans/MRIs), Lower monthly premiums and lower out-of-pocket costs than most other HMO plans available to individual plan members. Ask to see the members BCBSIL ID card for current information. Blue Choice Blue Medicare Advantage Great-West Healthcare HMOI of Illinois Humana Choice PPO Humana Gold Choice (Medicare PFFS) Humana Gold Plus (DME for AMG only) Humana HMO (DME for Advocate sites only) Humana POS Humana PPO Medicare (Nursing, Hospice, PAP - Central CBA, Enteral - Central CBA) Personal Care PHCS - Infusion & DME only UI Health participates in the following health plans and accepts Medicare assignment. Thats why Blue Cross and Blue Shield of Illinois (BCBSIL) offers health care coverage with a wide variety of options across a range of price levels. 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. BluePrint PPOSM Best Fit: 51-150 Employees Access to more than 23,000 doctors and over 200 hospitals. 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. Copyright 2021 Health Care Service Corporation. Blue Choice Options' unique benefit plan tiered design helps you control your care and expenses. Silver plan monthly premiums are more than Bronze plans, but the out-of-pocket costs for services are lower with the insurance carrier covering around 70% of the cost of services. 155.220(c) and (d) and standards established under 45 C.F.R. Were here to help you streamline administration, control costs and meet regulatory requirements. Your employees have a choice of Primary Care Providers from a large network of contracting HMO physicians and medical groups. HealthMarkets is ranked Excellent (5 out of 5 stars) by 92% of customers on Trustpilot: Based on 3,101 customer reviews on Trustpilot in the health insurance agency category as of 4/29/21. External link You are leaving this website/app (site). Blue Cross Blue Shield With the public health emergency ending, BCBS companies remain committed to ensuring access to care. HMO (Health Maintenance Organization) plans typically require members to select a primary care physician (PCP) to coordinate care within the network. 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. Health care benefits are a crucial part of recruiting new employees and retaining your existing workforce. Northwestern Medical Group | Northwestern Medicine Please check your benefit booklet or your plan's terms if you are unsure. Medicare Advantage PPO (Devoted Choice Illinois) Medicare Advantage PPO (effective 1/1/2023) Christ; Condell; Good Samaritan; Good Shepherd; . Blue Cross & Blue Shield of Illinois aims to fill Pilsen jobs | Crain's BCBSIL provides Illinois small business employers with a variety of health care plan options that include access to a large network of providers and comprehensive benefits to fit your employees' needs and your organization's budget. PDF Accepted Health Plans - Advocate Health Care No obligation to enroll. You can usually visit specialists without a referral, including out-of-network specialists. If prescription drugs are bought from an out of network pharmacy additional charges may apply. Legal and Privacy | Non-Discrimination Notice | 833-923-1784. Copyright document.write(new Date().getFullYear()) Health Care Service Corporation. The Blue Precision Bronze HMO Plan 205 uses the Blue Precision HMO network, one the largest HMO network in Illinois. The details:Current members of Methodist First Choice will be able to choose doctors that are in the Blue Precision HMO network. File is in portable document format (PDF). A PPO offers more flexibility with limited coverage or reimbursement for out-of-network providers. Learn more about the differences between these options: PPO plans allow members more flexibility than an HMO to see specialists. BlueChoice Preferred Gold Plan 101 was discontinued January 1, 2017. Blue Choice PPO network offers access to a contracting hospital network created by considering: Geographic accessibility The number of board certified doctors on staff One option is Adobe Reader which has a built-in reader. PPO plans allow you to visit whatever in-network physician or healthcare provider you wish without first requiring a referral from a primary care physician. Blue FocusCare Plans are good for individuals that dont mind limited networks. Plan options within each metal tier include Participating Provider Option (PPO) and Health Maintenance Organization (HMO) choices. 155.220(c) and (d) and standards established under 45 C.F.R. related information. It will open in a new window. 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. BlueEdge combines a Participating Provider Option (PPO) with an employer-funded Health Care Account (HCA) that pays for covered health care expenses. The choice to use contracted doctors and hospitals in the larger PPO network at a higher cost. PDF Blue Choice Preferred PPOSM (BCE) - Illinois Health Agents areas. Eligibility and benefit quotes include important information about the patients benefits, such as membership verification, coverage status and applicable copayment, coinsurance and deductible amounts. Anthem Blue Cross Blue Shield: Health Insurance, Medicare & More The plan designs are identical to the Blue Precision HMO plans. Also ask for a drivers license or other photo ID to help guard against medical identity theft. Register now *In addition to staying in network, you or your doctor may need to get benefit approval or "prior authorization" before you get treatment for certain services for them to be covered. This new site may be offered by a vendor or an independent third party. Blue Choice PPO | Blue Cross and Blue Shield of Texas Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the . PPO plans generally come with a higher monthly premium than HMOs. Out-of-pocket medical costs can also run higher with a PPO plan. Most PDF readers are a free download. Remember, its important to check eligibility and benefits for each patient before every scheduled appointment. HSA funds from you and/or your employees are used to pay for covered health care expenses. Benefit Explanation: Member will be responsible for copay per emergency room admission before and after meeting the plan deductible. Here is the general, basic benefit structure of a tiered product: BCBSIL is committed to providing quality health insurance to all communities of Illinois. Availity provides administrative services to BCBSIL. Blue Choice Opt PPO SM Network Expanding Throughout Illinois Bronze Blue Choice Preferred Bronze PPOSM 201 202 302 2502 Individual Deductible 3 $6,100 $4,500 $6,350 $5,000 Coinsurance 50% 40% 40% 50% Out-of-Pocket . Our Rating: Bronze PPO Plans are catastrophic plans that are health savings account (HSA) eligible. A PPO is generally a good option if you want more control over your choices and don't mind paying more for that ability. Medical | Blue Cross and Blue Shield of Illinois PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. You may be responsible for paying the difference between the cost of a brand name drug and generic drug, if a generic was also available. This is an HMO plan. Healthplanradar.com is not connected with or endorsed by the United States federal government or the federal Medicare program. Simply call 911 or go immediately to the nearest emergency facility. Open Access Aetna Select (includes Aetna HealthFund Plans) Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. The site may also contain non-Medicare related information. Premium subsidies vary by address and subject to eligibility. What's Blue Cross Physician Choice PPO and how does it work? Blue Cross Blue Shield 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. 300 East Randolph Street. The site may also contain non-Medicare related information. . The main differences between the two are the size of the health care provider network, the flexibility of coverage or payment assistance for doctors in-network vs out-of-network, and the monthly payment. Members and covered dependents must live or work in the network service area. Blue Cross Physician Choice PPO | FAQ | bcbsm.com Regional Medical Group | Northwestern Medicine Chicago, Peoria, 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. The United Healthcare (UHC) Choice Plus plan is a PPO plan that allows you to see any doctor in their network including specialists without a referral. Blue Choice Select PPO | Blue Cross and Blue Shield of Illinois Blue FocusCare HMO: 1 Bronze, 1 Silver, 1 Gold, BlueCare Direct w/ Advocate: 1 Bronze, 1 Silver, 1 Gold, Blue Precision HMO: 1 Bronze, 2 Silver, 1 Gold, Blue Choice Preferred PPO: 5 Bronze, 2 Silver, 1 Gold, 1 Catastrophic. . Benefit coverage under Blue Choice Options PPO includes: This is only a brief description of some of the plan benefits. Members can choose a primary care physician (PCP). The HMO network provides basic care and prescription medication coverage while coordinating with our care specialists for any necessary referrals. Outside of our network, only emergency medical services are covered. Learn More Are you losing Medicaid? What states have the Medigap birthday rule? Blue Cross Blue Shield - Blue Choice PPO Blue Cross Blue Shield - Blue Choice Options (Tier 1) Blue Cross Blue Shield - HMOI (Medical Group/IPA Information in Legend below) (Patients must have a referral for services) . Sales agents may be compensated based on a consumers enrollment in a health plan. Insurance Carriers | Duly Health and Care - DuPage Medical Group Contributory dental plans include minimum contribution requirements from employers. All quotes are estimates and are not final until consumer is enrolled. Choose from a variety of health care plan options that allow you access to our large network of providers and comprehensive benefits. If you call a phone number or click a link shown on our website, we may receive compensation. 1. PPOs are one of the most popular types of health insurance plans because of their flexibility. Healthplanradar.com is for research purposes only. Most PDF readers are a free download. Our plans give members access to a large network of providers and comprehensive coverage. Blue Cross and Blue Shield of Illinois Blue Choice Preferred Silver PPO 203. Blue Choice Preferred PPO Plans have a higher monthly premium and often lower out-of-pocket costs than Blue Choice Preferred Silver plans. With the PPO plan, you can receive care from any of the physicians and hospitals within the plan's network, as well as outside of the network for covered services. HMO plans typically have lower monthly premiums. 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