Medical
The Consumer Choice Plan is a High Deductible Health Plan (HDHP) that includes a tax-advantaged Health Savings Account (HSA) and prescription drug coverage. Blue Cross Blue Shield of Illinois (BCBSIL) and Kaiser administer the plan.
How the plan works
- In-network preventive care is 100% covered, no deductible.
- You pay the full cost for non-preventive services, including prescription drugs, until you meet the annual deductible. After that, you pay coinsurance and the plan pays the balance.
- Once you meet the out-of-pocket maximum, the plan pays 100% of covered charges for the rest of the year.
Features | In-Network | Out-of-Network |
---|---|---|
Providers |
|
|
Annual Deductible* (includes medical and Rx) |
Employee only: $1,750 Family: $3,500** |
BCBSIL only: Employee only: $3,500 Family: $7,000** |
Annual Out-of-Pocket Maximum* (includes deductible, copays and coinsurance for medical and |
Employee only: $3,425 Family: $6,850 |
BCBSIL only: Employee only: $6,850 Family: $13,700 |
Annual Benefit Maximum |
None |
|
Lifetime Maximum |
None |
|
What You Pay | ||
Office Visit | 20% after deductible |
BCBSIL: 40% after deductible
Kaiser: Not covered |
Lab Tests and X-rays | 20% after deductible |
BCBSIL: 40% after deductible
Kaiser: Not covered |
Well Care/Preventive Care | You pay nothing |
BCBSIL: 40% after deductible
Kaiser: Not covered |
Inpatient Care | 20% after deductible |
BCBSIL: 40% after deductible
Kaiser: Not covered |
Emergency Room | 20% after deductible and $100 copay (copay waived if admitted) | BCBSIL: 40% after deductible and $100 copay
Kaiser: 20% after deductible |
Prescription Drugs (Rx) | ||
You pay the full cost for prescription drugs until you meet the medical plan deductible. Then you pay the applicable copay. The plan pays 100% once you meet the medical plan out-of-pocket maximum. Prescription drugs are not subject to a separate out-of-pocket maximum. Certain preventive drugs are covered 100%, the deductible does not apply. For more details, review the applicable Formulary list.
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*Annual deductibles and out-of-pocket limits for in-network and out-of-network must be met separately.
**The entire family deductible must be met before the plan will pay benefits for any covered family members.
Resources to live healthier
We care about your health and wellness. That’s why we offer health support resources for you and your family.
LEARN MORETransparency in Coverage
BCBSIL and Kaiser create and publish machine-readable files on behalf of BMO. Go to BCBSIL Transparency in Coverage site or Kaiser Transparency in Coverage Site.