Medical
The Consumer Choice Plan is a High-Deductible Health Plan (HDHP) that includes a tax-advantaged Health Savings Account (HSA). The plan is administered by Blue Cross Blue Shield of Illinois (BCBSIL).
How the plan works
The Consumer Choice Plan provides comprehensive medical coverage including prescription drug benefits. The plan features an HSA which allows you to set aside money on a before-tax basis to pay for eligible expenses now or in the future. With the Consumer Choice plan:- You can see any provider you choose, but you’ll get higher benefits and pay less when you see in-network providers.
- 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.
- There are no annual or lifetime benefit limits.
Below is a high-level overview of the Consumer Choice Plan.
| Features | In-Network | Out-of-Network |
|---|---|---|
| Annual Deductible* (includes medical and Rx) |
Individual coverage: $1,750 Family coverage $3,500** |
Individual coverage: $3,500 Family coverage $7,000** |
| Annual Out-of-Pocket Maximum* (includes deductible, copays and coinsurance for medical and Rx) |
Individual coverage: $3,425 Family coverage $6,850 |
Individual coverage: $6,850 Family coverage $13,700 |
| Annual Benefit Maximum | None | |
| Lifetime Maximum | None | |
| What you pay | ||
| Office Visit | 20% after deductible | 40% after deductible |
| Lab Tests and X-rays | 20% after deductible | 40% after deductible |
| Well Care/Preventive Care | You pay nothing | 40% no deductible |
| Inpatient Care | 20% after deductible | 40% after deductible |
| Emergency Room | 20% after deductible and $100 copay (copay waived if admitted) |
40% after deductible and $100 copay (copay waived if admitted) In-network benefits apply if considered an emergency |
| Prescription Drugs (Rx) | ||
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You have prescription drug coverage through Express Scripts. Most prescription drugs are subject to the deductible, then you pay the applicable coinsurance. Learn more |
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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.
**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.
Transparency in Coverage
BCBSIL creates and publishes machine-readable files on behalf of BMO. To link to the machine-readable files go to the BCBSIL Transparency in Coverage site.