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BMO U.S. Benefits

Medical Highlights

Here’s a high-level overview of the Consumer Choice Plan.
 

For details, review your medical SPD: Blue Cross Blue Shield Medical SPD (employees in Illinois) or UnitedHealthcare Medical SPD (employees outside of Illinois).

FeaturesIn-NetworkOut-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 MaximumNone
Lifetime MaximumNone
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)

You have prescription drug coverage through Express Scripts. Most prescription drugs are subject to the deductible, then you pay the applicable coinsurance. Learn more

*Annual deductibles and out-of-pocket limits for in-network and out-of-network must be met separately.


Maximize your dollars

Generally, you can use any provider you want, but you'll pay less when you use in-network providers:

  • Illinois: Blue Cross Blue Shield of Illinois PPO network
  • Outside of Illinois: UnitedHealthcare Choice Plus network

 
 

Get the App

We want to make your life easier. Mobile apps are a simple, quick way to maximize your benefits, save money and take charge
of your health.

Download the apps to your smartphone or tablet from your app store.

BCBSIL


UnitedHealthcare

Express Scripts