- Overview
- Blue Choice Preferred Silver PPO 203
- Blue Choice Preferred Silver PPO 303
- Blue Choice Preferred Silver PPO 706
Blue Choice Preferred Silver PPO Plans
Our Rating:
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 plans. 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 203 – $2,250 individual deductible and 50% coinsurance
- Blue Choice Preferred Silver Plan 303 – $2,250 individual deductible and 50% coinsurance
- Blue Choice Preferred Silver Plan 706 – $5,800 individual deductible and 40% coinsurance
- Both use 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 68% of doctors and hospitals in Illinois.
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.
Blue Choice Preferred Silver PPO 203
2023 Plan Summary
| Important Questions | Answers | Why this Matters: |
| What is the overall deductible ? | Individual: Participating $2,250; Non-Participating $15,000 Family: Participating $6,750; Non-Participating $45,000 |
Generally, you must pay all of the costs from providers up to the deductible amount before this plan begins to pay. If you have other family members on the plan, each family member must meet their own individual deductible until the total amount of deductible expenses paid by all family members meets the overall family deductible |
| Are there services covered before you meet your deductible? | Yes. In-Network Preventive Health Care services and services with a copay are covered before you meet your deductible | This plan covers some items and services even if you haven’t yet met the deductible amount. But a copayment or coinsurance may apply. For example, this plan covers certain preventive services without cost-sharing and before you meet your deductible. See a list of covered preventive services at www.healthcare.gov/coverage/preventive-care-benefits/ . |
| Are there other deductibles for specific services? |
No | You don’t have to meet deductibles for specific services. |
| What is the out-of-pocket limit for this plan? |
Individual: Participating $9,100; Non-Participating Unlimited Family: Participating $18,200; Non- Participating Unlimited |
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other family members in this plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met. |
| What is not included in the out-of-pocket limit? |
Premiums, balance-billed charges, and health care this plan doesn’t cover. |
Even though you pay these expenses, they don’t count toward the out-of-pocket limit. |
| Will you pay less if you use a network provider? | Yes. See www.bcbsil.com
or call 1- 800-892-2803 for a list of Participating Providers. |
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider’s charge and what your plan pays (balance billing). Be aware your network provider might use an out-of-network provider for some services (such as lab work). Check with your provider before you get services. |
| Do you need a referral to see a specialist? |
No. | You can see the specialist you choose without a referral. |
Your cost if you use
a Participating
Provider (You will pay the least)
Your cost if you use
a Non-Participating
Provider (You will pay the most)
$10/visit; deductible does not apply
50% Coinsurance
50% Coinsurance
50% Coinsurance
No Charge; deductible does not apply
50% Coinsurance
Freestanding Facility: 30%
coinsurance
Hospital: 50% coinsurance
50% Coinsurance
Freestanding Facility: 30%coinsurance Hospital: 50% coinsurance
50% Coinsurance
prescription drug coverage is available here .
Retail – Preferred –
$5/prescription
Non-Preferred –
$10/prescription
Mail – $15/prescription;
deductible does not apply
deductible does not apply
Up to a 90-day supply at mail order. Specialty drugs limited to a 30-day supply. Payment of the difference between the cost of a brand name drug and a generic may also be required if a generic drug is available.
All Out-of-Network prescriptions are subject to a 50% additional charge after the applicable copay/coinsurance. Additional charge will not apply to any deductible or out-of-pocket amounts. You may be eligible to synchronize your
prescription refills, please see your benefit booklet* for details.
Any differences between the cost of the generic drug and the cost of the brand name drug will apply to the deductible or out-of-pocket maximum.
The applicable cost sharing (by tier) and the cost difference between the generic and brand will never exceed the overall cost of the drug.
The amount you may pay per 30-day supply of a covered insulin drug, regardless of quantity or type, shall not exceed $100, when obtained from a Participating Pharmacy.
Retail – Preferred – $15/prescription
Non-Preferred – $25/prescriptionMail – $45/prescription;
deductible does not apply
deductible does not apply
Preferred – 30% coinsurance
Non-Preferred – 35%
coinsurance
Retail – 35% coinsurance
Preferred – 35% coinsurance
Non-Preferred – 40%
coinsurance
Retail – 40% coinsurance
45% coinsurance
45% coinsurance
50% coinsurance
50% coinsurance
surgery
Freestanding Facility:
$600/visit plus 30%
coinsurance
Hospital: $600/visit plus 50%
coinsurance
$2,000/visit plus 50%coinsurance
$200/visit plus 50%coinsurance
50% coinsurance
medical attention
$1,000/visit plus 50%coinsurance
$1,000/visit plus 50%coinsurance
50% coinsurance
50% coinsurance
$15/visit; deductible does not apply
50% coinsurance
stay
$850/visit plus 50%coinsurance
$2,000/visit plus 50%coinsurance
Preauthorization required. Preauthorization penalty: $1,000 or 50% of the eligible charge In-Network, $500 Out-of-Network. See your benefit booklet* for details.
50% coinsurance
50% coinsurance
health, behavioral
health, or substance
abuse needs
visits; 30% coinsurance for
other outpatient services
50% coinsurance
$850/visit plus 50%coinsurance
$2,000/visit plus 50%coinsurance
Primary Care: $10;
deductible does not apply
Specialist: 50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
$850/visit plus 50%coinsurance
$2,000/visit plus 50%coinsurance
recovering or have other special health needs
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
dental or eye care
No Charge; deductible does not apply
Up to a $30 reimbursement
is available; deductible does
not apply
No Charge; deductible does not apply
Up to a $75 reimbursement isavailable; deductible does not apply
details.
Not Covered
Not Covered
*For more information about limitations and exceptions, see the plan or policy document here.
Excluded Services & Other Covered Services:
- Acupuncture
- Dental care (Adult)
- Long-term care
- Non-emergency care when traveling outside the U.S.
- Routine eye care
- Weight loss programs
- Abortion care
- Bariatric surgery
- Chiropractic care (limited to 25 visits per calendar year)
- Cosmetic surgery (only for the correction of congenital deformities or conditions resulting from accidental injuries, scars, tumors, or diseases)
- Hearing aids (for children 1 per ear every 24 months, for adults up to $2,500 per ear every 24 months)
- Infertility treatment (covered for 4 procedures per benefit period)
- Private-duty nursing (with the exception of inpatient private duty nursing)
- Routine foot care (only in connection with diabetes)
Blue Choice Preferred Silver PPO 303
2023 Plan Summary
| Important Questions | Answers | Why this Matters: |
| What is the overall deductible ? | Individual: Participating $2,250; Non-Participating $15,000 Family: Participating $6,750; Non-Participating $45,000 |
Generally, you must pay all of the costs from providers up to the deductible amount before this plan begins to pay. If you have other family members on the plan, each family member must meet their own individual deductible until the total amount of deductible expenses paid by all family members meets the overall family deductible |
| Are there services covered before you meet your deductible? | Yes. In-Network Preventive Health Care services and services with a copay are covered before you meet your deductible | This plan covers some items and services even if you haven’t yet met the deductible amount. But a copayment or coinsurance may apply. For example, this plan covers certain preventive services without cost-sharing and before you meet your deductible. See a list of covered preventive services at www.healthcare.gov/coverage/preventive-care-benefits/ . |
| Are there other deductibles for specific services? |
No | You don’t have to meet deductibles for specific services. |
| What is the out-of-pocket limit for this plan? |
Individual: Participating $9,100; Non-Participating Unlimited Family: Participating $18,200; Non- Participating Unlimited |
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other family members in this plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met. |
| What is not included in the out-of-pocket limit? |
Premiums, balance-billed charges, and health care this plan doesn’t cover. |
Even though you pay these expenses, they don’t count toward the out-of-pocket limit. |
| Will you pay less if you use a network provider? | Yes. See www.bcbsil.com
or call 1- 800-892-2803 for a list of Participating Providers. |
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider’s charge and what your plan pays (balance billing). Be aware your network provider might use an out-of-network provider for some services (such as lab work). Check with your provider before you get services. |
| Do you need a referral to see a specialist? |
No. | You can see the specialist you choose without a referral. |
Your cost if you use
a Participating
Provider (You will pay the least)
Your cost if you use
a Non-Participating
Provider (You will pay the most)
$10/visit; deductible does not apply
50% Coinsurance
50% Coinsurance
50% Coinsurance
No Charge; deductible does not apply
50% Coinsurance
Freestanding Facility: 30%
coinsurance
Hospital: 50% coinsurance
50% Coinsurance
Freestanding Facility: 30%coinsurance Hospital: 50% coinsurance
50% Coinsurance
prescription drug coverage is available here .
Retail -Preferred –
$5/prescription
Non-Preferred –
$10/prescription
Mail – $15/prescription;
deductible does not apply
deductible does not apply
Up to a 90-day supply at mail order. Specialty drugs limited to a 30-day supply. Payment of the difference between the cost of a brand name drug and a generic may also be required if a generic drug is available.
All Out-of-Network prescriptions are subject to a 50% additional charge after the applicable copay/coinsurance. Additional charge will not apply to any deductible or out-of-pocket amounts. You may be eligible to synchronize your
prescription refills, please see your benefit booklet* for details.
Any differences between the cost of the generic drug and the cost of the brand name drug will apply to the deductible or out-of-pocket maximum.
The applicable cost sharing (by tier) and the cost difference between the generic and brand will never exceed the overall cost of the drug.
The amount you may pay per 30-day supply of a covered insulin drug, regardless of quantity or type, shall not exceed $100, when obtained from a Participating Pharmacy.
Retail -Preferred – $15/prescription
Non-Preferred – $25/prescriptionMail – $45/prescription;
deductible does not apply
deductible does not apply
Preferred – 30% coinsurance
Non-Preferred – 35%
coinsurance
Retail – 35% coinsurance
Preferred – 35% coinsurance
Non-Preferred – 40%
coinsurance
Retail – 40% coinsurance
45% coinsurance
45% coinsurance
50% coinsurance
50% coinsurance
surgery
Freestanding Facility:
$600/visit plus 30%
coinsurance
Hospital: $600/visit plus 50%
coinsurance
$2,000/visit plus 50%coinsurance
$200/visit plus 50%coinsurance
50% coinsurance
medical attention
$1,000/visit plus 50%coinsurance
$1,000/visit plus 50%coinsurance
50% coinsurance
50% coinsurance
$15/visit; deductible does not apply
50% coinsurance
stay
$850/visit plus 50%coinsurance
$2,000/visit plus 50%coinsurance
Preauthorization required. Preauthorization penalty: $1,000 or 50% of the eligible charge In-Network, $500 Out-of-Network. See your benefit booklet* for details.
50% coinsurance
50% coinsurance
health, behavioral
health, or substance
abuse needs
other outpatient services
50% coinsurance
$850/visit plus 50%coinsurance
$2,000/visit plus 50%coinsurance
Primary Care: $10;
deductible does not apply
Specialist: 50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
$850/visit plus 50%coinsurance
$2,000/visit plus 50%coinsurance
recovering or have other special health needs
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
50% coinsurance
dental or eye care
No Charge; deductible does not apply
Up to a $30 reimbursement
is available; deductible does
not apply
No Charge; deductible does not apply
Up to a $75 reimbursement isavailable; deductible does not apply
details.
Not Covered
Not Covered
Excluded Services & Other Covered Services:
- Acupuncture
- Dental care (Adult)
- Long-term care
- Non-emergency care when traveling outside the U.S.
- Routine eye care
- Weight loss programs
- Abortion care
- Bariatric surgery
- Chiropractic care (limited to 25 visits per calendar year)
- Cosmetic surgery (only for the correction of congenital deformities or conditions resulting from accidental injuries, scars, tumors, or diseases)
- Hearing aids (for children 1 per ear every 24 months, for adults up to $2,500 per ear every 24 months)
- Infertility treatment (covered for 4 procedures per benefit period)
- Private-duty nursing (with the exception of inpatient private duty nursing)
- Routine foot care (only in connection with diabetes)
Blue Choice Preferred Silver PPO 706
2023 Plan Summary
| Important Questions | Answers | Why this Matters: |
| What is the overall deductible ? | Individual: Participating $5,800; Non-Participating $15,000 Family: Participating $11,600; Non-Participating $45,000 |
Generally, you must pay all of the costs from providers up to the deductible amount before this plan begins to pay. If you have other family members on the plan, each family member must meet their own individual deductible until the total amount of deductible expenses paid by all family members meets the overall family deductible |
| Are there services covered before you meet your deductible? | Yes. In-Network Preventive Health Care services and services with a copay are covered before you meet your deductible | This plan covers some items and services even if you haven’t yet met the deductible amount. But a copayment or coinsurance may apply. For example, this plan covers certain preventive services without cost-sharing and before you meet your deductible. See a list of covered preventive services at www.healthcare.gov/coverage/preventive-care-benefits/ . |
| Are there other deductibles for specific services? |
No | You don’t have to meet deductibles for specific services. |
| What is the out-of-pocket limit for this plan? |
Individual: Participating $8,900; Non-Participating Unlimited Family: Participating $17,800; Non- Participating Unlimited |
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other family members in this plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met. |
| What is not included in the out-of-pocket limit? |
Premiums, balance-billed charges, and health care this plan doesn’t cover. |
Even though you pay these expenses, they don’t count toward the out-of-pocket limit. |
| Will you pay less if you use a network provider? | Yes. See www.bcbsil.com
or call 1- 800-892-2803 for a list of Participating Providers. |
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider’s charge and what your plan pays (balance billing). Be aware your network provider might use an out-of-network provider for some services (such as lab work). Check with your provider before you get services. |
| Do you need a referral to see a specialist? |
No. | You can see the specialist you choose without a referral. |
Your cost if you use
a Participating
Provider (You will pay the least)
Your cost if you use
a Non-Participating
Provider (You will pay the most)
$40/visit; deductible does not apply
50% Coinsurance
$80/visit; deductible does not apply
50% Coinsurance
No Charge; deductible does not apply
50% Coinsurance
40% coinsurance
50% Coinsurance
40% coinsurance
50% Coinsurance
prescription drug coverage is available here .
Retail – $20/prescription
Mail – $60/prescription; deductible
does not apply
deductible does not apply
Up to a 90-day supply at mail order. Specialty drugs limited to a 30-day supply. Payment of the difference between the cost of a brand name drug and a generic may also be required if a generic drug is available.
All Out-of-Network prescriptions are subject to a 50% additional charge after the applicable copay/coinsurance. Additional charge will not apply to any deductible or out-of-pocket amounts. You may be eligible to synchronize your
prescription refills, please see your benefit booklet* for details.
Any differences between the cost of the generic drug and the cost of the brand name drug will apply to the deductible or out-of-pocket maximum.
The applicable cost sharing (by tier) and the cost difference between the generic and brand will never exceed the overall cost of the drug.
The amount you may pay per 30-day supply of a covered insulin drug, regardless of quantity or type, shall not exceed $100, when obtained from a Participating Pharmacy.
Retail – Preferred – $40/prescription
Mail – $120/prescription; deductible
does not apply
deductible does not apply
Retail – Preferred – $80/prescription. Mail – $240/prescription
Retail – $80/prescription
$350/prescription
$350/prescription
surgery
40% coinsurance
$2,000/visit plus 50%coinsurance
40% coinsurance
50% coinsurance
medical attention
40% coinsurance
40% coinsurance
40% coinsurance
40% coinsurance
$60/visit; deductible does not apply
50% coinsurance
stay
40% coinsurance
$2,000/visit plus 50%coinsurance
Preauthorization required. Preauthorization penalty: $1,000 or 50% of the eligible charge In-Network, $500 Out-of-Network. See your benefit booklet* for details.
40% coinsurance
50% coinsurance
health, behavioral
health, or substance
abuse needs
40% coinsurance for other outpatient services
50% coinsurance
40% coinsurance
$2,000/visit plus 50%coinsurance
Primary Care: $40;
deductible does not apply
Specialist: 50% coinsurance
50% coinsurance
40% coinsurance
50% coinsurance
40% coinsurance
$2,000/visit plus 50%coinsurance
recovering or have other special health needs
40% coinsurance
50% coinsurance
40% coinsurance
50% coinsurance
40% coinsurance
50% coinsurance
40% coinsurance
50% coinsurance
40% coinsurance
50% coinsurance
50% coinsurance
dental or eye care
No Charge; deductible does not apply
Up to a $30 reimbursement
is available; deductible does
not apply
No Charge; deductible does not apply
Up to a $75 reimbursement isavailable; deductible does not apply
details.
Not Covered
Not Covered
Excluded Services & Other Covered Services:
- Acupuncture
- Dental care (Adult)
- Long-term care
- Non-emergency care when traveling outside the U.S.
- Routine eye care
- Weight loss programs
- Abortion care
- Bariatric surgery
- Chiropractic care (limited to 25 visits per calendar year)
- Cosmetic surgery (only for the correction of congenital deformities or conditions resulting from accidental injuries, scars, tumors, or diseases)
- Hearing aids (for children 1 per ear every 24 months, for adults up to $2,500 per ear every 24 months)
- Infertility treatment (covered for 4 procedures per benefit period)
- Private-duty nursing (with the exception of inpatient private duty nursing)
- Routine foot care (only in connection with diabetes)