Blue Precision – Bronze HMO Plans – 2024
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The plans below use the Blue Precision HMO network, one the largest HMO networks in Illinois. 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. Bronze plans may be for you if you have fewer medical needs, would rather have a low monthly payment, and don’t take prescription drugs regularly.
Below is a summary of the three Blue Choice Preferred Bronze Plan Options. Please visit the toggles below to see plan information in detail.
There are 3 Bronze HMO plans:
- Blue Precision Bronze HMO 205 – $7,400 individual deductible and 50% coinsurance
- Blue Precision Bronze HMO 701 – $1,500 individual deductible and 50% coinsurance
- Blue Precision Bronze HMO Standard – Select Rx Copays – $7,500 individual deductible and 50% coinsurance
Compare the features, options and costs of Bronze® 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.
See toggles below for plan comparisons. Information is based on Participating Providers. For Non-Participating Provider information, please download the plan summaries listed above.
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Deductibles
| 205 | 701 | Standard ? Select Rx Copays | |
|---|---|---|---|
|
Overall Deductible Individual/Family
|
$7,400 / $14,800 | $1,500 / $3,000 | $7,500 / $15,000 |
|
Are there services covered before you meet deductible
|
Yes. | Yes. | Yes. |
|
Are there other deductibles for specific services
|
No. | No. | No. |
|
Out-of-pocket limit Individual/Family**
|
$9,200 / $18,400 | $9,200 / $18,400 | $9,200 / $18,400 |
|
Will you pay less if you use network provider?
|
Yes. | Yes. | Yes. |
|
Referral to see a specialist?
|
Yes. | Yes. | Yes. |
**Premiums, balance billing & health care this plan doesn’t cover are not included in the out-of-pocket limit
Office Visit / Testing
| 205 | 701 | Standard ? Select Rx Copays | |
|---|---|---|---|
|
Primary Care for injury/illness
|
$65/visit | $90/visit | $50/visit |
|
Specialist visit
|
$105/visit | $160/visit | $100/visit |
|
Preventative care/screening
|
No Charge | No Charge | No Charge |
|
Diagnostic test (xray, blood)
|
$100/lab, $150/xray | $250/test | 50% |
|
Imaging (CT/PET/MRI)
|
$300/test | $450/test | 50% |
**Premiums, balance billing & health care this plan doesn’t cover are not included in the out-of-pocket limit
Generic / Brand / Specialty Drug Comparison
If you need Drugs to treat your illness or condition. For information on whether or not deductibles apply, please download the plan summaries
| 205 | 701 | Standard ? Select Rx Copays | |
|---|---|---|---|
|
Generic Drugs (Preferred)
|
10% | $40 / $120 | $25 / $75 |
|
Generic Drugs (Non Preferred)
|
15% | $150 / $450 | $25 / $75 |
|
Brand drugs (Preferred)
|
20% | 35% | $50 / $150 |
|
Brand Drugs Non Preferred
|
30% | 40% | $100 / $300 |
|
Specialty Drugs Preferred
|
40% | 45% | $500 |
|
Specialty Drugs Non Preferred
|
50% | 50% | $500 |
Outpatient Surgery / Emergency Comparison
| 205 | 701 | Standard ? Select Rx Copays | |
|---|---|---|---|
|
Facility Fee Freestanding
|
$300/visit + 50% | $750/visit + 50% | 50% |
|
Facility fee Hospital
|
NA | NA | N/A |
|
Physician/surgeon Fee
|
$150/visit | $400/visit | 50% |
|
Emergency Room Care
|
$1,000/visit + 50% | $2,000/visit + 50% | 50% |
|
Emergency Medical Transportation
|
50% | 50% | 50% |
|
Urgent Care
|
$105/visit | $160/visit | $75/visit |
Hospital Stay / Health Services / Pregnancy
| 205 | 701 | Standard ? Select Rx Copays | |
|---|---|---|---|
|
Facility Fee for hospital stay
|
$850/visit | $1,500/day + 50% | 50% |
|
Physician/surgeon Fees
|
No Charge | No Charge | No Charge |
|
Mental health, behavioral health, or substance abuse services: Outpatient
|
$65 office, 50% other | $90 office, 50% other | $50 office, 50% other |
|
Mental health, behavioral health, or substance abuse services: Inpatient
|
$850/day | $1,500/day + 50% | 50% |
|
If you are pregnant ? office visit
|
Primary: $65 / Specialist: $105 | Primary: $90 / Specialist: $160 | Primary: $50 / Specialist: $100 |
|
Childbirth/delivery/professional services
|
No Charge | No Charge | No Charge |
|
Childbirth/delivery facility services
|
$850/visit | $1,500/day + 50% | 50% |
Help recovering / other special needs
| 205 | 701 | Standard ? Select Rx Copays | |
|---|---|---|---|
|
Home Health Care
|
No Charge | No Charge | No Charge |
|
Rehabilitation Services
|
$65/visit | $90/visit | $50/visit |
|
Habilitation services
|
$65/visit | $90/visit | $50/visit |
|
Skilled nursing care
|
$500/day | $800/day | 50% |
|
Durable medical equipment
|
No Charge | No Charge | No Charge |
|
Hospice services
|
50% | 50% | 50% |
Childrens Dental / Eye care
| 205 | 701 | Standard ? Select Rx Copays | |
|---|---|---|---|
|
Children?s eye exam
|
No Charge | No Charge | No Charge |
|
Children?s Glasses
|
No Charge | No Charge | No Charge |
|
Children?s Dental check-up
|
Not Covered | Not Covered | Not Covered |
Excluded & Other Covered Services
Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.)
| 205 | 701 | Standard ? Select Rx Copays | |
|---|---|---|---|
|
Acupuncture
|
? | ? | ? |
|
Dental Care (Adult)
|
? | ? | ? |
|
Long-term Care
|
? | ? | ? |
|
Non-emergency care when traveling outside of US
|
? | ? | ? |
|
Weight loss programs
|
? | ? | ? |
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
| 205 | 701 | Standard ? Select Rx Copays | |
|---|---|---|---|
|
Abortion care
|
? | ? | ? |
|
Bariatric surgery
|
? | ? | ? |
|
Chiropractic care
|
? | ? | ? |
|
Cosmetic surgery
|
? | ? | ? |
|
Hearing aids
|
? | ? | ? |
|
Infertility treatment
|
? | ? | ? |
|
Private-duty nursing
|
? | ? | ? |
|
Routine eye care
|
? | ? | ? |
|
Routine Foot Care
|
? | ? | ? |
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