BluePrint^SM: HMO

(51-150 employees)

Advantages

• Members choose a contracting medical group/independent practice association from one of the largest HMO networks in the state.
• There's no annual deductible and generally no claim forms.
• Copayment levels are low.

Benefits

Members also enjoy access to a range of benefits when care is provided/coordinated through their primary care provider (PCP).

• Doctor office visits
• Preventive care and wellness services for children and adults such as:
  • Routine physicals
  • Immunizations
  • Tests and screenings for breast and cervical cancer, prostate and colon cancer
• Outpatient surgery and diagnostic tests
• Outpatient and inpatient hospital services and treatments
• Maternity care
• Mental health and substance abuse (inpatient and outpatient)*
• Rehabilitative therapy (such as physical, speech and occupational)

Other coverage that does not require a PCP referral includes:

• Emergency care
• Out-of-area coverage (traveling/temporarily living out of state)
• Substance abuse treatment (inpatient and outpatient)
• Vision exams at the cost of an office visit copayment; discounts on lenses, frames and permanent contact lenses, vision correction surgery and disposable contact lenses
• Discounts on hearing aids
• Discounts on chiropractic care, acupuncture, massage therapy and health and wellness products
• Prescription drug card benefit with 90-day supply program for maintenance medications

Network Choices

Qualifying employers can offer employees one or both Blue Cross and Blue Shield of Illinois HMO networks. Having more network options gives you greater flexibility to design the health care benefits that suit your budget - and are affordable and attractive to employees.

Depending on the group size they can offer:

• BlueAdvantage HMO - A broad provider network of contracting medical groups/independent practice associations and contracting hospitals at a more affordable cost.
• HMO Illinois - One of the largest networks of primary care physicians (PCPs) and hospitals in the state at a higher cost.

Check with your Blue Cross and Blue Shield of Illinois representative to determine which package is the best fit for your company.

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Compare benefit plan designs

*Members of Physicians Care Network, Inc. coordinates mental health care directly with the behavioral health network provider.