Health insurance costs include monthly premium payments, individual/family deductibles, out-of-pocket expenses, copayments, and coinsurance. Here is what you can expect with SelectBlue^® plans:

• Individual in-network deductibles ranging from $0 to $5000 – customize your plan by choosing a deductible amount that works best for your situation
• $20-$30 copayment for non-preventive care outpatient physician services
• $75 copayment for outpatient emergency care
• $10 copayments for generic prescription drugs
• Coinsurance ranging from 0 to 20 percent of services provided in-network, after deductible and copayments are met
• Annual out-of-pocket maximum of $1000-$3,000 for individuals and $3,000-$9,000 for families

BlueChoice^® Select Only: The BlueChoice network allows you to save on premiums and the cost of covered services when you use a contracting BlueChoice^® hospital, doctor or specialist. You do not need to select a primary care physician or obtain a referral to see a specialist.

For more information on costs, get a quick quote or see the Outline of Coverage documents under What’s Included with SelectBlue - More Plan Details.

• Coverage for major hospital, medical and surgical expenses incurred as a result of a covered accident or sickness
• Coverage for daily hospital room and board, miscellaneous hospital services, surgical services, anesthesia services, in-hospital medical services, and out-of-hospital care
• Although you can go to the hospital or doctor of your choice, your benefits under a SelectBlue^® plan will be higher, and your costs lower, when you use the services of participating PPO or BlueChoice^® providers.
• As with all individual Blue Cross and Blue Shield of Illinois plans, the freedom of not having to select a primary care doctor or obtain a referral to see a specialist

More Plan Details

It’s important to know the critical features of the health plan you are considering. Each plan’s Outline of Coverage provides brief descriptions of the basic provisions of our SelectBlue^® plans, as well as details on policy renewability, benefit exclusions and coverage limitations.

The information in the Outline of Coverage does not incorporate changes mandated by the Affordable Care Act of 2010  and is not reflective of the final benefits for products with an October 1, 2010, or later effective date. Please view the Important Notice Regarding Your Benefits for additional information regarding Affordable Care Act benefits.

• SelectBlue Outline of Coverage 
• SelectBlue Advantage Outline of Coverage 
• BlueChoice Select Outline of Coverage 

• Important Notice Regarding Your Benefits 

At Blue Cross and Blue Shield of Illinois, we understand your concerns about coverage continuity. Blue Cross and Blue Shield of Illinois will never terminate or refuse to renew your Policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a plan may be terminated or a renewal refused:

• Failure to pay
• The plan is discontinued (90 days notice given with an option to convert to any plan we offer)
• Discovery of fraud or an intentional misrepresentation of facts (30 days prior written notice given)
• If you no longer reside, live or work in an area where we are authorized to do business

For more information on plan renewability, see the Outline of Coverage documents under What’s Included with SelectBlue - More Plan Details.

Every insurance plan has limitations. These limits are there to keep health care costs down for everyone. A pre-existing condition is just one example of a plan limitation. For example:

• A pre-existing condition may limit or exclude your participation in a plan. This means your health care expenses related to that specific condition will not be covered by the plan during the specified time.
• There is a waiting period of 365 days for pre-existing conditions, including optional maternity coverage.
• Children under 19 cannot be denied coverage due to a pre-existing condition(s).

It’s important to know the limitations of your health plan. For a list of exclusions and limitations, see the Outline of Coverage documents under What’s Included with SelectBlue^® - More Plan Details.

You can customize any SelectBlue plan with add-on coverage and insurance.

Optional Maternity Coverage

• Covers inpatient and outpatient hospital services
• Includes coverage for medical and surgical services
• Maternity benefits begin 365 days after the effective date of the maternity coverage

Optional Dental Coverage

• Covers cleanings, check-ups and other preventive procedures immediately – no waiting period
• One of the highest maximum benefit amounts available – up to $1,500 per person per year
• Up to 20 percent discount for orthodontic services at participating providers
• Learn more about optional dental coverage

• Your out-of-pocket cost for prescription drugs will vary based on the plan deductible you choose.
• Your out-of-pocket cost for prescription drugs usually is less when you choose generic or formulary brand drugs.
• Your benefit plan includes a mail service program that offers you the convenience of having covered maintenance medications delivered directly to you.
• Members have access to a variety of online tools that can help you learn more about prescription drugs and manage your pharmacy benefit.
• Prescription Drug Utilization/Benefit Management Programs are being added to policies with effective dates on or after 1/1/2012. See Compare Plans Chart for more information.