The Community Participating Option (CPO) plan gives members freedom of choice, flexibility, a broad range of benefit options, and offers the convenience and security of local contracting doctors and hospitals. With the CPO plan:
- You have access to the large Participating Provider Option (PPO) network of contracting doctors and hospitals throughout Illinois.
- There is no need to select a primary care physician because you can choose a doctor whenever you need care.
- You do not need a referral to see a specialist or to get another opinion about a medical condition.
- The choice of doctors and is always yours.
CPO Benefits
With the CPO plan, benefits may include coverage for:
- Doctor office visits
- Inpatient hospital services
- Outpatient hospital services
- Maternity care
- Hospital emergency medical and accident treatment
- Breast and cervical cancer screenings
- Muscle manipulation services
- Physical, speech and occupational therapies
- Infertility treatment
- Mental health and chemical dependency treatment
- Reconstructive surgery following a mastectomy
Preventive Care
CPO coverage may include preventive care benefits for well-child and adult care, including:
- Physical exams
- Diagnostic tests
- Immunizations
Group plan coverage may vary.
Use Network Doctors and Hospitals for Greater Benefits
When you receive care from network CPO doctors and hospitals:
- Benefits are paid at the highest level.
- There are no claim forms to complete.
- There are no up-front payments for medical services (except for copayments) and charges for non-covered services.
- There’s no balance billing—network doctors and hospitals accept Blue Cross and Blue Shield of Illinois’ negotiated rates.
You also have the option to use a network PPO doctor or hospital. Benefits are paid in-network, but at a lower level than services from CPO network doctors and hospitals.
You always have the option to receive care outside the network, but benefits will be paid at the lowest level.
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