Blue Access for Producers

BlueEdge Benefits

BlueEdgeSM gives employees freedom of choice, flexibility, a broad range of benefits and the largest contracting network in Illinois. Across the country, PPO networks are linked through the BlueCard® PPO program so it should be easy for employees to find a doctor or hospital when traveling or if some family members live, work or study anywhere in the United States.

When employees receive care from contracting PPO network doctors and hospitals:

  • Benefits are paid at the highest level.
  • There are no claim forms to complete.
  • They are not responsible for any charges above the Blue Cross and Blue Shield negotiated fee or allowable amount.
  • They do not need a referral to see the doctor of their choice.
  • Once PPO coverage begins, the only other out-of-pocket expenses are any plan-specific coinsurance payments for covered benefits, plus any charges for non-covered services.

Employees can always choose to receive care from doctors and hospitals outside the network, but benefits will be paid at a lower level.

BlueEdge Benefits Overview

Preventive Care Benefits
Services covered at 100 percent when received in network

  • Well-child and adult care, including immunizations
  • Screenings such as cholesterol, breast cancer and cervical cancer

Doctor and Hospital Benefits

  • Doctor office visits
  • Hospital and surgical care
  • Diagnostic testing
  • Emergency care benefits
  • Maternity care

Other Coverage

  • Rehabilitation therapy (physical, speech, occupational therapy)
  • Mental health and substance abuse treatment
  • Prescription drug card benefits (with mail service for maintenance medications)
  • Vision discounts
  • Hearing aid discounts
  • Reconstructive surgery following a mastectomy

Utilization Management

  • Medical Services Advisory (pre-notify inpatient hospital stays)
  • Mental health/Substance abuse

Learn More About BlueEdge

BlueEdge Product Summary
BlueEdge Benefits
Spending Accounts & the Deductible
BlueEdge FAQs