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Medical Coverage

Your health care benefits are designed to provide coverage for the care you need, encourage you to maintain your good health, and help you manage your health care costs.

Medical Benefits

Networks of health care professionals and facilities are available to help meet the health care needs of you and your family.
Plan options:

Additional Benefits

  • Rabies prophylaxis vaccination series will be covered at 100% for In-network providers.  The primary vaccination will consist of three injections of HDCV or PCECV.  One injection per day on days 0, 7, 21, or 28.
  • Veterinarians and animal staff should receive a test for the rabies virus known as a titer every two years.  This titer will be covered at 100% for In-network providers.
  • Carry Over Deductible Credit – Any deductible met in the last quarter carries over to apply to the following year.  Please note, this only applies on the Non-HDHP plans

Prescription Drug Benefits 

Your health plan includes prescription drug benefits. These benefits are administered by a pharmacy benefits manager (PBM). Prime Therapeutics®* is the PBM for BCBSIL.

Pharmacy Network

When members visit a preferred pharmacy, they may pay a lower copay or coinsurance amount for a covered non-specialty prescription drug than when visiting an in-network non-preferred pharmacy. Members can find a preferred pharmacy at myprime.com. Preferred pharmacies include Walgreens, Walmart, Albertsons (including Osco Drug) and Health Mart Atlas (group of independent pharmacies).  Please note, CVS Pharmacy is considered Out of Network.

Pharmacy Drug List

  • All plans include prescription drug benefits. The benefit plan is based on the BCBSIL Performance Drug List. Benefits include clinical programs such as Prior Authorization and Step Therapy.
  • Drug List

*Prime Therapeutics LLC is a separate pharmacy benefit management company contracted by Blue Cross and Blue Shield of Illinois (BCBSIL) to provide pharmacy benefit management and related other services. BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.