Blue Advantage Entrepreneur HMOSM Product Overview
The Blue Advantage Entrepreneur HMO product is available to groups of 2+ employees.
- Members choose a contracting medical group/independent practice association from a large HMO network.
- There is no annual deductible and generally no claim forms.
- Copayment levels are low.
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
- 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
Blue Advantage HMOSM is a broad provider network of contracting medical group/independent practice associations (IPAs) and contracting hospitals at a more affordable cost.
Check with your Blue Cross and Blue Shield of Illinois representative to determine which package is the best fit for your client's company.
*Members of Physicians Care Network, Inc. coordinates mental health care directly with the behavioral health network provider.