SelectBlue^®

Umbrella Coverage Plans

SelectBlue Plan Comparison Chart

Benefit Highlight	SelectBlue^®	SelectBlue Advantage^SM	BlueChoice^SM Select
Participating providers Participating Providers The preferred providers covered at 100% of eligible benefits.	PPO Network 90% of IL doctors; over 200 IL hospitals		BlueChoice network¹
Individual Deductible Annual deductible The amount you must pay before your plan begins paying.
$0	√
$250	√	√
$500	√	√
$1,000	√	√
$1,750		√
$2,500	√	√
$5,000	√	√
Individual Out-of-Pocket Expense Limit Out-of-pocket expense limit The maximum amount you will have to pay per year in addition to any applicable deductibles.	$1,000	$3,000
Well-Adult Care	You pay $20 copayment	You pay $30 copayment
Well-Child Care	You pay $20 copayment	You pay $30 copayment
Coinsurance Coinsurance The percentage you pay for services after your deductible and applicable copayments are met.	You pay 0% or 20%	You pay 20%
Optional Maternity Coverage Coinsurance	You pay 0% or 20%	You pay 20%
Prescription Drugs	$0, $250, $500 deductible: Drug card with $10 copayment for generics	$250, $500 deductible: Drug card with $10 copayment for generics
Prescription Drugs	All other deductibles: You pay 20%	All other deductibles: You pay 20%
	Outline of Coverage	Outline of Coverage	Outline of Coverage

Copayments

The fixed amount you pay for each doctor office visit.

1. 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.

Get a Quote

Individual & Family Plans Only