BlueChoice Select® Value Choice
(51-150 employees) (151+ employees)
BlueChoice Select Value Choice plan designs offer lower cost options to employers with a low deductible and higher out of pocket expense without any benefit maximums. Members can see any physician for care and do not need referrals to see specialists. This product is available only in specific areas of Illinois (check with your Blue Cross and Blue Shield of Illinois account representative or broker for details).
In-Network Benefits — 80% / 50% Coinsurance
| Coinsurance | Deductible (Individual/Family) | Out-of-Pocket Max* (Individual/Family) | Office Visit/ Emergency Room Copay |
|---|---|---|---|
| 80% | $250 / $750 | $2,500 / $7,500 | 80% |
| 80% | $250 / $750 | $5,000 / $15,000 | 80% |
| 80% | $500 / $1,500 | $5,000 / $15,000 | 80% |
| 80% | $1,000 / $3,000 | $2,500 / $7,500 | 80% |
| 80% | $1,000 / $3,000 | $5,000 / $15,000 | 80% |
Out-of-Network Benefits
| Coinsurance | Deductible (Individual/Family) | Out-of-Pocket Max* (Individual/Family) |
|---|---|---|
| 50% | $500 / $1,500 | $5,000 / $15,000 |
| 50% | $500 / $1,500 | $10,000 / $30,000 |
| 50% | $1,000 / $3,000 | $10,000 / $30,000 |
| 50% | $2,000 / $6,000 | $5,000 / $15,000 |
| 50% | $2,000 / $6,000 | $10,000 / $30,000 |
* The out-of-pocket maximums does not include the deductible.
Contact Us
Blue Cross and Blue Shield of Illinois
300 East Randolph Street
Chicago, Illinois 60601-5099
(800) 654-7385
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