No obligation to enroll. Mon-Fri: 8am-10pm, Sat-Sun: 8am-9pm ET
Advertisement from our partner
TTY users 711
Request a phone call
Blue Precision Silver HMO 704℠ - Rx Copays
Health Insurance Plan Details (2024 Plan)
by Blue Cross Blue Shield of Illinois
Monthly Premium
HMO
$ubsidy
Silver
- Deductible
- $7,500 /yr
- Max Out-of-Pocket
- $9,450 /yr
Details
| Deductible (per individual) | $7,500 /yr |
| Deductible (per family) | $15,000 /yr |
| Max Out-of-Pocket (per individual) | $9,450 /yr |
| Max Out-of-Pocket (per family) | $18,900 /yr |
| Drug Deductible (per individual) | $0 |
| Drug Deductible (per family) | $0 |
| Drug Max Out-of-Pocket (per individual) | Included in Medical |
| Drug Max Out-of-Pocket (per family) | Included in Medical |
| Plan Type | HMO |
| Includes Child Dental? | No |
| Includes Adult Dental? | No |
Out-of-Pocket Costs
| Preventive Care | No Charge |
| Primary Care Visit | $100 Copay |
| Specialist Visit | $130 Copay |
| Emergency Room | $1200 Copay with deductible and 50% Coinsurance after deductible |
| Inpatient Facility | $500 Copay per Stay with deductible and 50% Coinsurance after deductible |
| Inpatient Physician | No Charge |
| Generic Drugs | $25 Copay |
| Preferred Brand Drugs | $85 Copay |
| Non-preferred Brand Drugs | $120 Copay |
| Specialty Drugs | $250 Copay |
Plan Documents
| Summary of Benefits and Coverage | SBC doc |
| Provider Directory | Doctor lookup |
| Drug Formulary List | drug list |
Insurance Carrier Disclaimer
Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
* Figures shown are only for in-network medical costs
** Please check with insurance company if Copay and Coinsurance rates are before or after the deductible
Advertisement
Health Insurance Plans
Obamacare Plans
Off-Exchange Plans
Sign Up Help
Quote & Compare
Get advice from Licensed Insurance Agents
Looking for Other Options?
Short Term Health Insurance Plans
- Top Insurance Carriers
- No Enrollment Period Restrictions
- Choose Your Coverage Level
- Emergency & Hospital Coverage
Health Plan Radar
Partner
Call for a free quote & benefits review
Find the right short term coverage for your needs.