These plans have more than 7,000 primary care physician locations to choose from. These plans do now have any deductibles or claims forms. Co-pays are applied to some services.
HMO Blue Advantage Plan Comparison (Includes Premiums and Copay Amounts):
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services
The Health Maintenance Organizations (HMO) plan has more than 7,000 primary care physician locations to choose from. The HMO Plan does not have any deductibles or claim forms. Co-pays are applied to some services. Each member of your family must choose a Primary Care Physician (PCP) from the BCBS Blue Advantage Directory. Primary care physicians direct and coordinate all medical care and/or referrals to all specialists.
Each female member must choose a Woman’s Principal Health Care Provider (WCHCP) also referred to as an OB/GYN that is in the same group as her PCP and she may see this doctor as often as needed without a referral from her PCP. Please note: due to concern for continuity of care, members who are hospitalized or in the third trimester of pregnancy cannot change medical groups.
Call HMO membership customer service at (800) 892-2803, to verify that the medical site you select is currently accepting new patients and continues to participate in the BCBS Blue Advantage Plan. While you may make changes to your medical group at any time during the year, a request for change of physician must be made through the HMO membership office and can take up to 45 days. To make a change in medical groups, you may call Customer Service at (800) 892-2803 or go online to www.bcbsil.com and establish a username and password to initiate the change. You will need to continue seeing your current Medical Group and PCP until the change is effective. Once the change is made, you will receive a new ID card reflecting this change.
The plan limitations are defined in the Plan document. If Plan changes are needed due to a qualifying event, please contact Human Resources at extension 5371 or extension 5370.
NOTE: Enrolling or making changes to coverage is only allowed either 1) upon hire with the Village, 2) during open enrollment, or 3) within 30 days of a qualifying event (marriage, birth, loss of coverage, etc.)
Information concerning your privacy under the Blue Cross Blue Shield of Illinois medical plans visit bcbsil.com.
Terms to know under the BCBS Blue Advantage HMO Plan
- Primary Care Physician (PCP) is the HMO participating family practitioner, internist or pediatrician you choose as your provider of care. This doctor will provide and/or coordinate all your care.
- Co-payment is the amount or percentage the employee pays for services rendered or for prescriptions filled under this plan.
- Independent Practice Associations (IPA) are groups of doctors in private practices or small group offices that are contracted with HMO Illinois.
Important BCBSIL Phone Number:
- Membership changes and questions: (800) 892-2803
Blue 365
ALL Blue Cross Blue Shield of IL participants are eligible for discounts which may or may not necessarily be a covered expense under the Medical Plans. Blue365 offers discounts for members to save on products and services for a well balanced lifestyle. For more information, visit “https://www.blue365deals.com/”.
EyeMed Vision Care
HMO members and their dependents are covered for one routine vision exam per calendar year at no cost, and members must utilize an EyeMed provider in order for that to be covered, and to take advantage of any hardware discounts.
As a member of Blue Cross and Blue Shield of Illinois (BCBSIL), you and your covered dependents are eligible for vision care benefits through EyeMed Vision Care. Click here to view additional information regarding your benefits.
To find a Vision Provider for HMO Members (EyeMed) click on the following link: eyemedvisioncare.com/bcbsil. On the right hand side of the page, click find a provider and enter the provider's zip code. Or you can contact EyeMed Customer Service at 844-684-2254.
You are not required to have an EyeMed account to utilize your vision benefits. If you would like to check on your vision benefits, check claims, etc. online, then an account would need to be created at eyemedvisioncare.com/bcbsil. (Note: This login is separate from your Blue Access for Members (BAM) account that is used for your HMO Medical plan).
Additionally, all Blue Cross Blue Shield of Illinois offers members vision care and variety of other discounts. Visit the insurance plan pages for more information.