Blue Cross Alternative

Plans Designs


	Effective December 1, 2000: The Blue Cross Alternative now covers non admitted emergencies.

The Alternative from Blue Cross and Blue Shield pays hospital and surgical charges only. Most outpatient charges, including the cost for outpatient prescriptions, are Not Covered. When using preferred providers, coverage is 80% after deductible. Coverage is 60% after deductible when care is received from a non-participating provider.

We believe that this shoudl be insurance of the last resort. We believe that you should get comprehensive coverage that covers inpatient and outpatient expenses.

This plan is for Illinois Residents.

Plan Highlights
PPO Network	Blue Cross
Maternity	No
Well Care	No
Rx Card	No RX Coverage
Office Copay	Not covered
App. Fee	No
See The Brochure (1.5mb) .pdf

The following summary is NOT a solicitation to sell you insurance. Solicitations can only be made with state, and insurance company, approved brochures. Information contained in this web may contain generalities or inaccuracies. Please read the brochures and policies for specific limitations and exclusions.


	Plan Summary

Benefit Description	In Network Benefits	Out of Network Benefits
Calendar Year Deductible (3x per family)	$500 to $2500
Coinsurance	80%	80% & 60%
Out of pocket limit (plus deductible 3x per family)	$1000 or $2000	$5,000 or $10,000
Primary care and specialist Office visits	Not covered	Not Covered
Hospital Charges	Subject to deductible, then covered at 80%	Subject to deductible, then covered at 60%
Preventive care and Office visits	Not covered	Not covered
Other Physician Services Surgical procedures Assistant surgeons Anesthesia	Subject to deductible, then covered at 80%	Subject to deductible, then covered at 80%
Hospital Services Inpatient Outpatient surgical facility Other Outpatient charges covered only if related to inpatient stay or surgery. Outpatient X-ray, lab test, diagnostic imaging, radiation therapy.	Subject to deductible, then covered at 80%	Subject to deductible, then covered at 60% Additional $300 Deductible per inpatient admission.
Other Services Radiation Chemotherapy Renal Dialysis Ambulance	Subject to deductible, then covered at 80%	Subject to deductible, then covered at 80%
Prescriptions Electronic filing at most major Rx.	Not covered	Not covered
-Outpatient Emergency, - Pre 12/1/2000	Deductible Waived, Covered at 80% Illness Covered only if admitted to the hospital hospital.
-Outpatient Emergency, - Post 12/1/2000	Covered at 80% after $125 copayment. Deductible waived
LIFETIME MAXIMUM	$5,000,000

Preexisting condition clause - Preexisting conditions are those health conditions which were diagnosed or treated by a provider during the 12 months prior to the coverage effective date, or for where symptoms existed which would cause an ordinarily prudent person to seek diagnosis or treatment. Any Preexisting condition will be subject to a waiting period of 365 days.

Blue Cross Members First Package of benefits included:

Vision Plan -Pay Just $25 for an eye exam for glasses. Discounts from 100 statewide centers. Not covered by plan.

Dental Program -Reduced pricing from member dentists save 25% or more. Not covered by plan.

Hearing Program - receive discounts on hearing aids and hearing aid evaluations. Pay as little as $49 for a basic hearing exam.

Pre-certification - Notification required prior to all elective hospital admissions. Emergency and Maternity notification required within 2 business days of admission.