MEDICAL
What are your usual healthcare needs?
Do you have frequent doctor or urgent care visits? Do you have a condition that requires a specialist? Do you take prescription medications? Compare how each plan covers the services you need most often.
Do you prefer specific doctors or hospitals?
If you want to stay with your favorite doctors and facilities, check whether they are in the plan’s network. If they are not, and you are comfortable paying a bit more to see them, consider a plan with both in-network and out-of-network benefits.
To find a provider in the network, go to bcbsil.com and select from the Find Care dropdown menu. Log in or Search as Guest with the plan/network: Participating Provider Organization (PPO).
Consider the bottom line.
How much is the payroll deduction? Do you have to meet a deductible? What is the out-of-pocket maximum? How much of the cost is covered by the plan? How much are copayments for office visits, prescriptions, etc. All of these factors together affect your total cost for healthcare.
Which plan is right for you?
That depends on your healthcare needs, doctors and budget.
● PPO Plan
● HSA Plan 1
● HSA Plan 2
Medical Plan Options
You have the choice between three different medical plans all administered by BlueCross BlueShield of IL (BCBSIL). The first is a traditional PPO medical plan and the other two are High Deductible Health Plans (HSA compatible).
The PPO (Preferred Provider Organization) Plan might be right for you if:
- You want to be able to see any provider, even a specialist, without a referral
- You are willing to pay more to see out-of-network providers
A High Deductible Health Plan (HDHP) might be right for you if:
- You want to be able to see any provider, even a specialist, without a referral
- You are willing to pay more to see out-of-network providers
- You want tax-free savings on your healthcare costs
- You want to build a savings account for future healthcare costs for you and your eligible family members
- You want an extra way to add to your retirement savings.
Who Is Eligible?
All full time associates scheduled to work 30+ hours per week.
Provider Networks
All three of the BCBSIL medical plan options allow you to partner with providers, facilities, and hospitals across the national network.
All Associates Residing Outside IL, NJ and WI: BlueCard Network (Standard)
BlueCard network is the standard network for your BCBSIL medical plan involving the traditional two-tiered network for in-network benefits and out-of-network benefits.
Associates Residing in Illinois: Blue Choice Options (BCO)
Members residing in IL will utilize the Blue Choice Options (BCO) network. BCO is a three-tier network plan for members who want the benefits of a PPO and the flexibility to use a large network when the need arises — all at a price lower than our traditional BlueCard Network. Blue Choice Options offers the same range of health care benefits and member services as the larger PPO network but may save you money over other PPO health plans.
- Tier 1 – You pay the least out-of-pocket cost by using a participating provider in the Blue Choice OPT PPO network.
- Tier 2 – You pay an additional out-of-pocket cost by choosing a participating provider in the larger PPO network.
- Tier 3 – You pay the highest out-of-pocket cost by selecting an out-of-network provider.
Associates Residing in New Jersey and Wisconsin: Select Networks
Members residing in NJ and WI will utilize the respective Select Networks. The Select Network offers better discounts for providers that lead to lower costs for associates. Plan design mirrors the BlueCard network with in-network benefits and out-of-network benefits for the PPO and HSA plans.
All Associates: Carrum: Bundled Surgeries of Excellence
Carrum is here to provide you with the highest-quality healthcare experience possible for far less cost for your surgeries. The following types of surgeries are required to be utilized by the Carrum network in order to have your benefits covered: Joint, weight loss, and spine.
More information regarding Carrum Health below.
CVS / Caremark: Pharmacy
The pharmacy benefits are administered through the CVS/Caremark network of nationwide retail pharmacies.
Blue Access for Members
Save time with self-service support tools and health and wellness resources available through a convenient and secure website.
- Check the status of your claims
- Print a temporary ID card
- View claim history
- Review and print an EOB
- Find a doctor with the Provider Finder
- Find the prescription drug formulary
Go to bcbsil.com/member and log in to Blue Access for Members via web or mobile.
Benefits Value Advisor
Speak to a BCBSIL Benefits Value Advisor (BVA) who can help you navigate through the healthcare system. Advisors can assist with:
- Understanding your benefits
- Finding in-network providers
- Comparing Costs
- Scheduling Appointments
- Helping with pre-certification for in-network providers
- Guiding you to online educational tools
- Contacting providers for many conditions, including scans, procedures and surgery.
BVAs are available 24/7 and can be reached at (844) 297-2583 via phone or live chat.
Mobile App
With the BCBSIL App, you can manage your health care information whenever, wherever.
- Access temporary digital member ID card
- Find an in-network doctor, hospital or urgent care facility or search for Spanish-speaking doctors
- Access your claims, coverage and deductible information
- Secure login with Face ID
- (iOS only) and Fingerprint ID
To download the app, go to Google Play, the App Store or text BCBSILAPP to 33633.
Your BCBSIL ID Cards
For 2025, all members will be receiving new ID cards. Two ID cards are provided for family coverage.
You can call (844) 297-2583 or log on to Blue Access for Members to order additional or replacement ID cards.
NEW!
Who Is Eligible?
All full time associates scheduled to work 30+ hours per week and enrolled in any of the BCBSIL medical plans and their dependents 18+.
What is Carrum?
Today, more than ever, having surgery can be complicated and costly. Carrum Health is a surgery and medical benefit that makes it easier, more comfortable, and less expensive to get the highest-quality health care for a variety of procedures including knee, hip, shoulder, spine, heart, and weight loss surgeries, cancer care, and more.
Beginning January 1, 2025, anyone enrolled in a medical plan and in need of bariatric surgery, total joint replacement surgery, or spinal fusions will be required to go through Carrum Health. If you get one of these surgeries outside of Carrum, it will not be covered.
Required Surgeries
Hip Replacement
Knee Replacement
Spinal Fusion
Bariatric Procedures
Non-Required Surgeries
Orthopedic
Cardiac
Cancer
Other general surgery
Note: This may not be a complete list of all required and non-required surgeries. Please contact Carrum before you schedule your procedure to make sure you are using a network provider
Total Support
Your personal care specialist makes sure you have a simplified care experience. Carrum helps with all planning and paperwork, allowing you to focus on your health. If you need to travel for care, your personal care specialist will make your travel arrangements and Carrum will cover the costs for you and a companion.
How it Works
- Register for Carrum Health
- Complete an initial questionnaire to access top specialists located close to you
- See how much you will save compared to your traditional insurance plan
- Meet you care specialist. A dedicated care specialist will be with you every step of the way to answer your questions, gather information you need, and schedule an initial consultation
- Receive world-class care
To learn more or apply visit Crate & Barrel and Carrum Health or call 888.855.7806
Medical Plans
* Indicates the coinsurance after the deductible has been satisfied
To find a provider in the network, go to bcbsil.com and select from the Find Care dropdown menu.
Log in or Search as Guest with the plan/network: Participating Provider Organization (PPO).
PHARMACY
Who Is Eligible?
All full time associates scheduled to work 30+ hours per week and enrolled in any of the BCBSIL medical plans.
Pharmacy Plans
* Indicates the coinsurance after the deductible has been satisfied
+ Out-of-Network Pharmacy is not covered
Note: If you are an IL resident, you will utilize the IL BCO Network: a 3-tier network with different benefit amounts depending on where you access your care. The difference is coinsurance amounts of Tier-1 80% (designated network), Tier-2 70% (standard network), and Tier-3 60% (out-of-network). Please use the provider finder network to identify which tier your current provider is part of and to receive the lowest cost for your care.
Note: NJ and WI residents will be joining the Select Network. Plan designs mirrors PPO / HSA plans
CVS/Caremark provides a benefit that is important to your overall health, whether you need a prescription for a short-term health issue or an ongoing condition.
Understanding the formulary can save you money.
$ Generic Drug
$ Brand Name Drug
$$ Specialty Drug
Download the CVS Caremark® mobile app from Google Play or the App Store to register your account.
What is a formulary?
A drug formulary is a list of prescription drugs covered by your medical plan. Most prescription drug formularies separate the medications they cover into four or five drug categories, or “tiers.” These groupings range from least expensive to most expensive cost to you. “Preferred” drugs generally cost you less than “non-preferred” drugs.
- Performance Drug List - Standard Control for Clients with Advanced Control Specialty Formulary
- Advanced Control Specialty Formulary
Get the most from your coverage
To get the most out of your prescription drug coverage, note where your prescriptions fall within the plan’s drug formulary tiers and ask your doctor for advice. Generic drugs are usually the lowest cost option. Generics are required by the Food and Drug Administration (FDA) to perform the same as brand-name drug equivalents.
To find out if a drug is on the plan’s formulary, visit Caremark.com or call the customer service number on your ID card.
Mobile App
The mobile app gives you a secure, simple way to manage your prescription benefits and member information. You’ll find easy-to-use tools that help you save time, get organized and stay on your path to better health.
- Find a nearby pharmacy no matter where you are.
- Keep an eye on drug costs and check for lower-cost alternatives that may save you money.
- Order and track refills – even get timely refill reminders – so you never miss a dose.
- Access your Rx list, member ID cards and Rx history at your doctor’s office or anytime you need them.
For savings opportunities and personalized support, visit Caremark.com/welcome-center,
download the app or call (800) 966-5772 for the Crate & Barrel customer care team.
Virtual Checkup
Making health checkups easier for you.
No hassles. No hoops to jump through.
No cost to you.
1. Order your Home Kit
Signing up takes less than 2 minutes. It has everything you need to complete your assessment in a few short minutes. And, we’ve included a little something extra, just for you.
2. Complete your checkup on your schedule
Follow the instructions inside your Home Kit and return your lab sample to us using the enclosed return packaging. Most people return their sample in 2-3 days.
2. Attend your private, virtual consultation
We’ll contact you to find a convenient time for you to review your results and develop a personalized action plan with a licensed nurse practitioner.
What's included in your Home Kit:
- An accurate blood pressure monitor that you get to keep.
- A compact reusable hand warmer.
- A virtually painless sample collection device. No finger stick!
- Easy to complete and return packaging.
- Easy to follow directions with video examples.
Wellbeing Incentive
To earn the wellbeing incentive for 2025 you must complete a biometric screening or a wellbeing physical exam AND a health risk assessment by December 31st 2024. Catapult Health is our preferred vendor for at home biometric screenings.
Virtual Check Up with Catapult
Health Risk Assessments
- Visit wellontarget.com and log in. If you have an existing Blue Access for Members SM (BAMSM) account, use your BAM username and password. If you aren’t a registered user yet, click “Register Now” to create an account.
- If you have not taken your HA, there will be a pop-up notification after you log in. You can also take your HA by clicking on “Start” in the “Health Assessment” box at the top of your dashboard. Once you have completed the HA, your reports will be available in this section.
Summary of Benefits and Coverage