Blue Cross Introduces New Tiered PPO Plan

Effective January 1st 2015, Blue Cross and Blue Shield of Illinois released a new PPO product called Blue Choice Options PPO. This plan uses a three tier system to offer a benefit level in between traditional BCBS PPO and Blue Choice.

Due to the use of “Blue Choice” in the name of this plan, providers have reported confusion over whether they are in-network. Please note that you are considered an in-network provider for these patients if you are either a contracted Blue Choice PPO or a regular PPO provider.

Tier 1 – Claims are processed at this tier when the smaller Blue Choice network is used. Tier 1 provides the low- est out-of-pocket expenses to the member.

Tier 2 – Claims are processed at this tier when the broader Blue Cross PPO network is used. While still “in-net- work,” tier 2 has a higher out-of-pocket expense.

Tier 3 – Claims are processed at this tier when a non-participating provider is used. Tier 3 benefits leave the member with the highest out-of-pock expenses.

You can identify Blue Choice Options PPO members in the following ways:
1 – The product name “Blue Choice Options” appears on the front of the ID card in the lower left corner.
2 – The network code for Blue Choice options is BCO and appears in Red on the lower left front of the ID card. 3 – Statement on the back of the card reads “This plan uses the Blue Choice OPT (BCO) network with tiered

benefits.”