Blue Cross Blue Shield & Mental Health Coverage

Overview on Blue Cross Blue Shield of Illinois

Blue Cross Blue Shield was founded in 1929, and is the oldest nationwide provider for health insurance in the United States. They are one of the largest and most influential health insurance providers, as they service more than 106 million Americans - including millions through government-supported healthcare programs. They are contracted with more than 96% of hospitals, and 95% of medical specialists, which allows them to provide customers with unprecedented coverage. Blue Cross Blue Shield of Illinois was founded in 1936, and happily provides more than 8.1 million clients with exemplary services. Blue Cross Blue Shield offers bronze, silver, and gold insurance plans for individuals and families, businesses, and federally employed individuals. Fortunately, almost all BCBS insurance programs include coverage for mental health and substance-use disorders. All of their plans follow the guidelines of the Affordable Care Act (ACA), and provide individuals with the same set of essential health benefits which include mental health benefits.

Blue Cross Blue Shield of Illinois & Mental Health Benefits

All Blue Cross Blue Shield insurance plans provide mental health benefits as preventative care. What this means is that meeting with a psychiatrist will be treated as any other doctor visit. Your mental health is just as important as your physical health, and if you have a mental or behavioral condition that goes untreated, it can adversely affect your physical health.

The Mental Health Parity and Addiction Act (MHPAEA) was passed in 2008. The law mandated insurance providers that offer mental health benefits to provide equal or better coverage for mental health and substance-use disorders. In other words, the law required insurance providers to treat mental health conditions the same physical health conditions. The purpose of the law was to make mental health coverage more accessible to the general population. Because Blue Cross insurance plans provide mental health coverage, they consider mental health visits the same as any other doctor visit. The passage of this law was a tremendous step forward for those with mental health conditions, because they were not adequately covered by insurance providers in the past.

If you or a loved one are exhibiting symptoms of any cognitive or affective condition, it is strongly advised that you arrange a meeting with a psychiatric specialist. Psychiatric conditions are fairly common, and fortunately they are treatable. Almost all psychiatric conditions will worsen if they go untreated, and this can adversely your physical health. It is not uncommon for mental conditions to become worse enough to inhibit individuals from being able to carry out routine tasks, and lead normal daily lives.

Individual & Family Health Care Plans

Blue Cross Blue Shield of Illinois individuals and families with a myriad of plan options. They have one of the largest and most reliable networks in Illinois, and provide individuals with the option of HMO and PPO plans. PPO plans typically have higher premiums, but provide individuals with more flexibility when seeking care. Whereas, HMO plans usually have lower premium payments, but require individuals to use a primary care physician. The table below helps visualize the some of the differences and benefits of the PPO and HMO plans for Blue Cross Blue Shield of Illinois.

 

 

Blue Cross Blue Shield insurance plans are divided into bronze, silver, and gold levels of care. The medal category signifies the degree of coverage, and the premium payment for the plan. The higher the medal, the more expensive the plan, but higher medal plans provide better coverage. Lower medal plans also require individuals to pay for a larger portion of their coverage, and consequently have higher out-of-pocket maximums. When you’re selecting a plan, you will want to determine the degree of care that you or your family will need in order to adequately protect yourself, and minimize your out-of-pocket maximum.

 

BCBS Bronze Insurance Plans

The table below provides a full breakdown of the bronze insurance plans provided by Blue Cross Blue Shield of Illinois. Bronze payment plans have the lowest monthly premiums, but have the highest out-of-pocket costs when an individual is seeking care. In other words, individuals will be held accountable for a larger percentage of their total health care costs.

 

 

As the table suggests, individuals with bronze plans will be accountable for at least 40% of the cost of care after they meet their deductibles. If an individual endures a serious and expensive claim against their policy, like an operation for a broken bone, they will be forced to pay for at least 40% of the cost of care. So, if an individual has an operation that costs $12,000, they will be required to pay for at least $4,800. Bronze insurance plans are best for individuals that rarely seek or need medical care.

 

BCBS Silver Insurance Plans

Silver insurance plans are one step above Bronze insurance plans. They have marginally higher premiums, but provide individuals with better coverage and have lower out-of-pocket maximum payments. Silver plans are best for individuals that require a moderate amount of care on a regular basis.

 

 

As you can see, Silver plans have significantly lower deductibles than Bronze plans. Meaning that individuals will have to spend less money before Blue Cross Blue Shield begins to pay for covered services. They also have lower copayments and coinsurance costs.

 

BCBS Gold Insurance Plans

Gold insurance plans are the best plans that Blue Cross Blue Shield of Illinois has to offer. Despite their higher premiums, Blue Cross Blue Shield will be held accountable for approximately 80% of the total cost of covered services. Gold plans have the lowest deductibles, copayments and coinsurance. If you or your family in need of more health care services than the average person or family, gold plans will serve as the best available option because they are the most cost effective option in the long-term.

 

 

The deductibles on Gold plans are half of the amount of Silver deductibles, and more than three times less expensive than Bronze deductibles. This means that Blue Cross Blue Shield will begin paying for covered services at a much faster rate. This helps to minimize individuals out-of-pocket costs.

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