Medical, Pharmacy, and Vision
Blue Solutions® for Small Employers
Choose from our wide variety of medical plans to help you strike the right balance between coverage and cost. Blue Solutions plans include all ten essential health benefits required by the Affordable Care Act, like doctor visits, hospital stays, and preventive care.
Our comprehensive medical plans feature:
Prescription drugs are a covered essential health benefit. We give your employees choices to help them lower their out-of-pocket costs. They can access up to 68,000 participating retail pharmacies in the FutureScripts® network* and take advantage of mail order for additional savings and convenience.
Pediatric vision is a covered essential health benefit for enrolled dependents up to age 19. Additionally, our plans include enhanced vision benefits for adults age 19 and older to help your employees get eyeglasses or contact lenses as well as regular eye exams, which can help them stay healthier by detecting chronic conditions such as diabetes. The Davis Vision® network offers a choice of more than 40,000 participating ophthalmologists, optometrists, and regional and national eyewear retailers, and your employees can maximize their vision benefits by using Visionworks† locations.
Pediatric dental is a covered essential health benefit for enrolled dependents up to age 19. Administered by United Concordia Dental, pediatric dental coverage includes $0 in-network preventive exams and diagnostic treatment to help children maintain good oral health. We also offer you the option to add adult dental benefits to your medical plans.
Download our 2016 Blue Solutions Overview Brochure for complete details.
Personal Choice® PPO Plans
PPO plans offer your employees flexibility to choose choose in-network (preferred) or out-of-network (non-preferred) providers. The choice is always theirs to make. Much higher out-of-pocket costs may apply for out-of-network care.
- In- and out-of-network coverage
- Freedom to see any doctor or specialist without referrals
- In-network benefits available coast-to-coast through the BlueCard® PPO network and around the world through BlueCard Worldwide®
Keystone Direct POS Plans
Direct POS plans provide both in- and out-of-network coverage, with the flexibility to visit most specialists without a referral‡. The highest benefit level and lowest out-of-pocket costs apply when a primary care physician (PCP) administers or refers for care.
- Must select a participating PCP to coordinate care
- No referrals needed to visit in-network specialists
- Away from Home Care® program for employees who temporarily reside outside the service area
Keystone HMO Plans
HMO plans are designed to help your employees save money. A participating PCP coordinates all of their care.
- In-network coverage
- Participating PCP coordinates employees’ primary care and refers them to in-network specialists for specialty care
- Emergency and urgent care access available outside the United States through BlueCard Worldwide®
Keystone HMO Proactive Plans
Keystone HMO Proactive plans work just like a typical HMO and use a tiered network. Employees can choose providers in any tier but save by choosing providers in the lowest-cost tier.
- Full access to the Keystone provider network with lower monthly premiums
- More than 50 percent of doctors and hospitals are in Tier 1 — Preferred, the lowest-cost tier
- Certain covered services, including preventive care, urgent care, and prescription drugs, have the same cost-share across tiers
High-Deductible Health Plans (HDHPs)
Our high-deductible health plans are PPO plans that can be paired with a spending account — either a Health Savings Account (HSA) or a Health Reimbursement Account (HRA) — to help your employees take more control over planning and paying for eligible heath care expenses.
- Integrated enrollment, payment, and account management at ibxpress.com with The BlueSaverSM HSA through Bank of AmericaTM, an independent company
- Mobile access to balance information with the IBX app
- Employer and employee tax advantages because HSAs and HRAs are not treated as taxable income if used to pay for qualified expenses
- Access to online tools help employees become more savvy health care consumers
* FutureScripts is an independent company providing pharmacy benefits management services for Independence Blue Cross. Certain Blue Solutions plans use the FutureScripts Preferred Pharmacy network, which includes more than 50,000 retail pharmacies.
† An affiliate of Independence Blue Cross has a financial interest in Visionworks.
‡ Referrals are required for physical/occupational therapy, spinal manipulation, and radiology. For lab work, a member’s primary care physician will provide them with a requisition form.