Plan Overview

Blue Solutions® lets you control how much you spend each month by making two basic decisions:
  1. How much employees pay when they visit a doctor or hospital (cost-sharing options)
  2. How much flexibility employees have when accessing care (product options)

Cost-sharing options

We offer four different types of plans in the Blue Solutions portfolio — copay, deductible, Health Reimbursement Account (HRA), and Health Savings Account (HSA). All of our plans offer comprehensive coverage and are health care reform compliant, including 100 percent coverage for preventive care, benefits for dependents up to age 26, and no lifetime maximums for in- or out-of-network care. What differentiates our plans is what your employees pay when they see a doctor or go to the hospital. With our copay plans, your employees will pay a fixed dollar amount for most services while our deductible, HRA, and HSA plans help reduce costs by requiring a deductible and coinsurance for certain services. Determine which type of plan is best for your company.

Copay plans

Deductible plans

HRA and HSA Plans

Office visits Copay Copay (select plans have deductible that applies) Coinsurance after deductible
Preventive care Covered 100 percent Covered 100 percent Covered 100 percent
Emergency care Copay Coinsurance after deductible Coinsurance after deductible
Inpatient hospital Copay Coinsurance after deductible Coinsurance after deductible
X-ray Copay Copay (POS/DPOS) Coinsurance after deductible (PPO) Coinsurance after deductible
Prescription drugs and routine eye care Yes Yes Yes
Pair with a tax-advantaged health savings account N/A N/A Yes

Cost sharing included in the chart above applies to in-network coverage only.  

Product Options

The second decision you need to make is how much flexibility you want to give your employees when accessing care. Our Personal Choice PPO plans provide the ultimate in flexibility. Your employees get in-network coverage across the country when using participating BlueCard® PPO providers plus coverage out of network. Keystone Direct POS is also an option, if out-of-network coverage is important to you. We control Keystone Direct POS costs by requiring a primary care physician and referrals for certain services.

Keystone Direct POS

Personal Choice®

Access to an expansive network of more than 42,500 physicians and specialists
Selection of a primary care physician required  
No referrals needed to visit in-network specialists to get the highest level of benefits1
In-network benefits coast-to-coast through BlueCard® PPO  
Away from Home Care® program for members who temporarily reside outside the service area  
Access to emergency and urgent care across the country and around the world through BlueCard® and BlueCard® Worldwide

1Direct POS members need a referral from their PCP for spinal manipulations, routine X-rays, physical/occupational therapy, and podiatry. For lab work, members should use the facility recommended by their PCP for the lowest out-of-pocket costs.