Coverage for Retirees Under Age 65
The Retiree Medical Plan would be a medical plan option if you retire from the University before you are Medicare eligible, under age 65, or if you are a covered dependent of a University retiree. This coverage may continue until you become eligible for Medicare, at which time your coverage under the Retiree Medical Plan becomes a supplement to your Medicare coverage.
Medical Coverage with the Retiree Medical Plan, Under Age 65
You can visit the eligible licensed provider of your choice. You receive special advantages if you visit certain physicians. If you visit a BCBS PPO provider, your care is considered "in-network," and the plan will cover a higher percentage of your costs. If you do not visit a BCBS PPO provider, your care is considered to be "out-of-network," and the Retiree Medical Plan will pay less than if you saw an in-network provider.
Because BCBSIL negotiates significant discounts with providers who are part of its network, the prevailing fee schedule can be significantly lower as compared with what out-of-network providers may charge for some services. You should check with BCBSIL before receiving care from a provider who is not part of the Plan's network.
Select key Features
The following represents a partial list of the features the Retiree Medical Plan. Please refer to the Retiree Medical Plan Information brochure for detailed information.
- In-Network -Generally, after you meet the deductible, the plan covers 80% of the cost of covered services based on the prevailing fee schedule, and you pay the rest. The plan covers 100% after you reach the out-of-pocket limit.
- Out-of-Network
- Annual deductible of $200 per individual and a $200 per hospital admission.
- Generally, after you meet the deductible, the plan pays 65% of the covered charges based on the BCBS prevailing fee schedule until you reach the annual out-of-pocket limit.
- Certain limits apply, meaning you are responsible for any amount that exceeds the BCBS's prevailing fee schedule.
- You or your physician file claim forms for reimbursement.
- Annual deductible of $200 per individual.
- The out-of-pocket limit is $1,100 per family.
- The maximum cumulative amount the plan will cover per lifetime is $2,000,000.
- Prescription drugs are administered by Caremark. You pay a copayment at the time of purchase.
- Prescription drugs are not subject to the $200 deductible and do not count towards the $1,100 out-of-pocket limit.