Page 5 - 2022 US Benefits Guide FINAL

MEDICAL AND PHARMACY

PLAN OVERVIEW

We offer the choice of two medical plans through BlueCross Blue Shield IL for all U.S. employees. In addition,
California employees are offered two plans through Kaiser. All medical options include coverage for
prescription drugs. If enrolled in the BCBSIL, you will receive prescription coverage through ExpressScripts.
Kaiser offers Rx coverage through their HMO plans. To select the plan that best suits your family, you should
consider the key differences between the plans, the cost of coverage (including payroll deductions), and how
the plan covers services throughout the year.

Making the most of your plan
Understanding how Getting the most out of your plan also depends on how well you
your plan works understand it. Keep these important tips in mind when you use your plan.

 In-network providers and pharmacies: You will always pay less if
1. YOUR DEDUCTIBLE you see a provider within the medical and pharmacy network.
You pay out-of-pocket for most  Preventive care: In-network preventive care is covered at 100% (no
medical and pharmacy expenses until cost to you). Preventive care is often received during an annual
you reach the deductible. physical exam and includes immunizations, lab tests, screenings and
If you are enrolled in the HDHP Plan, other services intended to prevent illness or detect problems before
you can pay for these expenses from you notice any symptoms.
your Health Savings Account (HSA).  Preventive drugs: Certain women’s preventive medications will be
covered at no cost to the member. For a full list of these prescriptions,
2. YOUR COVERAGE please contact Customer Service. In the BCBSIL plans, diabetic
Once your deductible is met, you and testing supplies will be covered at 100%, with deductible applying in
the plan share the cost of covered the HDHP Plan.
medical and pharmacy expenses  Pharmacy coverage: Medications are placed in tiers based on drug
with coinsurance. You will pay a cost, safety and effectiveness. These tiers also affect your coverage.
percentage of each eligible expense,  Generic – A drug that offers equivalent uses, doses, strength, quality
and the plan will pay the rest. and performance as a brand-name drug, but is not trademarked.
 Brand preferred – A drug with a patent and trademark name that is
3. YOUR OUT-OF-POCKET considered “preferred” because it is appropriate to use for medical
MAXIMUM purposes and is usually less expensive than other brand-name
When you reach your out-of-pocket options.
maximum, the plan pays 100% of  Brand non-preferred – A drug with a patent and trademark name.
covered medical and pharmacy This type of drug is “not preferred” and is usually more expensive
expenses for the rest of the plan year. than alternative generic and brand preferred drugs.
Your deductible and coinsurance
apply toward the out-of-pocket  Specialty – A drug that requires special handling, administration or
maximum eligible health care monitoring. Most can only be filled by a specialty pharmacy and have
expenses. additional required approvals.
 Mail order pharmacy: If you take a maintenance medication on an
ongoing basis for a condition like high cholesterol or high blood
pressure, you can use the mail order pharmacy to save on a 90-day
supply of your medication.

About your Medical and Dental coverage for Members outside the state of Illinois
• Even though you might live outside Illinois, your BCBSIL and Delta Dental IL coverage is
nationwide with providers across the country, and with BCBSIL, around the world.
• Search for doctors and hospitals at www.bcbsil.com on your computer or through the
BCBSIL app to find providers in your area.
• Search for dental providers at www.deltadentalil.com on your computer or through the
Delta Dental app to find providers in your area.
• When you use BCBSIL and Delta Dental providers, you pay less for your services.
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