Emergency Room Coverage

This blog will detail ER coverage amongst the 6 carriers marketed.

Emergency Services are covered with all plans and are considered  a plan deductible expense unless noted otherwise.

Blue Cross and Blue Shield of Illinois (BCBSIL) is the only carrier that offers 100% coverage (you owe nothing) at the ER or waives the plan deductible, requiring the insured to pay 20% of the bill towards the plans out-of-pocket expense limit...dependent on plan with 6 out of 8 including this benefit.

All other carriers will slap the insured on the wrist with a copay or access fee before subjecting the bill to the plans deductible.

Certain carriers offer a Supplemental Accident Benefit (SAB) rider that can be purchased for additional premium for benefit amounts of $1,000, $2,500, $5,000 and $10,000.  This benefit will reduce the bill on an accident by the benefit amount selected.  Dependent on the carrier, the amount that paid out by the SAB does not apply towards the plan deductible or out-of-pocket.

Unfortunately with private plans you can not walk into the ER and only owe a copayment.

For further information on benefits please contact The Shoppe.

Thanks,

Jordan