Medical and Prescription Drug Plans
Blue Cross Blue Shield of IL
AHEAD offers medical plan options through Blue Cross Blue Shield of Illinois (BCBSIL). If you reside in California or Hawaii, review the additional regional medical plan options available to you.
The PPO plan provides you with access to a national network of healthcare providers who meet stringent credentialing standards.
BCBSIL
The High Deductible Health Plan (HDHP) uses the same network as the PPO plan, but the plan does not pay for services until you satisfy your deductible. When you are enrolled in the HDHP, you can open a health savings account (HSA) to help you pay for qualified medical expenses.
Your BCBSIL Health Plan
| Medical Benefits | PPO | HDHP | ||
|---|---|---|---|---|
| In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Annual Deductible | ||||
| Per Person | $1,250 | $2,500 | $3,000 | $6,000 |
| Family Maximum | $3,750 | $7,500 | $6,000 | 12,000 |
| Coinsurance | 20% | 40% | 20% | 40% |
| Maximum Out-of-Pocket (includes deductible) | ||||
| Per Person | $3,000 | $6,000 | $4,000 | $8,000 |
| Family Maximum | $7,000 | $14,000 | $8,000 | $16,000 |
| Lifetime Maximum | Unlimited | Unlimited | ||
| AHEAD HSA Contributions* | ||||
| Individual | N/A | $1,000 | ||
| Non-Single | N/A | $2,000 | ||
| Prescriptions | ||||
| Retail | $15/$40/$60** | Copays + 25% | 20% after deductible | 40% after deductible |
| Mail Order | 2x retail** | Not covered | 2x retail | Not covered |
| Other Covered Services | ||||
| Physician Services | $25 copay | 40% after deductible | 20% after deductible | 40% after deductible |
| Specialist Services | $50 copay | 40% after deductible | 20% after deductible | 40% after deductible |
| Annual Physical Exams | No Charge | 40% after deductible | No Charge | 40% after deductible |
| Well-Child Care | No Charge | 40% after deductible | No Charge | 40% after deductible |
| Hospital Services | 20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible |
| Admission Deductible | $0 | $300 | $0 | $300 |
| Outpatient Surgery | 20% after deductible | 40% after deductible | 20% after deductible | 70% after deductible |
| Emergency Care (waived if admitted) | $250 | 20% after deductible | ||
| * Employee HSA contributions are matched $1 for $1 with an AHEAD employer match, up to the maximum employer match for the individual plan ($1,000) or family plan ($2,000). ** Separate Rx OOP max applies ($1,000 per person; $3,000 family) to the PPO plan. |
||||
About Your Deductible
PPO Plan
The PPO plan has an embedded deductible. If you have other family members on the plan, each family member must meet their own individual deductible until the total amount of deductible expenses paid by all family members meets the overall family deductible.
HDHP Plan
The HDHP has a non-embedded deductible. If you have other family members on the plan, the overall family deductible must be met before the plan begins to pay. Any combination of family member expenses go toward the deductible.
2026 Twice Monthly Medical Contributions—BCBSIL Plans
| Contribution Plan by Tier | PPO | HDHP |
|---|---|---|
| Employee Only | $100.87 | $63.73 |
| Employee and Spouse/Domestic Partner | $226.08 | $141.23 |
| Employee and Child(ren) | $203.46 | $128.43 |
| Family | $335.43 | $203.09 |
Online Tools from BCBSIL
Log on as a member and you can access claim history, print temporary ID cards, contact member services for assistance and much more.
To register, go to the link below and fill out the information necessary to get signed up. With your account, you are able to view medical costs, deductible balance and plan design in greater detail.
You have access to a variety of tools as a member:
- Blue Access Mobile App
- Health and Wellness Resources
- Valuable Member Programs
You can search for participating providers on the website. Remember that by receiving services from an in-network provider, you incur lower out-of-pocket costs.
High Deductible Participants
AHEAD partners with Optum Bank HSA. If you enroll in the HDHP during your new hire enrollment, we will open an Optum Bank health savings account (HSA) for you. Your Optum HSA is integrated into your Empower Retirement profile, giving you a one-stop shop for your retirement AND health savings accounts investments.
AHEAD provides annual contributions of up to $1,000 for employee only and $2,000 for family. The employer HSA contribution is a $1/$1 match deposited in your account every payroll. The HSA contribution limits for 2026 are $4,400 for self-only coverage and $8,750 for family coverage. Keep in mind that this is inclusive of the AHEAD employer contribution.
Blue365 Discount Programs
As a member, you have access to additional special program discounts. Additional details can be accessed at www.blue365deals.com.
To register, visit www.blue365deals.com, click register and enter your personal information. You will receive emails offering savings delivered to your email inbox, or you may visit the site to view available deals.
Discounts may be available at the following retailers:
- Davis Vision
- Oral B
- Crest
- Beltone
- Jenny Craig
- Seattle Sutton’s
- Retrofit
- Reebok
- Skechers
- Life Time Fitness
- Handstand Kids
- Nutrisystem
Hinge Health—Musculoskeletal Solution
Hinge Health provides a digital, coach-led program based on proven non-surgical care guidelines. In-home exercise therapy is designed to relieve pain from:
- Knee
- Hip
- Low back
- Shoulder
- Neck
Through this program you will receive:
- Unlimited one-on-one health coaching
- Personalized exercise therapy
To learn more visit www.hingehealth.com/ahead.
Teladoc
Teladoc provides support for managing type 1 and type 2 diabetes, as well as blood pressure.
Includes
-
- Glucometer and BP monitor
- Unlimited strips and lancets
- Personalized Insights
- One-on-one coaching
- Guidance on healthy habits
- Meter can send data directly to your doctor
BCBSIL at a Glance—Value-Added Benefits
For your medical benefit questions, claims information or any other BCBSIL benefits-related inquiry, contact:
800-541-2767
www.bcbsil.com
Well onTarget Health and Wellness Portal
Access health and wellness resources that can help you manage your health. Resources include:
- Health risk assessments
- Online health encyclopedia
- Web-based clinical tracking
- Ask a nurse, trainer, dietitian, life coach
- Life points program
- Self-directed courses
- Enroll in a fitness plan at a reduced rate at https://bcbsilforyourhealth.com
Visit https://www.bcbsilcommunications.com/wellontarget/blue-points.html
Learn to Live Program
Learn to Live program is a self-guided program available to those enrolled in the AHEAD BCBS plans. Learn to Live addresses conditions such as stress, anxiety, worry, depression, social anxiety, insomnia and substance abuse.
There is some coaching available to members, but the First Stop Health (FSH) program is more focused on clinical support from licensed counselors, whereas the Learn to Live program is more focused on self-guided care with coach engagement when needed.
While the Learn to Live program is a great resource for many employees, it does not provide the same level of care as the FSH programming.
24/7 Nurseline
800-299-0274
- General health information and guidance for specific conditions from fevers to bee stings
- Coaching on appropriate treatment paths
Blue Access for Members
Blue Access Website
A secure member website that gives you immediate access to healthcare benefit information and easy-to-use tools:
- Check claim status, confirm coverage for you and your dependents, use Provider Finder® to locate a contracting doctor or hospital, access interactive tutorials
- Hospital comparison tools
- Treatment cost advisor™
BCBSIL App
Download the BCBSIL app to easily access your ID card, find providers, review claims and more.
App Store
Google Play
Mail Order Prescriptions
877-357-7463
Through BCBSIL and Prime Therapeutics, you may be able to save time and get more for your money by getting your prescriptions through mail order.