Medical
Littelfuse offers the choice of two medical plans through Blue Cross Blue Shield: the HDHP Plan or the PPO Plan.
To select the plan that best suits you and your family, consider the key differences between the plans, the cost of coverage including payroll deductions, and how each plan covers services throughout the year.
How Your Plan Works
- Your deductible. You pay out-of-pocket for most medical and pharmacy expenses, except those with a copay, until you reach your deductible. If you’re enrolled in the BCBSIL HDHP Plan, you can pay these expenses from your Health Savings Account.
- Your coverage. Once your deductible is met, you and the plan share the cost of covered medical and pharmacy expenses through coinsurance. The plan pays a percentage of each eligible expense and you pay the rest.
- Your out-of-pocket maximum. When you reach your out-of-pocket maximum, the plan pays 100% of covered medical and pharmacy expenses for the rest of the plan year. Your deductible and coinsurance both count toward it.
Making the Most of Your Plan
Stay in network. You’ll generally pay less when you use providers and pharmacies inside the network.
Use your preventive care. In-network preventive care is covered at 100%, at no cost to you. That includes immunizations, lab tests, screenings and other services intended to prevent illness or catch problems before you have symptoms. Check your insurer’s preventive care guidelines to see what qualifies.
Contact
Medical Coverage
800-526-6593
Pre-Authorization:
800-635-1928
Provider Locator:
800-810-2583
24/7 Nurseline:
800-299-0274
Plan Summary
| MEDICAL PLAN PROVISIONS | BCBSIL HDHP PLAN | BCBSIL PPO PLAN | ||
|---|---|---|---|---|
| In-network | Out-of-network | In-network | Out-of-network | |
| Littelfuse contribution to HSA (individual / family) | $500 / $1,000 | N/A | ||
| Annual deductible (individual / family) | $3,400 / $6,800 | $6,800 / $13,600 | $1,750 / $3,500 | $3,500 / $7,000 |
| Out-of-pocket maximum, including deductible (individual / family) | $6,000 / $12,000 | $12,000 / $24,000 | $4,000 / $8,000 | $8,000 / $16,000 |
| Preventive care | Covered at 100% | 40%* | Covered at 100% | 40%* |
| Primary care provider office visit | 20%* | 40%* | $35 copay | 40%* |
| Specialist office visit | 20%* | 40%* | $50 copay | 40%* |
| Telemedicine | No cost | 40%* | No cost | 40%* |
| X-ray and lab | 20%* | 40%* | 20%* | 40%* |
| Inpatient hospital services | 20%* | 40%* | 20%* | 40%* |
| Outpatient hospital services | 20%* | 40%* | 20%* | 40%* |
| Urgent care | 20%* | 40%* | $60 copay | 40%* |
| Emergency room | $200 per visit, waived if admitted | $200 per visit, waived if admitted1 | ||
* After deductible.
1 To avoid a $250 penalty, contact Blue Cross and Blue Shield for preauthorization at least one business day in advance of any non-emergency inpatient admission, and no later than two business days after any emergency admission.
Where to get care
The right level of care depends on your condition — and the cost can vary significantly.
Virtual Visit
Care anytime, anywhere, by phone or through MDLIVE. Contact for non-emergency care, advice and diagnosis — available 24/7. Good for allergies, cold or flu symptoms, urinary tract infections, fever, sore throat or cough, headaches.
Doctor’s Office
A personal appointment for full-service care that doesn’t need attention right away, such as annual and sports physicals, health screenings, vaccines, medicine refills, anxiety and depression, coughs and colds.
Urgent Care
Same-day treatment for non-life-threatening illness or injury including: cuts requiring stitches, ear infections, insect bites, sprains and strains, nausea, pink eye.
Emergency Room
Treatment for life-threatening emergencies. Examples include Broken bones, chest pain, difficulty breathing, head injuries, uncontrolled bleeding, sudden dizziness or numbness, mental health crisis.
Additional resources
24/7 Nurseline
Speak with a registered nurse any time. Nurses can help you decide whether you or a covered family member should go to the emergency room or urgent care, or make a doctor’s appointment. Call 1-800-299-0274.
Telemedicine through MDLIVE
If you’re enrolled in a Blue Cross Blue Shield medical plan, you have access to board-certified doctors by mobile app, online video or telephone, 24/7.
Digital Exercise Therapy through Hinge Health
Personalized care plans and coaching for back, muscle and joint health. Available to you and eligible dependents aged 18 and over at no additional cost.
Cancer Services and Support Program
Tools, resources and expertise to help before, during and after cancer treatment, at no additional cost. Log in to Blue Access for Members at bcbsil.com and select Cancer Support Services, or call the number on the back of your member ID card and ask for a cancer care nurse.
Prescription Cost Assistance through FlexAccess™
Help lowering the cost of certain high-cost medications, at no additional cost to you or your eligible dependents. Call 888-302-3618 or email FlexAccess Services to find out whether your prescription is part of the program.
FlexAccess™ Qualified HDHP Program
If you’re in the high-deductible plan and haven’t met your deductible yet, you can sign up for a drug manufacturer’s coupon or copay assistance program. Call Prime Member Services at 844-210-0823.