IC Blue by Blue Cross Blue Shield
of Michigan
other Blue Cross Blue Shield health plans
Individual Care BlueSM, or IC Blue, is a new PPO product offered by Blue Cross and Blue Shield of Michigan (BCBSM) that provides individuals a prescription drug benefit. BCBSM is offering IC Blue coverage beginning Jan. 1, 2004, for new nongroup and group conversion members.
The IC Blue prescription drug coverage includes the following key features
- 50 percent co-payment, based on the approved amount, with a $10 minimum and $100 maximum member cost per prescription
- $2,500 per member annual benefit maximum
- Once BCBSM has paid $2,500 in benefits in a calendar year for a member, the member may continue to fill prescriptions at network pharmacies and will pay the BCBSM-negotiated rate for prescriptions. This rate may be lower than the rate charged to pharmacy customers not enrolled with IC Blue.
IC Blue hospital, surgical and medical coverage includes the following key features:
- $0 deductible
- Office visits not covered
- $2,500 copayment maximum per family
- 30 percent copayment on covered in-network services
- 50 percent copayment on covered out-of-network services (additional 20 percent is not applied to family copayment maximum)
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