National Medical Options
Your RRD Medical Program can help support your health and manage your health care costs.
February 16, 2026
Overview
You have four National Medical Program options provided by Blue Cross and Blue Shield of Illinois (BCBSIL):
- HSA Value (eligible for a Health Savings Account)
- HSA Advantage (eligible for a Health Savings Account)
- Copay Advantage
- BCBS Coupe PPO
All options include prescription drug coverage provided through CVS Caremark.
Depending on where you live, you might be eligible for a regional medical option.
Requirements for Cost-Effective Health Care
To help you get the best care at the best price, BCBSIL requires you do the following:
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Call OneImaging for non-emergency, non-urgent MRIs and CTs. OneImaging makes it easy and convenient to get medical imaging without the long wait times and high costs often found elsewhere. You won’t have coverage if you don’t call OneImaging for non-urgent/non-emergency MRI or CT. (This requirement applies to all National Medical Program options, including BCBS Coupe PPO.)
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Use a SleepCharge provider when you need testing or treatment for sleep conditions such as obstructive sleep apnea, insomnia, restless leg syndrome, and circadian rhythm disorders. (This requirement applies to all National Medical Program options, including BCBS Coupe PPO.)
- Use a “Blue Distinction Specialty Care” facility for these five surgical specialties: bariatric, cardiac, knee and hip replacement, spine and transplant surgeries. Blue Distinction facilities are recognized for delivering higher quality care. If you choose not to use a Blue Distinction Specialty Care facility, you will pay higher coinsurance: 40% for the HSA Advantage and Copay Advantage National Medical Program options, and 45% for HSA Value National Medical Program option. (This requirement doesn't apply to BCBS Coupe PPO.)
- Receive prior authorization for hospitalizations, radiation therapy (proton treatment, radiation treatment, etc.), skilled nursing and rehabilitation, home health care, and other services listed in the SPD that require preauthorization. (This requirement doesn't apply to BCBS Coupe PPO.)
For more details about these requirements and the additional costs you’ll avoid by following them, contact a health advocate at 1-800-537-9765.
Good News About Your Prescription Drug Benefits!
With any of the National Medical Program options, you can use in-network or out-of-network providers, but you will save money when you receive care from in-network providers. Use the BCBSIL Provider Finder tool to find providers by location, and compare them based on price, patient reviews and recognition. You can also check to be sure your providers are in-network by calling the number on the back of your insurance ID card prior to receiving services.
2026 National Medical Program Options
Here’s an overview of the National Medical Program options. The annual deductible (amount you pay before receiving benefits) applies to all services except in-network preventive care. Your out-of-pocket maximum protects you in case of unexpected or catastrophic expenses. This is the most you will ever have to pay in a calendar year for covered and allowed medical expenses.
Contact Information
Network Names
Value and Advantage Medical Program Network Name: PPO
Florida Network Names: BCBS HSA Value FL; BCBS HSA Advantage FL; BCBS Copay Advantage FL
Georgia Network Names: BCBS HSA Value GA; BCBS HSA Advantage GA; BCBS Copay Advantage GA
Maryland Network Names: BCBS HSA Value MD; BCBS HSA Advantage MD; BCBS Copay Advantage MD
New Jersey Network Names: BCBS HSA Value NJ; BCBS HSA Advantage NJ; BCBS Copay Advantage NJ
New York Network Names: BCBS HSA Value NY; BCBS HSA Advantage NY; BCBS Copay Advantage NY
Tennessee Network Names: BCBS HSA Value TN; BCBS HSA Advantage TN; BCBS Copay Advantage TN
Wisconsin Network Names: BCBS HSA Value WI; BCBS HSA Advantage WI; BCBS Copay Advantage WI[/su_spoiler]
Coverage Transparency
The federal Transparency in Coverage rule requires our group health plan to publicly share detailed price and cost-sharing information starting July 1, 2022. The Rule requires health plans to post machine readable files (MRFs) that show the negotiated rates for in-network providers and the allowed amounts for out-of-network providers, for certain services covered by the group health plan. Each of our health plan insurers and third-party administrators will publish the MRFs online and update them each month at the following links:
Note that MRFs are formatted to allow third parties, such as researchers, regulators and app developers, to more easily access and analyze data about health care costs and may be difficult for others to review.
Family: $3,800
Family: $3,000
Family: $5,600
Family: $16,000; Individual cap of $8,000
Family: $16,000; Individual cap of $8,000
Family: $16,000; Individual cap of $8,000
Out-of-Network: 40% after deductible
Out-of-Network: 40% after deductible
Out-of-Network: 50% after deductible
Out-of-Network: 40% after deductible
Out-of-Network: 40% after deductible
Out-of-Network: 50% after deductible
Out-of-Network: 20% if true emergency; otherwise 40% after deductible
Out-of-Network: $500 copay + 20% of remaining balance if true emergency; otherwise 50% of remaining balance after deductible
Out-of-Network: 25% if true emergency; otherwise 50% after deductible
Family: $3,800
Family: $16,000; Individual cap of $8,000
Out-of-Network: 40% after deductible
Out-of-Network: 40% after deductible
Out-of-Network: 20% if true emergency; otherwise 40% after deductible
Family: $3,000
Family: $16,000; Individual cap of $8,000
Out-of-Network: 40% after deductible
Out-of-Network: 40% after deductible
Out-of-Network: $500 copay + 20% of remaining balance if true emergency; otherwise 50% of remaining balance after deductible
Family: $5,600
Family: $16,000; Individual cap of $8,000
Out-of-Network: 50% after deductible
Out-of-Network: 50% after deductible
Out-of-Network: 25% if true emergency; otherwise 50% after deductible