Regional Medical Options

Last Updated December 13, 2023

Based on where you live, you might be eligible to enroll in a regional medical option.

Overview

These regional medical options are available in certain areas of the country. If any of these options are available to you, you will see them listed when you log in to the enrollment website:

Prescription Drug Coverage

If you elect a regional medical option, prescription drug coverage is provided through the medical vendor — not CVS Caremark. If you have questions about prescription drug coverage, please contact the applicable medical vendor.

2024 Regional Medical Program Options

Kaiser Permanente Options — Atlanta Area

Kaiser HSAMedical

Annual Deductible

 

Individual:$4,500

Family:$4,500 Embedded i

Annual Out-of-Pocket Maximum

 

Individual:$6,250

Family:$6,250 Embedded i

Coinsurance

40%

Physician Care Office Visits

 

 

PCP:40% after deductible

Specialist:
40% after deductible

Preventive Care:0%

General Hospital Services

 

 

Lab:40% after deductible

X-Ray:40% after deductible

Diagnostic:40% after deductible

Hospital Services

 

Inpatient:
40% after deductible

Outpatient:
40% after deductible

Emergency Services 

 

ER:40% after deductible

Urgent Care:40% after deductible

Mental Health/Substance Abuse 

Inpatient:
40% after deductible

Office Visit:40% after deductible

Kaiser HSAMedical
Annual Deductible

Individual:$4,500

Family:$4,500 Embedded i

Annual Out-of-Pocket Maximum

Individual:$6,250

Family: $6,250 Embedded i

Coinsurance 

40%

Physician Care Office Visits 

PCP: 40%
after deductible

Specialist:
40%
after deductible

Preventive Care: 0%
after deductible

General Hospital Services 

Lab:40%
after deductible

X-Ray:40%
after deductible

Diagnostic:40%
after deductible

Hospital Services

Inpatient:
40%
after deductible

Outpatient:
40%
after deductible

Emergency Services 

ER:40%
after deductible

Urgent Care:40%
after deductible

Mental Health/Substance Abuse 

Inpatient:
40%
after deductible

Office Visit:40%
after deductible

Kaiser HSAPrescription Drug
Annual Deductible

Combined Deductible

Generic

 

Retail:
$15

Mail Order:
$30

Formulary

 

Retail:$35

Mail Order:
$70

Non-Formulary

 

Retail:
$35

Mail Order:
$70

Specialty

Retail:
30% up to $200

Mail Order:
N/A

Kaiser HSAPrescription Drug
Annual Deductible

Combined Deductible

Generic

Retail:
$15

Mail Order:
$30

Formulary

Retail:$35

Mail Order:
$70

Non-Formulary

Retail:
$35

Mail Order:
$70

Specialty

Retail:30% up to $200

Mail Order:N/A

Kaiser Permanente Options — California 

Kaiser HSA
Medical

Annual Deductible

 

Individual:$4,500

Family:$4,500 Embedded i

Annual Out-of-Pocket Maximum

 

Individual:$6,250

Family:$6,250 Embedded i

Coinsurance

40%

Physician Care Office Visits

 

 

PCP:$40 after deductible

Specialist:
$50 after deductible

Preventive Care:0%

General Hospital Services

 

 

Lab:40% after deductible

X-Ray:40% after deductible

Diagnostic:40% after deductible

Hospital Services

 

Inpatient:
40% after deductible

Outpatient:
40% after deductible

Emergency Services 

 

ER:$250 after deductible

Urgent Care:$40 after deductible

Mental Health/Substance Abuse 

 

Inpatient:
40% after deductible

Office Visit:$40 after deductible

Kaiser HSA
Medical
Annual Deductible 

Individual:$4,500

Family:$4,500 Embedded i

Annual Out-of-Pocket Maximum 

Individual:$6,250

Family:$6,250 Embedded i

Coinsurance

40%

Physician Care Office Visits

PCP:$40
after deductible

Specialist:
$50
after deductible

Preventive Care:0%
after deductible

General Hospital Services

Lab:40%
after deductible

X-Ray:40%
after deductible

Diagnostic:40%
after deductible

Hospital Services

Inpatient:
40%
after deductible

Outpatient:
40%
after deductible

Emergency Services  

ER:$250
after deductible

Urgent Care:$40
after deductible

Mental Health/Substance Abuse  

Inpatient:
40%|
after deductible

Office Visit:$40
after deductible

Kaiser HSAPrescription Drug
Annual Deductible

Combined Deductible

Generic

 

Retail:$15

Mail Order:
$30

Formulary

 

Retail:$35

Mail Order:
$70

Non-Formulary

 

Retail:$35

Mail Order:
$70

Specialty

Retail:40% up to $250

Mail Order:N/A

Kaiser HMOPrescription Drug Kaiser HSAPrescription Drug
Annual Deductible Annual Deductible

$100 for brand and specialty only

Combined Deductible

Generic Generic

Retail:$10

Mail Order:$10

Retail:$15

Mail Order:
$30

Formulary Formulary

Retail:$30

Mail Order:$30

Retail:$35

Mail Order:
$70

Non-Formulary   Non-Formulary  

Retail:$30

Mail Order:$30

Retail:$35

Mail Order:
$70

Specialty Specialty

Retail:20% up to $150 after drug deductible

Mail Order:N/A

Retail:40% up to $250

Mail Order:N/A

Kaiser Permanente Options — Colorado

Kaiser HSA
Medical

Annual Deductible

Individual: $4,500

Family: $4,500 Embedded i

Annual Out-of-Pocket Maximum

Individual: $6,250

Family: $6,250 Embedded i

Coinsurance

40%

Physician Care Office Visits

PCP:$50 after deductible

Specialist:$50 after deductible

Preventive Care:0% after deductible

General Hospital Services

Lab:40% after deductible

X-Ray:40% after deductible

Diagnostic:40% after deductible

Hospital Services

Inpatient:40% after deductible

Outpatient:40% after deductible

Emergency Services 

ER:$250 after deductible

Urgent Care:$50 after deductible

Mental Health/Substance Abuse 

Inpatient:40% after deductible

Office Visit:$50 after deductible

 

Kaiser HMO
Medical

Kaiser HSA
Medical

Annual Deductible Annual Deductible

Individual: $500

Family: $500 Embedded i

Individual: $4,500

Family: $4,500 Embedded i

Annual Out-of-Pocket Maximum Annual Out-of-Pocket Maximum

Individual:
$3,000

Family: $3,000 Embedded i

Individual: $6,250

Family: $6,250 Embedded i

Coinsurance Coinsurance

20%

40%

Physician Care Office Visits Physician Care Office Visits

PCP:$20

Specialist:$20

Preventive Care:0%

PCP:$50
after deductible

Specialist:$50
after deductible

Preventive Care:0%
after deductible

General Hospital Services General Hospital Services

Lab:0%

X-Ray:20%

Diagnostic:20%

Lab:40%
after deductible

X-Ray:40%
after deductible

Diagnostic:40%
after deductible

Hospital Services Hospital Services

Inpatient:20%

Outpatient:20%

Inpatient:40%
after deductible

Outpatient:40%

Emergency Services  Emergency Services 

ER:20%

Urgent Care:$25

ER:$250
after deductible

Urgent Care:$50
after deductible

Mental Health/Substance Abuse  Mental Health/Substance Abuse 

Inpatient:20%

Office Visit:$20

Inpatient:40%
after deductible

Office Visit:$50
after deductible

Kaiser HSAPrescription Drug
Annual Deductible

Combined Deductible

Generic

 

Retail:$15

Mail Order:
$30

Formulary

 

Retail:$35

Mail Order:
$70

Non-Formulary

 

Retail:
$35

Mail Order:
$70

Specialty

Retail:40% up to $200

Mail Order:N/A

Kaiser HSAPrescription Drug
Annual Deductible

Combined Deductible

Generic

Retail:$15

Mail Order:
$30

Formulary

Retail:$35

Mail Order:
$70

Non-Formulary

Retail:
$35

Mail Order:
$70

Specialty

Retail:40% up to $200

Mail Order:N/A

Kaiser Permanente Options — Mid-Atlantic States

Kaiser HSAMedical

Annual Deductible

 

Individual:$4,500

Family:$4,500 Embedded i

Annual Out-of-Pocket Maximum

 

Individual:$6,250

Family:$6,250 Embedded i

Coinsurance

40%

Physician Care Office Visits

 

 

PCP:$50 after deductible

Specialist:
$50 after deductible

Preventive Care:0% after deductible

General Hospital Services

 

 

Lab:40% after deductible

X-Ray:40% after deductible

Diagnostic:40% after deductible

Hospital Services

 

Inpatient:
40% after deductible

Outpatient:
40% after deductible

Emergency Services 

 

ER:$250 after deductible

Urgent Care:$50 after deductible

Mental Health/Substance Abuse 

 

Inpatient:
40% after deductible

Office Visit:$50 after deductible

Kaiser HSAMedical
Annual Deductible

Individual:$4,500

Family:$4,500 Embedded i

Annual Out-of-Pocket Maximum 

Individual:$6,250

Family:$6,250 Embedded i

Coinsurance

40%

Physician Care Office Visits

PCP:$50
after deductible

Specialist:
$50
after deductible

Preventive Care:0%
after deductible

General Hospital Services

Lab:40%
after deductible

X-Ray:40%
after deductible

Diagnostic:40%
after deductible

Hospital Services 

Inpatient:
40%
after deductible

Outpatient:
40%
after deductible

Emergency Services 

ER:$250
after deductible

Urgent Care:$50
after deductible

Mental Health/Substance Abuse  

Inpatient:
40%
after deductible

Office Visit:$50
after deductible

 

Kaiser HSAPrescription Drug
Annual Deductible

Combined Deductible

Generic

 

Retail:
$20

Mail Order:
$40

Formulary

 

Retail:$50

Mail Order:
$100

Non-Formulary

 

Retail:
50%

Mail Order:
50%

Specialty

Retail:50% up to $150

Mail Order:N/A

Kaiser HSAPrescription Drug
Annual Deductible

Combined Deductible

Generic

Retail:
$20

Mail Order:
$40

Formulary

Retail:$50

Mail Order:
$100

Non-Formulary

Retail:
50%

Mail Order:
50%

Specialty

Retail:50% up to $150

Mail Order:N/A

Kaiser Permanente Options — Oregon

Kaiser HSA Medical

Annual Deductible

 

Individual: $4,000

Family: $4,000 Embedded i

Annual Out-of-Pocket Maximum

 

Individual: $6,650

Family: $6,650 Embedded i

Coinsurance

40%

Physician Care Office Visits

 

 

PCP: 40% after deductible

Specialist:
40% after deductible

Preventive Care: 0% after deductible

General Hospital Services

 

 

Lab: 40% after deductible

X-Ray: 40% after deductible

Diagnostic: 40% after deductible

Hospital Services

 

Inpatient:
40% after deductible

Outpatient:
40% after deductible

Emergency Services 

 

ER: 40% after deductible

Urgent Care: 40% after deductible

Mental Health/Substance Abuse 

 

Inpatient:
40% after deductible

Office Visit: 40% after deductible

Kaiser HSA Medical
Annual Deductible  

Individual: $4,000

Family: $4,000 Embedded i

Annual Out-of-Pocket Maximum

Individual: $6,650

Family: $6,650 Embedded i

Coinsurance

40%

Physician Care Office Visits

PCP: 40%
after deductible

Specialist:
40%
after deductible

Preventive Care: 0%
after deductible

General Hospital Services

Lab: 40%
after deductible

X-Ray: 40%
after deductible

Diagnostic: 40%
after deductible

Hospital Services

Inpatient:
40%
after deductible

Outpatient:
40%
after deductible

Emergency Services

ER: 40%
after deductible

Urgent Care: 40%
after deductible

Mental Health/Substance Abuse

Inpatient:
40%
after deductible

Office Visit: 40%
after deductible

Kaiser HSAPrescription Drug
Annual Deductible

Combined Deductible

Generic

 

Retail:$15

Mail Order:
$30

Formulary

 

Retail:$30

Mail Order:
$60

Non-Formulary

 

Retail:
$50

Mail Order:
$100

Specialty

Retail:50%

Mail Order:N/A

Kaiser HSAPrescription Drug
Annual Deductible

Combined Deductible

Generic

Retail:$15

Mail Order:
$30

Formulary

Retail:$30

Mail Order:
$60

Non-Formulary

Retail:
$50

Mail Order:
$100

Specialty

Retail:50%

Mail Order:N/A

Kaiser Permanente Options — Washington

Kaiser HSAMedical

Annual Deductible

 

Individual:$4,500

Family:$7,350

Annual Out-of-Pocket Maximum

 

Individual:$6,000

Family:$7,350

Coinsurance

30%

Physician Care Office Visits

 

 

PCP:
30% after deductible

Specialist:
30% after deductible

Preventive Care:0%

General Hospital Services

 

 

Lab:30% after deductible

X-Ray:30% after deductible

Diagnostic:30% after deductible

Hospital Services

 

Inpatient:
30% after deductible

Outpatient:
30% after deductible

Emergency Services 

 

ER:$75/visit after deductible

Urgent Care:30% after deductible

Mental Health/Substance Abuse 

 

Inpatient:
30% after deductible

Office Visit:30% after deductible

Kaiser HSAMedical
Annual Deductible

Individual:$4,500

Family:$7,350
Embedded i

Annual Out-of-Pocket Maximum

Individual:$6,000

Family:$7,350
Embedded i

Coinsurance

30%

Physician Care Office Visits

PCP:30%
after deductible

Specialist:
30%
after deductible

Preventive Care:0%

General Hospital Services

Lab:30%
after deductible

X-Ray:30%
after deductible

Diagnostic:30%
after deductible

Hospital Services

Inpatient:
30%

Outpatient:
30%
after deductible

Emergency Services

ER:$75/visit
after deductible

Urgent Care:30%
after deductible

Mental Health/Substance Abuse

Inpatient:
30%
after deductible

Office Visit:30%
after deductible

Kaiser HSA
Prescription Drug
Annual Deductible

Combined Deductible

Generic

 

Retail:
$15

Mail Order:
$45

Formulary

 

Retail:$30

Mail Order:
$90

Non-Formulary

 

Retail:
N/A

Mail Order:
N/A

Specialty

Retail:
Contact Kaiser

Mail Order:
N/A

Kaiser HSA
Prescription Drug
Annual Deductible

Combined Deductible

Generic

Retail:
$15

Mail Order:
$45

Formulary

Retail:$30

Mail Order:
$90

Non-Formulary 

Retail:
N/A

Mail Order:
N/A

Specialty

Retail:
Contact Kaiser

Mail Order:
N/A

Contact Information

BCBSIL

Network Names

Network Name: Blue Advantage HMO
1-800-892-2803
BCBSIL app

Dean Health
1-800-279-1301

Kaiser Permanente California
1-800-464-4000

Kaiser Permanente Colorado
1-800-632-9700

Kaiser Permanente Georgia
1-888-865-5813

Kaiser Permanente Mid-Atlantic States
DC Metro: 301-468-6000
Outside DC Metro: 1-800-777-7902

Kaiser Permanente Northwest
1-800-813-2000

Kaiser Permanente Washington
1-888-901-4636