Medical
BMO offers a High Deductible Health Plan (HDHP) and a Preferred Provider Organization (PPO) plan administered by BCBSIL nationwide, or an HDHP and a DHMO plan administered by Kaiser, available in select locations.
BMO medical plans include prescription drug coverage.
Learn more.
The HDHP includes a tax-advantaged Health Savings Account to help you save money on eligible health care costs.
How the plan works
- The medical plans are administered by BCBSIL (available nationwide) or Kaiser (available in CA, CO and OR):
- With BCBSIL PPO: You can see any provider you choose, but you’ll get higher benefits and pay less when you see in-network providers.
- With Kaiser DHMO: The plan uses a provider network; most benefits are only covered when you use in-network providers.
- Both plans cover in-network preventive care at 100%, with no deductible, and include prescription drug coverage.
- The main differences between the plans are the annual deductibles and monthly premiums. Check out the 2025 PPO to HDHP Comparison Chart and 2025 Premiums for more details.
Here’s a high-level overview of in-network benefits for the BMO medical plans. For more detailed information, review the Medical Plan SPDs and the BCBSIL/Kaiser Summaries of Benefits and Coverage.
| In-Network Features | HDHP | BCBSIL PPO/Kaiser DHMO |
|---|---|---|
| Health Savings Account (HSA) Eligible |
You are eligible to set up an HSA when you enroll in the HDHP. BMO will make a core contribution to your account
|
Not available |
| Annual Deductible* |
Individual: $1,750 Family: $3,500** |
Individual: $750 Family: $1,500 *** |
| Annual Out-Of-Pocket Maximum* |
Individual: $3,425 Family: $6,850 |
Individual: $3,000 Family: $6,000 |
| Prescription Drugs |
BCBSIL: Provided through Express Scripts Kaiser: Provided through Kaiser |
|
| Coinsurance | 20% | 20% |
| Annual Benefit Maximum | None | |
| Lifetime Maximum | None | |
| What You Pay | ||
| Office Visit | 20% after deductible | Copay: $25 PCP, $40 specialist |
| Well Care/Preventive Care | You pay nothing | |
| Lab Test and X-rays | 20% after deductible | 20% after deductible |
| Inpatient Care | 20% after deductible | 20% after deductible |
| Urgent Care | 20% after deductible | $150 copay |
| Emergency Room | $100 copay and 20% coinsurance (copay waived if admitted) | $300 copay (copay waived if admitted) |
* Annual deductibles and out-of-pocket limits for in-network and out-of-network must be met separately.
**The entire family deductible must be met before the plan will pay benefits for any covered family members. If combined expenses for the family meet the family deductible, the deductible is met for the entire family.
*** Each covered person has an individual deductible. Once the individual deductible is met, the plan begins to pay benefits for that person. Once the total family deductible is reached, the plan starts to pay benefits for all covered family members, even if some members still need to meet their individual deductible.
Resources to live healthier
We care about your health and wellness. That’s why we offer health support resources for you and your family.
Transparency in Coverage
BCBSIL and Kaiser create and publish machine-readable files on behalf of BMO. Go to BCBSIL Transparency in Coverage site or Kaiser Transparency in Coverage Site.