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Insurance Plans Accepted at Palos Hospital

Palos Hospital participates on an “in-network” basis with most major insurance companies and payors, including Medicare and Medicaid, as shown in the list below. We recommend that you contact your insurance company to confirm Palos Hospital’s participation before you schedule an appointment. Your insurance company can also answer any questions you may have about your benefits and coverage.

If you are seeking services with Palos Medical Group (PMG) or at Palos Imaging & Diagnostics (PID), please refer to their separate pages to view a list of insurance plans they accept. While PMG and PID participate in many of the same insurance plans as Palos Hospital, they differ on some.

This list was last updated on July 9, 2020, and is subject to change at any time without notice.

Payor/Network
Plans accepted at Palos Hospital

Access to Care
http://www.accesstocare.org/

Select radiology services only: x-ray, breast ultrasound, and mammogram

Aetna
https://www.aetna.com/

Commercial:

  • Aetna Affordable Health Choices® (SRC only)
  • Aetna Choice® POS II (Aetna HealthFund®)
  • Aetna Choice® POS II (Open Access)
  • Aetna Health Network Only℠ (Open Access)
  • Aetna Health Network Option℠ (Open Access)
  • Aetna Open Access® Elect Choice® EPO (Aetna HealthFund®)
  • Aetna Open Access® Managed Choice® POS (Aetna HealthFund®)
  • Aetna Premier Care Network (APCN) – Choice POS II/Open Access Managed Choice
  • Aetna Premier Care Network (APCN) - Open Access Aetna Select
  • Aetna Premier Care Network Plus (APCN Plus) - Choice POSII
  • Aetna Premier Care Network Plus (APCN Plus) - Open Access Aetna Select
  • Aetna Select℠
  • Aetna Select℠ (Open Access)
  • Aetna Voluntary Plans
  • Aetna with Innovation Health Aetna Select
  • Aetna with Innovation Health POS
  • Aetna with Innovation Health PPO
  • Elect Choice® EPO
  • Elect Choice® EPO (Open Access)
  • HMO
  • Illinois Open Choice PPO
  • Illinois QPOS
  • Managed Choice® POS
  • Managed Choice® POS (Open Access)
  • National Advantage™ Program
  • Open Access Aetna Select℠ (Aetna HealthFund®)
  • Open Choice® PPO
  • Open Choice® PPO (Aetna HealthFund®)
  • QPOS®
  • Savings Plus of IL - Open Access Aetna Select
  • Savings Plus of IL - Open Access Aetna Select
  • Savings Plus of Northern Illinois
  • Savings Plus of Northern Illinois (HMO)

Medicare Advantage:

  • Aetna Medicare Premier Plus (PPO)
  • Aetna Medicare Prime (HMO)
  • Aetna Medicare Value (HMO)
  • Aetna Medicare Value (PPO)

Aetna Better Health
https://www.aetnabetterhealth.com/Illinois/

Medicare-Medicaid:

Aetna Better Health Premier Plan

Allwell Medicare HMO (IlliniCare)
https://allwell.illinicare.com/

Medicare Advantage

Ambetter/IlliniCare
https://www.ambetterhealth.com/

Commercial Exchange

Beacon Health Options/Beacon Health Strategies
https://www.beaconhealthoptions.com/

Behavioral Health/Substance Abuse Network

BeechStreet
https://www.beechstreet.com/Beechstreet/

PPO

Blue Cross and Blue Shield of Illinois
https://www.bcbsil.com/

Commercial:

  • Blue Choice PPO
  • Blue Choice Preferred PPO
  • Blue Options/Blue Choice Options (Tier 1)
  • Blue Choice Select PPO
  • BlueEdge Select HSA
  • Blue PPO
  • Blue Precision HMO
  • Blue Advantage HMO
  • HMO Illinois
  • PPO
  • Blue Cross FEP
  • Blue Advantage HMO Value Choice
  • BasicBlue PPO
  • BlueEdge HSA
  • BluePrint PPO
  • Blue Options PPO
  • Traditional Blue

Medicaid:

Blue Cross Community Health Plans

MedicareMedicaid:

Blue Cross Community MMAI

Medicare Advantage:

  • Blue Cross Medicare Advantage Basic (HMO)
  • Blue Cross Medicare Advantage Basic Plus (HMOPOS)
  • Blue Cross Medicare Advantage Premier Plus (HMOPOS)
  • Blue Cross Medicare Advantage Choice Plus (PPO)
  • Blue Cross Medicare Advantage Choice Premier (PPO)

Commercial Exchange:

  • Blue Precision HMO Bronze
  • Blue Precision HMO Silver
  • Blue Precision HMO Gold
  • Blue Precision HMO Platinum
  • Blue Choice Preferred PPO Bronze
  • Blue Choice Preferred PPO Silver
  • Blue Choice Preferred PPO Gold

Medicare Select:

Blue Cross Medicare Select

Bright Health
https://brighthealthplan.com/

Medicare Advantage

  • Bright Advantage Assist (HMO)
  • Bright Advantage Flex Plus (PPO)

ChoiceCare/Humana
https://www.choicecarenetwork.com/

PPO

CIGNA
https://www.cigna.com/

Commercial:

  • Cigna One Health
  • Network
  • Network POS
  • Open Access Plus
  • OA Plus
  • ChoiceFund OA Plus
  • ChoiceFund OA Plus with CareLink
  • Open Access Plus
  • PPO
  • ChoiceFund PPO

Please note: Palos Hospital does not participate in the Cigna Connect and LocalPlus networks.

CIGNA Behavioral Health, Inc.
https://apps.cignabehavioral.com/web/

Behavioral Health/Substance Abuse Network

CoFinity
https://www.cofinity.net/Cofinity/Index.aspx

PPO

ComPsych
https://www.compsych.com/

Behavioral Health/Substance Abuse Network

CorVel
http://www.corvel.com/

Workers' Compensation Program/Network

Coventry/PersonalCare/FirstHealth
http://coventryhealthcare.com/

Commercial:

  • HMO
  • POS
  • PPO

DuPage Medical Group (DMG) (fka Pronger Smith) (BCBS HMOI Site #082)

BCBS HMOI members of DMG (BCBS HMOI Site #082) with valid PCP referral and/or approval from DMG, as required

HealthSmart (formerly known as Interplan/Preferred Plan, inc.)
https://providerlookup.healthsmart.com/searchproviders.aspx

PPO


Workers' Compensation Program/Network

HFN
http://www.hfnllc.com/

PPO


Workers' Compensation Program/Network

Humana
https://www.humana.com/

Commercial:

  • Choice POS
  • COT National POS - Open Access
  • EPO PPO Open Access
  • GE Health Care Preferred
  • HMO Premier
  • HMO Select
  • Hospira Premier HMO Illinois
  • Humana PPO
  • Humana Preferred Kroger Lou
  • Humana Preferred POS - Open Access
  • Humana Preferred PPO
  • Humana/Choicecare Network PPO
  • Humana/ChoiceCare+ Network PPO
  • Illinois Coordinated Care Network/Loyola Physician Partners
  • Illinois Platinum HMO
  • IPA
  • National EPO
  • National POS - Open Access
  • National POS - Open Access Plus
  • P&G National POS
  • Saint Joseph Hospital NPOS

Medicare-Medicaid:

Humana Gold Plus Integrated

Medicare Advantage:

  • Edge by Humana
  • Employer HMO
  • Humana Community HMO-SNP
  • Humana Community Select HMO
  • Humana Gold Plus HMO
  • Humana Honor PPO 20
  • Humana Gold Choice Network PFFS
  • Medicare PPO
  • Medicare PPO/Employer Plus

Humana Behavioral Health
https://www.humanabehavioralhealth.com/

Behavioral Health/Substance Abuse Network

IlliniCare (incl Ambetter and Allwell)
https://www.illinicare.com/

Commercial Exchange:

Ambetter

Medicaid:

IlliniCare Health HealthChoice Illinois
(including SSI Non-Dual)

Medicare-Medicaid:

IlliniCare Health Medicare-Medicaid Plan (as of 06/26/20, see MeridianTotal)

Medicare Advantage:

Allwell Medicare (HMO)

Little Company of Mary Health Providers

Cardiac Rehabilitation Program

Longevity Health Plan
https://longevityhealthplan.com/

Medicare Advantage:

Longevity Health Plan (HMO I-SNP)

Loyola University Medical Group (LUMG) (BCBS HMOI Site #349)

BCBS HMOI members of LUMG (BCBS HMOI Site #349) with valid PCP referral and/or approval from LUMG, as required

Magellan Behavioral Health
https://www.magellanassist.com/default.aspx

Behavioral Health/Substance Abuse Network

Medicaid

N/A

Medicare

N/A

Meridian Health Plan

https://corp.mhplan.com/en/member/illinois/meridianhealthplan

Medicaid:

  • MeridianHealth HealthChoice Illinois
  • MeridianHealth HealthChoice Illinois - MLTSS

Medicare-Medicaid:

  • MeridianComplete
  • MeridianTotal

MulitPlan (includes PHCS)
https://www.multiplan.com/webcenter/portal/MultiPlan

Commercial:

PPO


Workers' Compensation Program/Network

Southland IPA (SIPA) (BCBS HMOI Site #444)

BCBS HMOI members of SIPA (BCBS HMOI Site #444) with valid PCP referral and/or approval from SIPA, as required

Sunrise Advantage Plan
https://sunriseadvantageplan.com/

Medicare Advantage:

Sunrise Advantage Community Pan (HMO)

Sunrise Advantage Plan (HMO I-SNP)

UniCare/Wellpoint (includes HealthLink)
https://www.unicare.com/health-insurance/home/overview

Commercial:

HMO

POS

PPO

UnitedHealthcare
https://www.uhc.com/

Commercial:

All Savers Health Plan

Heritage/United Healthcare of the River Valley Choice

Choice

Choice HMO

Choice Plus

Choice Plus with Harvard Pilgrim

Choice with Harvard Pilgrim

Core

Core Essential

Core HMO/Core Essential HMO

Heritage Plus

Heritage Select POS/HMO

Heritage Select EPO

Heritage Select Advantage - IA

Heritage Select Advantage - AR, GA, NC, SC, TN

Navigate HMO/Navigate Balanced HMO/Navigate Plus HMO

Navigate/Navigate Balanced

Navigate Plus

Medica Choice with UnitedHealthcare Choice Plus

NexusACO OA

NexusACO OAP

NexusACO R/NexusACO RB

Nexus ACO

Options PPO

Options PPO with Harvard Pilgrim

Passport Connect Choice

Passport Connect Choice Plus

Select

Select HMO

Select Plus

Medicare Advantage:

AARP Medicare Advantage Access (HMO)

AARP Medicare Advantage Choice (PPO)

AARP Medicare Advantage Plan 1 (HMO)

AARP Medicare Advantage Plan 2 (HMO)

AARP Medicare Advantage Walgreens (PPO)

UnitedHealthcare Medicare Advantage Assure (PPO)

UnitedHealthcare Nursing Home Plan 1 (HMO/POS-SNP)

UnitedHealthcare Nursing Home Plan 2 (PPO-SNP)

UnitedHealthcare Group Medicare Advantage PPO

Medicare Select:

AARP Medicare Select (Plan C & Plan F)

United Behavioral Health
https://provider.liveandworkwell.com/content/laww/cliniciansearch/en/spa.html#/search-by-location

Behavioral Health/Substance Abuse Network

Veterans Evaluation Services
https://www.vesservices.com/

Compensation and Pension Diagnostic Testing Services (Veterans)

WellCare (effective 01/01/2020)
https://www.wellcare.com/

Medicare Advantage

WellCare Edge (HMO)

WellCare Essential (HMO)

WellCare Essential (HMO-POS)

WellCare Exclusive (HMO)

WellCare Exclusive (HMO-POS)