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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 August 7, 2018 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 HMO
  • Aetna HMO Health Network Only
  • Aetna Choice POS
  • Aetna Choice POS ll
  • Aetna Elect Choice EPO
  • Aetna Managed Choice POS
  • Aetna NAP
  • Aetna Open Access
  • Aetna Open Access Elect Choice (EPO)
  • Aetna Open Access EPO
  • Aetna Open Access Health Network Only
  • Aetna Open Access HMO
  • Aetna Open Access Managed Choice (POS)
  • Aetna Open Access Managed Choice
  • Aetna Open Choice PPO
  • Aetna PPO
  • Aetna Premier Care Network
  • Aetna QPOS
  • Aetna Savings Plus
  • Aetna Select
  • Aetna Select Open Access
  • State of Illinois HMO
  • State of Illinois Open Access
  • State of Illinois QCHP (PPO)

Medicare Advantage:

  • Aetna Medicare Standard Plan (PPO)
  • Aetna Medicare Value Plan HMO
  • Aetna Medicare Value Plan PPO
  • Aetna Medicare Complete Plan 1 (HMO)

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

Medicare-Medicaid:

  • Aetna Better Health Premier Plan

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

  • *Commercial Exchange

Beacon Health Options (formerly known as ValueOptions)
https://www.beaconhealthoptions.com/

  • Behavioral Health/Substance Abuse Network - Commercial Plans Only

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 Precision HMO
  • Blue Advantage HMO
  • HMO Illinois
  • PPO

Medicaid:

  • Blue Cross Community Health Plans (including MLTSS) 

Medicare-Medicaid:

  • Blue Cross Community MMAI

Medicare Advantage:

  • Blue Cross Medicare Advantage Basic (HMO)
  • Blue Cross Medicare Advantage Basic Plus (HMO-POS)
  • Blue Cross Medicare Advantage Premier Plus (HMO-POS)
  • Blue Cross Medicare Advantage Choice Plus (PPO)
  • Blue Cross Medicare Advantage Choice Premier (PPO)
  • Blue Cross Medicare Advantage (PPO)
  • Blue Cross Medicare Advantage Elite (HMO-POS)

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

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

  • PPO

CIGNA
https://www.cigna.com/

Commercial:

  • HMO 
  • Open Access
  • Open Access Plus
  • 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

Fresenius Health Partners
https://esrdplans.com/

Medicare Advantage/C-SNP:

  • Fresenius Total Health

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

Commercial:

  • PPO

  • Workers' Compensation Program/Network

HFN
http://www.hfnllc.com/

Commercial:

  • PPO

  • Workers' Compensation Program/Network

Humana
https://www.humana.com/

Commercial:

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

*Medicare-Medicaid:

  • Humana Gold Plus Integrated

Medicare Advantage:

  • Humana Community HMO Diabetes and Heart (C-SNP)
  • Humana Gold Plus HMO
  • HumanaChoice PPO
  • Humana Gold Choice (PFFS)

Humana Behavioral Health (formerly known as Lifesync/Corphealth)
https://www.humanabehavioralhealth.com/

  • Behavioral Health/Substance Abuse Network

IlliniCare
https://www.illinicare.com/

*Commercial Exchange: 

  • Ambetter

*Medicaid: 

  • IlliniCare Health HealthChoice Illinois

*Medicare-Medicaid:

  • IlliniCare Health Medicare-Medicaid Plan

Little Company of Mary Health Providers

  • Cardiac Rehabilitation Program

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 Healthcare
https://www.magellanassist.com/default.aspx

  • Behavioral Health/Substance Abuse Network

Medicaid

  • N/A

Medicare

  • N/A

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

Medicaid:

  • Meridian Health HealthChoice Illinois 

Medicare Advantage:

  • Meridian Elite (HMO)
  • Meridian Essential (HMO)

Medicare-Medicaid:

  • MeridianComplete

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

Commercial:

  • PPO

  • Workers' Compensation Program/Network

National Home Life Assurance Company

  • Medicare Select

Preferred Network Access
https://pna-usa.net/home/services/

  • PPO

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 Plan ISNP
  • Sunrise Advantage Plan CSNP
  • Sunrise Advantage Plan MAPD

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 MedicareComplete Plan 1 (HMO)
  • AARP MedicareComplete Plan 2 (HMO)
  • AARP MedicareComplete Access
  • UnitedHealthcare Group Medicare Advantage PPO
  • UnitedHealthcare Nursing Home Plan (I-SNP)

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)

* Does not include Palos Behavioral Health