HMO Illinois Product Overview

HMO Illinois offers the health care benefit coverage members want and need.

Advantages

HMO Illinois members enjoy:

• Choice of a contracting medical group/independent practice association from one of the largest HMO networks in the state
• No claim forms
• Flexible plan design options with deductible/coinsurance and copay features

Benefits

Members also enjoy access to a range of benefits when care is provided/coordinated through their primary care provider (PCP).

• Doctor office visits
• Preventive care and wellness services for children and adults such as
  • routine physicals
  • immunizations
  • tests and screenings for breast and cervical cancer, prostate and colon cancer
• Outpatient surgery and diagnostic tests
• Outpatient and inpatient hospital services and treatments
• Maternity care
• Mental health and substance abuse (inpatient and outpatient)*
• Rehabilitative therapy (such as physical, speech and occupational)

• Other coverage and discounts on services such as:
  • Emergency care
  • Out-of-area coverage (traveling/temporarily living out of state)
  • Substance abuse treatment (inpatient and outpatient)
  • Vision exams at the cost of an office visit copayment and discounts on lenses, frames and permanent contact lenses, vision correction surgery and disposable contact lenses
  • Discounts on hearing aids 
  • Discounts on chiropractic care, acupuncture and massage therapy and health and wellness products
• Prescription drug card benefits with 90-day supply program for maintenance medications

Network Choices

Qualifying employers can offer employees one or both Blue Cross and Blue Shield HMO networks. Having more network options gives you greater flexibility to design the health care benefits that suit your budget - and are affordable and attractive to employees.

Depending on group size, you can offer:

Blue Advantage HMO - A broad provider network of contracting medical groups/independent practice associations and hospitals - at a more affordable cost.

HMO Illinois - One of the largest provider networks of primary care physicians (PCPs) and hospitals in the state - at a higher cost.

Check with your account representative to determine which package is the best fit for your company.

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* Members of Physicians Care Network, Inc. coordinates mental health care directly with the behavioral health network provider.