Government Insurance Plans
Government-sponsored health insurance plans include different types of Medicare and Medicaid plans, which cover your medical and surgical expenses. The University of Chicago Medicine participates with traditional Medicare and Medicaid plans as well as some Medicare Advantage and some Medicaid managed care plans.
Your insurance plan’s customer service representative can help verify your benefits, out-of-pocket costs and coverage. UChicago Medicine contracts with a variety of government plans to meet the needs of our patients.
Medicaid & HealthChoice Illinois Plans
In January 2018, the Illinois Department of Health Care and Family Services (HFS) expanded Medicaid managed care to include all counties across Illinois. The new, expanded program is called HealthChoice Illinois. If you have Medicaid and want to continue receiving your medical care from UChicago Medicine and/or the the University of Chicago Physicians Group, you will need to choose a HealthChoice plan that includes UChicago Medicine and the UChicago Physicians Group as in-network providers.
We accept the following Medicaid & HealthChoice Illinois plans:
| Medicaid | UChicago Medicine | Ingalls |
|---|---|---|
| Medicaid (Illinois) | Y | Y |
| Aetna Better Health |
Y* | Y |
| BCBS Community |
N | Y |
| CountyCare |
Y** | Y |
| Meridian |
N | N |
| Molina |
N | N |
| YouthCare (through Meridian) |
Y | Y |
Y-Contracted
Y*-Pediatrics and transplant-related care
Y**-In-network for pediatric primary and specialty care and adult specialty care only.
N-Not Contracted
To learn about your Medicaid health plan choices, call the Illinois Department of Healthcare & Family Services’ Client Enrollment Services at 877-912-8880 (TTY: 1-866-565-8576) or visit the website at www.enrollHFS.Illinois.gov.
If you have questions regarding your insurance benefits at UChicago Medicine, please contact our financial counseling team at OPSFinancialCounseling@uchospitals.edu.
We participate in the following transplant network plans:
- Aetna
- AIG Medical
- American Health Holding
- Blue Distinction Centers for Transplant (BDCT)
- Cigna LifeSource
- Community Healthcare System
- General Electric
- Interlink
- Kaiser Permanente
- Optum
- Southeastern Indiana Health Organization (SIHO)
- Tethys Health Ventures
- USA Network
- Zing Health (Medicare Advantage Plan)
Our list of accepted insurance providers is subject to change at any time. You should contact your insurance company to confirm UChicago Medicine participates in their network before scheduling your appointment. Your insurance plan's customer service representatives can also help you verify your benefits, out-of-pocket costs and coverage. If you have questions regarding your insurance benefits at UChicago Medicine, please contact our financial counseling team at OPSFinancialCounseling@uchospitals.edu.
Medicare & Medicare Advantage Plans
Medicare does not pay for every medical service on every occasion. Instead, Medicare has rules to determine if certain tests, services and procedures can be covered. These coverage rules are based on your medical condition and, sometimes, on the number of times that you have had a particular test, service or procedure in the past. However, just because Medicare does not pay for something does not mean it is unnecessary.
UChicago Medicine’s outpatient clinics are obligated to apply the Medicare coverage rules when they bill Medicare. When making appointments or ordering tests, our clinic staff will check to see if your test, service or procedure will be covered before you are provided with the service.
If it’s likely Medicare won’t pay for a test or procedure that’s been ordered by your doctor, our staff will ask you to sign an "advance beneficiary notice," which is also called an ABN. The ABN is a document Medicare requires all hospitals and doctors to use when Medicare does not pay for a service. It makes sure patients have a choice about their health care in the event that Medicare does not pay. If we ask you to sign an ABN, you will have two options:
- You may choose to receive the test or procedure, agree to be responsible for payment and sign the ABN.
- You may choose not to receive the test or procedure, refuse to be responsible for payment and sign the ABN.
If you are given an ABN, our staff will be available to answer your questions about your financial responsibility and payment options so you can make an informed decision about your health care.
We accept the following Medicare and Medicare Advantage insurance plans:
| Medicare/Medicare Advantage Plans | UChicago Medicine | Ingalls |
| Traditional Medicare | Y | Y |
| AARP Medicare Complete Access HMO | N | N |
| AARP Medicare Complete Plan 1 HMO | N | N |
| AARP Medicare Complete Plan 2 HMO |
N | N |
| Aetna Better Health Premier Plan MMAI |
N | N |
| Aetna Medicare Plan PPO | Y | Y |
| Aetna Medicare Prime Plan HMO | Y*** | Y*** |
| Aetna Medicare Prime Plan PPO | Y | Y |
| Ascension Complete IL (Centene Venture Health Plan) HMO | Y* | Y |
| BCBS Community MMAI | Transplant only | Y |
| BCBS Medicare Advantage HMO | Y** | N |
| BCBS Medicare Advantage HMO-POS | Y** | N |
| BCBS Medicare Advantage PPO | Y | Y |
| Cigna HealthSpring Medicare Advantage |
N | N |
| Humana Choice PPO |
Y | Y |
| Humana Community HMO |
N | N |
| Humana Employer HMO – Chicago |
Y* | Y |
| Humana Gold Choice PFFS |
Y | Y |
| Humana Gold Plus HMO – Chicago |
Y* | Y |
| Humana Gold Plus HMO – IN |
Y* | Y |
| Humana Health Plan MMAI |
N | N |
| Humana Medicare PPO/Employer PPO Plus |
Y | Y |
| Humana Total Care Advantage HMO |
N | N |
| Meridian Complete MMAI |
N | N |
| Provider Partners Health Plan |
Y | Y |
| UnitedHealthcare Group Medicare Advantage PPO |
N | N |
| UnitedHealthcare Nursing Home Plan HMO-POS SNP |
N | N |
| Zing Health |
N | Y |
Y-Contracted
N-Not Contracted
*If primary care provider is not a UChicago Medicine physician, referrals for specialist needed.
**, patients can have UCMC PCP (Site 753). If PCP not at UCMC, specialists w/referrals only.
*** Specialty care only with referral; No primary care
We participate in the following transplant network plans:
- Aetna
- AIG Medical
- American Health Holding
- Blue Distinction Centers for Transplant (BDCT)
- Cigna LifeSource
- Community Healthcare System
- General Electric
- Interlink
- Kaiser Permanente
- Optum
- Southeastern Indiana Health Organization (SIHO)
- Tethys Health Ventures
- USA Network
- Zing Health (Medicare Advantage Plan)
Our list of accepted insurance providers is subject to change at any time. You should contact your insurance company to confirm UChicago Medicine participates in their network before scheduling your appointment. Your insurance plan's customer service representatives can also help you verify your benefits, out-of-pocket costs and coverage. If you have questions regarding your insurance benefits at UChicago Medicine, please contact our financial counseling team at OPSFinancialCounseling@uchospitals.edu.
Medicaid & HealthChoice Illinois Plans
In January 2018, the Illinois Department of Health Care and Family Services (HFS) expanded Medicaid managed care to include all counties across Illinois. The new, expanded program is called HealthChoice Illinois. If you have Medicaid and want to continue receiving your medical care from UChicago Medicine and/or the the University of Chicago Physicians Group, you will need to choose a HealthChoice plan that includes UChicago Medicine and the UChicago Physicians Group as in-network providers.
We accept the following Medicaid & HealthChoice Illinois plans:
| Medicaid | UChicago Medicine | Ingalls |
|---|---|---|
| Medicaid (Illinois) | Y | Y |
| Aetna Better Health |
Y* | Y |
| BCBS Community |
N | Y |
| CountyCare |
Y** | Y |
| Meridian |
N | N |
| Molina |
N | N |
| YouthCare (through Meridian) |
Y | Y |
Y-Contracted
Y*-Pediatrics and transplant-related care
Y**-In-network for pediatric primary and specialty care and adult specialty care only.
N-Not Contracted
To learn about your Medicaid health plan choices, call the Illinois Department of Healthcare & Family Services’ Client Enrollment Services at 877-912-8880 (TTY: 1-866-565-8576) or visit the website at www.enrollHFS.Illinois.gov.
If you have questions regarding your insurance benefits at UChicago Medicine, please contact our financial counseling team at OPSFinancialCounseling@uchospitals.edu.
We participate in the following transplant network plans:
- Aetna
- AIG Medical
- American Health Holding
- Blue Distinction Centers for Transplant (BDCT)
- Cigna LifeSource
- Community Healthcare System
- General Electric
- Interlink
- Kaiser Permanente
- Optum
- Southeastern Indiana Health Organization (SIHO)
- Tethys Health Ventures
- USA Network
- Zing Health (Medicare Advantage Plan)
Our list of accepted insurance providers is subject to change at any time. You should contact your insurance company to confirm UChicago Medicine participates in their network before scheduling your appointment. Your insurance plan's customer service representatives can also help you verify your benefits, out-of-pocket costs and coverage. If you have questions regarding your insurance benefits at UChicago Medicine, please contact our financial counseling team at OPSFinancialCounseling@uchospitals.edu.
Medicare & Medicare Advantage Plans
Medicare does not pay for every medical service on every occasion. Instead, Medicare has rules to determine if certain tests, services and procedures can be covered. These coverage rules are based on your medical condition and, sometimes, on the number of times that you have had a particular test, service or procedure in the past. However, just because Medicare does not pay for something does not mean it is unnecessary.
UChicago Medicine’s outpatient clinics are obligated to apply the Medicare coverage rules when they bill Medicare. When making appointments or ordering tests, our clinic staff will check to see if your test, service or procedure will be covered before you are provided with the service.
If it’s likely Medicare won’t pay for a test or procedure that’s been ordered by your doctor, our staff will ask you to sign an "advance beneficiary notice," which is also called an ABN. The ABN is a document Medicare requires all hospitals and doctors to use when Medicare does not pay for a service. It makes sure patients have a choice about their health care in the event that Medicare does not pay. If we ask you to sign an ABN, you will have two options:
- You may choose to receive the test or procedure, agree to be responsible for payment and sign the ABN.
- You may choose not to receive the test or procedure, refuse to be responsible for payment and sign the ABN.
If you are given an ABN, our staff will be available to answer your questions about your financial responsibility and payment options so you can make an informed decision about your health care.
We accept the following Medicare and Medicare Advantage insurance plans:
| Medicare/Medicare Advantage Plans | UChicago Medicine | Ingalls |
| Traditional Medicare | Y | Y |
| AARP Medicare Complete Access HMO | N | N |
| AARP Medicare Complete Plan 1 HMO | N | N |
| AARP Medicare Complete Plan 2 HMO |
N | N |
| Aetna Better Health Premier Plan MMAI |
N | N |
| Aetna Medicare Plan PPO | Y | Y |
| Aetna Medicare Prime Plan HMO | Y*** | Y*** |
| Aetna Medicare Prime Plan PPO | Y | Y |
| Ascension Complete IL (Centene Venture Health Plan) HMO | Y* | Y |
| BCBS Community MMAI | Transplant only | Y |
| BCBS Medicare Advantage HMO | Y** | N |
| BCBS Medicare Advantage HMO-POS | Y** | N |
| BCBS Medicare Advantage PPO | Y | Y |
| Cigna HealthSpring Medicare Advantage |
N | N |
| Humana Choice PPO |
Y | Y |
| Humana Community HMO |
N | N |
| Humana Employer HMO – Chicago |
Y* | Y |
| Humana Gold Choice PFFS |
Y | Y |
| Humana Gold Plus HMO – Chicago |
Y* | Y |
| Humana Gold Plus HMO – IN |
Y* | Y |
| Humana Health Plan MMAI |
N | N |
| Humana Medicare PPO/Employer PPO Plus |
Y | Y |
| Humana Total Care Advantage HMO |
N | N |
| Meridian Complete MMAI |
N | N |
| Provider Partners Health Plan |
Y | Y |
| UnitedHealthcare Group Medicare Advantage PPO |
N | N |
| UnitedHealthcare Nursing Home Plan HMO-POS SNP |
N | N |
| Zing Health |
N | Y |
Y-Contracted
N-Not Contracted
*If primary care provider is not a UChicago Medicine physician, referrals for specialist needed.
**, patients can have UCMC PCP (Site 753). If PCP not at UCMC, specialists w/referrals only.
*** Specialty care only with referral; No primary care
We participate in the following transplant network plans:
- Aetna
- AIG Medical
- American Health Holding
- Blue Distinction Centers for Transplant (BDCT)
- Cigna LifeSource
- Community Healthcare System
- General Electric
- Interlink
- Kaiser Permanente
- Optum
- Southeastern Indiana Health Organization (SIHO)
- Tethys Health Ventures
- USA Network
- Zing Health (Medicare Advantage Plan)
Our list of accepted insurance providers is subject to change at any time. You should contact your insurance company to confirm UChicago Medicine participates in their network before scheduling your appointment. Your insurance plan's customer service representatives can also help you verify your benefits, out-of-pocket costs and coverage. If you have questions regarding your insurance benefits at UChicago Medicine, please contact our financial counseling team at OPSFinancialCounseling@uchospitals.edu.