Insurance Information

Your Loyola Medicine doctor is your strongest ally in the fight to stay healthy, and your insurance plan affects the doctor you can choose. Loyola accepts most major health insurance plans, including HMO, PPO and POS plans, Medicare and more. Please see our list of accepted plans. 

If you do not have health insurance, learn about the Affordable Care Act, how to enroll in insurance through the Healthcare Marketplace and how to apply for Medicaid, Medicare and the Children's Health Insurance Program.

Loyola Family Care

Loyola Family Care is a new health plan for qualified Illinois Medicaid recipients. Learn more about Loyola Family Care.

Our Obstetrics and Gynecology Coverage Policy

In accordance with Illinois state law, Loyola allows open access to obstetricians and gynecologists for women who have enrolled in an HMO consistent with the HMO policy.

Loyola accepts many types of insurance, including policies from major insurers, dental and vision plans, Medicare replacement and supplemental policies, Medicaid, Affordable Care Act plans, and other coverage.

List of Accepted Insurance Plans

Loyola accepts many types of insurance, including policies from major insurers, dental and vision plans, Medicare replacement and supplemental policies, Medicaid, Affordable Care Act plans, and other coverage.

INSURANCE OR PAYOR NAME

TYPE OF PLAN

Aetna

HMO

Aetna

POS, PPO, EPO (Aetna Open Access; Choice POS II; Choice Plus; QPOS; Open Choice; Elect Choice)

Aetna Signature Administrators

PPO

Aetna

EPO

Aetna

PPO

Aetna for Elm Employees

PPO

Aetna for Elm Employees

EPO

Beech Street

PPO

Blue Cross/Blue Shield of Illinois – Site 349 LUMC

HMO (Option A plans: HMOI; HMO Illinois; Classic Blue; Blue Precision; Blue Advantage)

Blue Cross/Blue Shield of Illinois

HMO – Not Site 349 (Option B plans: HMOI; HMO Illinois; Classic Blue)

BlueCross/BlueShield of Illinois

HMO – Not Site 349 (Option C plans: Blue Advantage HMO; Blue Perform.
Patient may be treated by Loyola specialist and hospital with referral but patient may not select a Loyola primary care physician.)

BlueCross/BlueShield of Illinois

POS (Blue Choice)

BlueCross/Blue Shield of Illinois

PPO (Option A plans: PPO; BlueEdge PP; Blue Advantage PPO (IL); Blue Choice Select PPO; Lumenos)

BlueCross/Blue Shield of Illinois

PPO (Option B: Chicago Dist. Council of Carpenters; Pipefitters Local 597; Carpenters Welfare Fund.
Option C: ICHIP
Option D: Chicago Area IB of T
Option E: Chicago Laborers Welfare Fund
Option F: Midwest Operating Engineers
Option G: Federal Employee
Option H: MCHC – Loyola Medical Center

Blue Cross/Blue Shield Out-of- State (non-Illinois)

HMO POS EPO
(With HMO and POS, patient may be treated by Loyola specialist and hospital with referral, but patient may not select a Loyola primary care physician. )

Blue Cross/Blue Shield Out-of- State (non-Illinois)

PPO

Blue Cross/Blue Shield Coordinated Home Care

Home Health Care

Cadence Employee Health Plan

Employee Health Plan

Chicago Area IB of T (Local 703)

PPO

Christian Brothers Services

PPO

Cigna

HMO

Cigna

POS

Cigna

PPO

Cigna

EPO

Cigna

Indemnity

CoMed

PPO

CompCare of the Ozarks

PPO

DigiTrace

PPO (Specialists only)

DuPage Medical Clinic

IPA (Specialists only)

Elmcare L.L.C.

IPA (Specialists only)

Formost Inc.

HMO

Hammond Clinic LLC

IPA (Specialists only)

HealthLink

PPO/HMO

HealthSouth Corp.

PPO (Hospital only)

HealthSelect

IPA

HFN (Healthcare's Finest Network)

PPO, EPO

Hinsdale Hospital and Hinsdale Physicians Healthcare

IPA (Specialists only)

Holy Cross Health Partners

IPA (Specialists only)

Holy Family Health Plus

IPA (Specialists only)

Humana

HMO (Option A: Premier HMO; Illinois Platinum HMO; HMO Select; Select HMO) (Patient may be referred but cannot select Loyola primary care physician)

Humana

HMO (Option B: National HMO; HMO Premier – formerly National HMO)

Humana

HMO (Option C: HMO Premier Open Access)

Humana

EPO

Humana

PPO (Option A: ChoiceCare Network; PPO Smart Net – Choice Care Network; Humana Preferred PPO)

Humana

PPO (Option B: ChoicePOS – Works as PPO)

Humana

PPO (Option C: Humana National POS; Humana National POS-Open Access; Humana National POS-Open Access Plus – All work as PPOs)

Humana

PPO (Humana Preferred POS-Open Access – Works as PPO)

Independent Physicians @ Mercy

IPA (Specialists only)

Lake County Physicians Association

IPA (Specialists only)

Land of Lincoln

PPO

LifeTrac Network

Transplant Network

MacNeal Hospital Chicago Health Systems

IPA (Specialists only)

McHenry County Physicians Organization (MCPO)

IPA (Specialists only)

The Medical Care Group (TMCG)

IPA (Specialists only)

Mercy Physicians Association (MPA)

IPA (Specialists only)

Monastery of the Holy Cross

PPO

Naperville HealthCare Associates

IPA (Specialists only)

Optum Health

Transplant Network

PHCS

PPO

PPO Next

PPO

Preferred Network Access (PNA)

PPO

Preferred Plan Inc. (PPI)

PPO

Preferred Plan Inc. (PPI)

PPO, EPO

Providers First PPO

PPO

Resurrection Health Preferred

IPA (Specialists only)

Resurrection Health Preferred — Holy Family

IPA (Specialists only)

Resurrection Physicians Provider Group (RPPG)

IPA (Specialists only)

Rockford Health Plans Inc.

HMO, POS (Patient may be referred but cannot select Loyola primary care physician)

Rockford Health Plans Inc.

PPO

Rush MacNeal Loyola (RML) Specialty Hospital

Specialty Hospital (Hospital only)

Select Health Network

HMO, PPO

St. Francis Health Care Ltd.

IPA (Specialists only)

St. Francis Health Preferred

IPA (Specialists only)

St. James PHO

IPA (Specialists only)

Student Insurance Loyola (Stritch School of Medicine)

PPO

The Medical Care Group (TMCG)

IPA (Specialists only)

Unicare

HMO (Patient may be referred but cannot select Loyola primary care physician)

Unicare

POS (Patient may be referred but cannot select Loyola primary care physician)

Unicare

PPO

Unicare

Indemnity

Union Health Services (SEIU Local 25 and Local 1 Health and Welfare Fund)

HMO (Patient may be referred but cannot select Loyola primary care physician)

Union Health Services (SEIU Local 25 and Local 1 Health and Welfare Fund)

PPO

United HealthCare (UHC)

HMO

United HealthCare (UHC) Compass

HMOx

United HealthCare (UHC)

EPO

United HealthCare (UHC)

POS

United Healthcare (UHC)

PPO

United Healthcare (UHC) Options PPO plans

PPO

United Healthcare

Managed Indemnity

United Healthcare

Indemnity

US Steel - Garyworks

PPO (Specialists and hospital)

USA Managed Care

PPO

Village of North Riverside

PPO

West Suburban Health Plans

PHO (Specialists only)

MEDICARE REPLACEMENT AND SUPPLEMENTAL PLANS

AARP

Medicare Supplement

Aetna Medicare Replacement

Medicare Replacement

Bankers Life Medicare Select

Medicare Supplement

Blue Cross/Blue Shield of Illinois
Medicare Select

Medicare Supplement

Blue Cross/Blue Shield Medicare Advantage

Medicare HMO Replacement Plan

Humana Medicare

Medicare Replacement (PFFS & Gold Choice)

Humana Medicare (limited to certai doctors)

Medicare Replacement HMO

Galaxy Health Network

Medicare Supplement

Medicare

Federal Program

Secure Horizons

Medicare Replacement (PFFS)

Secure Horizons

Medicare Supplement

Sterling

Medicare Replacement (PFFS)

Sterling

Medicare Supplement

Today’s Options

Medicare Replacement PFFS

Unicare

Medicare Replacement PFFS

United Healthcare - Medicare Advantage

Medicare Group PPO (Replacement PPO)

United HealthCare - Medicare Select

Medicare Select (Select Plans Cover Part C and/or F)

MEDICAID

 

Aetna Better Health

Medicaid Managed Care (MCO)

Accountable Care Entities

Medicaid Managed Care (ACE*)

Care Coordination Entities

Medicaid Replacement HMO (CCE*)

Children with Special Needs

Medicaid Managed Care (CSN-CCE*)

County Care

Medicaid Managed Care (MCO)

DCFS

State of Illinois program: Department of Children and Family Services

Early Intervention

Department of Human Services program for children up to age 3 who have developmental delays

Illinois Health Connect

Medicaid Managed Care

Loyola Family Care

Medicaid Managed Care: Accountable Care Enterprise

Medicaid

State of Illinois program

*Medicaid Managed Care other than those listed here (including other ACE, CCE and CSN Plans)

Medicaid Managed Care (Patient may be referred but cannot select Loyola primary care physician)

HEALTHCARE MARKETPLACE EXCHANGE PLANS

Blue Cross PPO

 

Blue Cross Choice

 

Blue Precision

 

Humana Chicago HMOx

 

Humana Choice POS

 

Land of Lincoln: Co-Options Land of Lincoln National

 

Land of Lincoln Freedom

 

Land of Lincoln Preferred

 

United HealthCare (UHC) Compass

 

OTHER COVERAGE TYPES

 

MEDICARE-MEDICAID INITIATIVE PROGRAMS (DUALS)

Blue Cross Blue Shield Medicare/Medicaid Initiative Program (Duals)

Medicare/Medicaid Initiative Program (MMAI)

OTHER

 

Access to Care

ATC Location 180: This charity program provides primary care to those who do not qualify for federal or state aid

CHAMPVA

Program for disabled veterans and family members

DENTAL AND VISION PLANS

 

Always Vision

Vision Plan

Starmount

Vision Plan

Cigna Dental

PPO
Dental Plan

DeCare Dental Networks

PPO
Dental Plan

Delta Dental Networks

PPO
Dental Plan

Delta Dental PPO

PPO
Dental Plan

Dental Health Alliance (DHA)

PPO
Dental Plan

Metlife Dental PPO

PPO
Dental Plan

Frequently Asked Questions About Insurance

We know you are likely to have questions. We hope you find all of the information you need here, but our provider relations staff can help you understand which insurance plans we accept. Provider relations can be reached by calling 708-216-5014.

If you have more questions, please call 888-584-7888. We'll put you in touch with the right person to answer your questions about health insurance, help you locate a doctor and provide general information.

How do I know whether Loyola Medicine is part of my insurance plan? 
Talk to a representative of the health insurance plan. Ask if the plan contracts with Loyola University Medical Center. If your health insurance plan requires you to use a primary care physician (PCP), ask your PCP to refer you to a Loyola-affiliated provider when necessary and appropriate. Loyola contracts with many providers.

How do I find a Loyola doctor who is in my health plan? 
Call us at 888-584-7888. We'll help you locate a doctor who meets your healthcare needs and participates in your insurance plan. 

With so many hospitals in the Chicago area, why should I choose Loyola Medicine? 
Loyola’s renowned doctors can meet your healthcare needs, from preventive care to hospitalization, rehabilitation and home care. And with numerous locations offering both primary and specialty care, there is a Loyola doctor conveniently located near your home or work.

Is Loyola Medicine a health insurance plan? 
No. But Loyola works closely with several health maintenance organizations. Loyola contracts with many major health insurance plans, preferred provider organizations and point of service plans for their members' care. There are many health plans that give you access to Loyola doctors and services.

Still have questions?
Call us at 888-584-7888. We'll put you in touch with the right people to answer your questions about health insurance, help you choose a doctor and provide general information.

Our Obstetrics and Gynecology Policy

Loyola allows open access to obstetricians and gynecologists for women who have enrolled in an HMO consistent with the HMO policy.

What Obstetric Care Includes

Obstetric care includes the following services:

  • An initial evaluation
  • Any 23-hour admission to rule out labor
  • Emergency/emergent antenatal admission for hypertension, metabolic disturbances, preterm rupture of membranes, third trimester bleeding, pre-eclampsia
  • Genetic counseling with amniocentesis for AMA, and/or abnormal triple testing and/or any other abnormalities
  • Hospital admission for delivery
  • One postpartum visit
  • Up to 12 subsequent routine prenatal care visits

Obstetric care includes the following tests:

  • 24-hour urine for proteinuria, preeclampsia
  • 3-hour glucose tolerance test (GTT) if glucose screen abnormal
  • 50 gram glucola
  • Amniocentesis if history of prior congenital or genetic abnormality
  • Amniocentesis if over 35 years, genetic counseling if amniocentesis shows abnormalities
  • Antibody screen
  • Blood type
  • Chlamydia
  • Complete blood count (CBC), liver function tests, fibrinogen and fibrin split products for preeclampsia
  • Gonococcus
  • Hemocrit
  • Hemoglobin
  • Hepatitis screen
  • HIV testing
  • Non-stress testing and/or biophysical testing (may substitute contraction stress test for biophysical profile) if post estimated date of confinement, post dates, intrauterine growth retardation, preeclampsia or decreased fetal movement
  • One basic ultrasound
  • Pap smear
  • Perinatal strep screen
  • Rapid plasma reagin (RPR)
  • Repeat ultrasound for third trimester bleeding, decreased fetal growth or size greater than dates
  • Rhogam x 1 if Rh negative
  • Rubella
  • Urine culture and sensitivity
  • Targeted level II sonography if prior history of congenital or genetic abnormalities
  • Triple test if less than 35 years​

What Gynecology Care Includes

Gynecologic care includes the following services:

  • Pap smear
  • Visits

Gynecologic care includes the following tests:

  • Blood tests including CBC, HB and HCT
  • Cervical/vaginal culture
  • Colposcopy (protocol necessary)
  • Endometrial biopsy
  • FSH and LH tests
  • Incision and drainage (I and D) of abscesses and cysts
  • Pelvic ultrasound
  • Pregnancy test
  • Quantitative serum HCG
  • Routine mammogram over the age of 50 years
  • Urinalysis
  • Urine culture
  • Vulvar biopsy​​

Please contact your insurance company for more information regarding its policy on open access to obstetricians and gynecologists.