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 annual deductible and, generally, claim forms
• Low copayment levels

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 that does not require a PCP referral includes:
  • 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 benefit with 90-day supply for maintenance medications

Network

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

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