Northwestern Medical Group

Commercial health insurance is a type of private health insurance coverage. It helps you pay for your medical and surgical expenses. This type of health insurance is often offered by employers.

Northwestern Medicine hospitals and physician clinics have contracts for insurance with the organizations listed below. Coverage for Northwestern Medicine facilities and physicians may be in-network or out-of-network. This depends on your plan. You may require authorization for services by your plan before receive care. Please check with your health plan’s customer service to verify coverage details. This information can impact your out-of-pocket costs.

Changes to Cigna Plus Northwestern Medicine for Cook County for 2023

Cigna Plus Northwestern Medicine will not be available for residents of Cook County. However, residents of DuPage, Kane, Lake and McHenry counties will still have coverage in Cook County if they receive care at Northwestern Memorial Hospital.

Aetna

Aetna Choice POS
Aetna Choice POS II
Aetna Elect Choice
Aetna EPO
Aetna Health Network Only
Aetna Health Network Option
Aetna HMO
Aetna Illinois Preferred Plan
Aetna Managed Choice POS
Aetna NAP
Aetna Open Access Elect Choice
Aetna Open Access HMO
Aetna Open Access Managed Choice
Aetna Open Choice PPO (including, but not limited to Aetna Signature Administrators® and Open Choice)
Aetna Performance Network
Aetna Premier Care Network (contact your insurance company)
Aetna Premier Care Network Plus (contact your insurance company)
Aetna QPOS
Aetna Savings Plus
Aetna Select
Aetna Student Health
Aetna Traditional Choice
Aetna Voluntary Group Medical Plan (Indemnity Plan)

Beechstreet (PHCS)

Blue Cross Blue Shield

If your Blue Cross Blue Shield HMO plan site number is not listed below, and your primary care provider is not employed by Northwestern Medicine or part of Northwestern Medicine Physician Network, you will need a referral to see a specialist or have other services at Northwestern Medicine.

For questions about referrals, please call Blue Cross Blue Shield’s customer service line. This phone number is on the back of your insurance card.

Blue Cross Blue Shield of Illinois HMO Plans associated with Northwestern Medicine include:

  • Site #475: Northwestern Medicine Physician Network West and Northwest Suburb
    Your BCBS ID card will state: NMPN W, NW Sub
  • Site #489: Northwestern Medicine Physician Network Chicago and North Suburb
    Your BCBS ID card will state: NMPN, CHI, N Sub

Blue Cross Blue Shield

Blue Cross Blue Shield - HMOI

  • Blue Cross Blue Shield of Illinois sites 475 and 489 for Northwestern Medicine Physician Network primary care and specialty care services.
  • If you have a Blue Cross Blue Shield of Illinois HMO site that is not listed on the table above and not affiliated with Northwestern Medicine, you will need an authorized referral for specialty care services. To find out if your physician is with Northwestern Medicine, visit Find a Doctor on nm.org.

Blue Cross Blue Shield - Blue Advantage HMO

  • Blue Cross Blue Shield of Illinois sites 475 and 489 for Northwestern Medicine Physician Network primary care and specialty care services with the exception of Northwestern Medical Group primary care providers.
  • If you have a Blue Cross and Blue Shield of Illinois HMO site that is not listed on the table above and not affiliated with Northwestern Medicine, you will need an authorized referral for specialty care services. To find out if your physician is with Northwestern Medicine, visit Find a Doctor on nm.org.

Blue Cross Blue Shield - Blue Choice PPO
Blue Cross Blue Shield - Blue Choice Options (Tier 1)
Blue Cross Blue Shield – PPO
Blue Choice Preferred Gold PPO 204
Blue Choice Preferred Gold PPO 707
Blue Precision Gold HMO 207
Blue Precision Gold HMO 703 - Rx Copays
Blue Precision Gold HMO 707
Blue Choice Preferred Silver PPO 303
Blue Choice Preferred Silver PPO 203
Blue Choice Preferred Silver PPO 706
Blue Precision Silver HMO 206
Blue Precision Silver HMO 306
Blue Precision Silver HMO 704 - Rx Copays
Blue Precision Silver HMO 706
Blue Choice Preferred Bronze PPO 302
Blue Choice Preferred Bronze PPO 502
Blue Choice Preferred Bronze PPO 201
Blue Choice Preferred Bronze PPO 202
Blue Choice Preferred Bronze PPO 601
Blue Choice Preferred Bronze PPO 701
Blue Choice Preferred Bronze PPO 705
Blue Choice Preferred Bronze PPO 708
Blue Precision Bronze HMO 205
Blue Precision Bronze HMO 701 - Rx Copays
Blue Precision Bronze HMO 708

Cigna

CIGNA Behavioral Health, Inc
Cigna - Open Access
Cigna - Open Access Plus
Cigna - Choice Fund Open Access Plus
Cigna - ChoiceCare PPO
Cigna - EPO
Cigna - Global Health Benefits
Cigna - GWH POS Open Access Plus
Cigna - HMO (or POS)
Cigna - HMO (or POS) Open Access
Cigna - Local Plus
Cigna - Network Open Access
Cigna - Network POS
Cigna - One Health HMO eff 4/1/19
Cigna Plus with Northwestern Medicine 4400 (Effective 1/1/2023)*
Cigna Plus with Northwestern Medicine 2000 (Effective 1/1/2023)*
Cigna - POS
Cigna - PPO
Cigna - Shared Administration PPO and OAP

*Cigna Plus with Northwestern Medicine is being offered to residents of DuPage, Kane, Lake and McHenry counties for 2023. Patients residing in these counties will have access to NMH. This product is not offered in Cook County. Questions regarding this plan can be directed to Cigna.

Coventry Health Care - First Health HMO, PPO and POS

Global Excel - PPO

Health Alliance PPO and HMO

HFN

HFN - EPO (HFN20)
HFN - PPO (HFN10)
HFN - Workers' Compensation Program/Network

Humana

Humana - Choice POS
Humana - ChoiceCare PPO
Humana - EPO
Humana - HMO Premier (patients must have a referral for services)
Humana - HMO Select (specialist services only)
Humana - Illinois Platinum HMO (specialist services only)
Humana - National Preferred POS - Open Access
Humana - PPO
Humana - Preferred PPO

Imagine Health

MultiPlan/PHCS

The Alliance

United Behavioral Health - Optum

United Healthcare

United Healthcare - All Savers
United Healthcare - Choice
United Healthcare - Choice Plus
United Healthcare - Core
United Healthcare - HMO (Patients must have a referral for services)
United Healthcare - HMO Plus
United Healthcare - Navigate
United Healthcare - Open Access (Patients must have a referral for services)
United Healthcare - Options PPO
United Healthcare - Select Plus
United Healthcare - Select
United Healthcare Affiliates - Participate through UHC PPO

Health exchanges or health insurance marketplaces were established in accordance with the Affordable Care Act (ACA) of 2010. These marketplaces provide a set of government-regulated and standardized healthcare plans where individuals may purchase health insurance policies, some of which include federal subsidies.

Changes to Cigna Plus Northwestern Medicine for Cook County for 2023

Cigna Plus Northwestern Medicine will not be available for residents of Cook County. However, residents of DuPage, Kane, Lake and McHenry counties will still have coverage in Cook County if they receive care at Northwestern Memorial Hospital.

2023 Options

The plans below offer current access to Northwestern Medicine on Get Covered Illinois, the official health insurance marketplace for Illinois for the 2023 calendar year.

  • Blue Choice Preferred PPO
  • Blue Cross Blue Shield Precision

    If your Blue Cross Blue Shield HMO plan site number is not listed below, and your primary care provider is not employed by Northwestern Medicine or part of Northwestern Medicine Physician Network, you will need a referral to see a specialist or have other services at Northwestern Medicine.

    For questions about referrals, please call Blue Cross Blue Shield’s customer service line. This phone number is on the back of your insurance card.

    Blue Cross Blue Shield of Illinois HMO Plans associated with Northwestern Medicine include:

    • Site #475: Northwestern Medicine Physician Network West and Northwest Suburb
      Your BCBS ID card will state: NMPN W, NW Sub
    • Blue Cross Blue Shield of Illinois sites 475 for Northwestern Medicine Physician Network primary care and specialty care services with the exception of Northwestern Medical Group primary care providers.
    • If you have a Blue Cross Blue Shield of Illinois HMO site that is not listed on the table above and not affiliated with Northwestern Medicine, you will need an authorized referral for specialty care services. To find out if your physician is with Northwestern Medicine, visit Find a Doctor on nm.org.
  • Cigna Plus With Northwestern Medicine
    An HMO product that requires the selection of a primary care physician at Northwestern Medicine.

For instructions on how to enroll in any of these plans, please call 312.926.7440, TTY 711.

Bronze

Blue Choice Preferred Bronze PPO 201
Blue Choice Preferred Bronze PPO 202
Blue Choice Preferred Bronze PPO 601
Blue Choice Preferred Bronze PPO 701
Blue Choice Preferred Bronze PPO 705
Blue Choice Preferred Bronze PPO 708
Blue Precision Bronze HMO 205
Blue Precision Bronze HMO 701 - Rx Copays
Blue Precision Bronze HMO 708
Cigna Plus Northwestern Medicine 0A*
Cigna Plus Northwestern Medicine 5000 Rx Copay*
Cigna Plus Northwestern Medicine HSA 7050*
Cigna Plus Northwestern Medicine 6800 Enhanced Diabetes Care*
Cigna Plus Northwestern Medicine Diabetes 7600 Enhanced Asthma COPD Care*
Cigna Simple Choice 9100
Cigna Simple Choice 7500

Silver

Blue Choice Preferred Silver PPO 203
Blue Choice Preferred Silver PPO 706
Blue Precision Silver HMO 206
Blue Precision Silver HMO 704 - Rx Copays
Blue Precision Silver HMO 706
Cigna Plus Northwestern Medicine 6000* 
Cigna Plus Northwestern Medicine 3800-2* 
Cigna Plus Northwestern Medicine 700-3* 
Cigna Plus Northwestern Medicine 0-4A*
Cigna Plus Northwestern Medicine 0B*
Cigna Plus Northwestern Medicine 0-2*
Cigna Plus Northwestern Medicine 0-3*
Cigna Plus Northwestern Medicine 0-4B*
Cigna Plus Northwestern Medicine 3000 Rx Copay*
Cigna Plus Northwestern Medicine 2500-2 Rx Copay*
Cigna Plus Northwestern Medicine 350-3 Rx Copay*
Cigna Plus Northwestern Medicine 100-4 Rx Copay*
Cigna Plus Northwestern Medicine 8000*
Cigna Plus Northwestern Medicine 6150-2*
Cigna Plus Northwestern Medicine 2000-3*
Cigna Plus Northwestern Medicine 650-4*
Cigna Plus Northwestern Medicine 3800 Enhanced Diabetes Care*
Cigna Plus Northwestern Medicine 3000-2 Enhanced Diabetes Care*
Cigna Plus Northwestern Medicine 600-3 Enhanced Diabetes Care*
Cigna Plus Northwestern Medicine 40-4 Enhanced Diabetes Care*
Cigna Plus Northwestern Medicine 4200 Enhanced Asthma COPD Care*
Cigna Plus Northwestern Medicine 3550-2 Enhanced Asthma COPD Care*
Cigna Plus Northwestern Medicine 750-3 Enhanced Asthma COPD Care*
Cigna Plus Northwestern Medicine 50-4 Enhanced Asthma COPD Care*
Cigna Simple Choice 5800
Cigna Simple Choice 5700-2
Cigna Simple Choice 800-3
Cigna Simple Choice 0-4C 

Gold

Blue Choice Preferred Gold PPO 204
Blue Choice Preferred Gold PPO 707
Blue Precision Gold HMO 207
Blue Precision Gold HMO 703 - RX Copays
Blue Precision Gold HMO 707
Cigna Plus Northwestern Medicine 750 Rx Copay*
Cigna Simple Choice 2000
Cigna Plus Northwestern Medicine 1900 Enhanced Diabetes Care*

All Levels

Health Alliance Marketplace Plans HMO (requires referral from primary care physician/referring specialist)

*Cigna Plus with Northwestern Medicine is being offered to residents of DuPage, Kane, Lake and McHenry counties for 2023. Patients residing in these counties will have access to NMH. This product is not offered in Cook County. Questions regarding this plan can be directed to Cigna.

Government plans are a wide range of plans that include a variety of Medicare and/or Medicaid plans. Northwestern Medicine participates in traditional Medicare and Medicaid as well as Family Health Plans (FHP), Integrated Care Plans (ICP) and Medicare-Medicaid Alignment Initiative (MMAI) plans. FHP, ICP and MMAI plans are often available to individuals who were previously eligible for traditional Medicaid but are now accessing managed Medicaid plans through expansion of the Affordable Care Act or “Obamacare.”

In addition, Northwestern Medicine participates with TriCare Military Services. For active duty military personnel and their families, this is administered by a plan for the Department of Defense.

Government & Military Plans

Medicare
Medicaid
Veteran Affairs Community Care Network administered by Optum
TriCare East Administered by Humana Military

Medicare Advantage Plans

Aetna - HMO 
Aetna - PPO 
Aetna - Open Access HMO
Aetna Prime HMO-POS
Blue Cross Blue Shield - PPO  
Blue Cross Blue Shield - HMO 
Cigna True Choice Plus Medicare (PPO)
Cigna Preferred Medicare (HMO)
Cigna True Choice Medicare (PPO)
Cigna True Choice Savings Medicare (PPO)
Cigna Courage Medicare (HMO)
Cigna True Choice Courage Medicare (PPO)
Health Alliance  (Referrals required for specialty care, NO primary care is covered)
Humana HMO Gold Plus
Humana PFFS
Humana PPO
Humana Honor PPO (Veterans Plan)
United HealthCare Chronic Complete Assure (PPO C-SNP)
United HealthCare Medicare Complete Access (Referrals required for specialty care, NO primary care is covered)
United HealthCare Medicare Advantage PPO 
United HealthCare AARP® Medicare Advantage Plan 1 (HMO) 
United HealthCare AARP® Medicare Advantage Plan 2 (HMO) 
United HealthCare AARP® Medicare Advantage Choice (PPO) 
United Healthcare AARP Medicare Advantage Walgreens (PPO) 
United HealthCare AARP® Medicare Advantage Patriot (PPO)

Medicare/Medicaid Alignment Initiative Agreements (MMAI)

Blue Cross Blue Shield
Humana

Medicaid Managed Care Programs/HealthChoice Illinois

Blue Cross Blue Shield
CountyCare 
Meridian 

Medical Group/IPA Site Medicare Advantage HMO
Site 757 (Northwestern Medicine) X