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. 

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

2024 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.

2024 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.

2024 Blue Cross Blue Shield - Blue Choice PPO
2024 Blue Cross Blue Shield - Blue Choice Options (Tier 1)
2024 Blue Cross Blue Shield - PPO
2024 Blue Choice Preferred Gold PPOSM 204 - Rx Copays
2024 Blue Choice Preferred Gold PPOSM 707
2024 Blue Precision Gold HMOSM 207
2024 Blue Precision Gold HMOSM 703 - Rx Copays
2024 Blue Precision Gold HMOSM 707
2024 Blue Choice Preferred Silver PPOSM 203
2024 Blue Choice Preferred Silver PPOSM 303
2024 Blue Choice Preferred Silver PPOSM 706
2024 Blue Choice Preferred Silver PPOSM 801 - Rx Copays
2024 Blue Precision Silver HMOSM 206
2024 Blue Precision Silver HMOSM 306
2024 Blue Precision Silver HMOSM 704 - Rx Copays
2024 Blue Precision Silver HMOSM 706
2024 Blue Choice Preferred Bronze PPOSM 201
2024 Blue Choice Preferred Bronze PPOSM 202
2024 Blue Choice Preferred Bronze PPOSM 601 - Rx Copays
2024 Blue Choice Preferred Bronze PPOSM 701 - Rx Copays
2024 Blue Choice Preferred Bronze PPOSM 708
2024 Blue Precision Bronze HMOSM 205
2024 Blue Precision Bronze HMOSM 701 - Rx Copays
2024 Blue Precision Bronze HMOSM 708

Cigna

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 - 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 2024. 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

Curaechoice

Global Excel - PPO

Health Alliance PPO and HMO

HFN

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

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. 

2024 Options

The plans below offer current access to Northwestern Medicine on Get Covered Illinois, the official health insurance marketplace for Illinois for the 2024 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

2024 Blue Choice Preferred Bronze PPOSM 201
2024 Blue Choice Preferred Bronze PPOSM 202
2024 Blue Choice Preferred Bronze PPOSM 601 - Rx Copays
2024 Blue Choice Preferred Bronze PPOSM 701 - Rx Copays
2024 Blue Choice Preferred Bronze PPOSM 708
2024 Blue Precision Bronze HMOSM 205
2024 Blue Precision Bronze HMOSM 701 - Rx Copays
2024 Blue Precision Bronze HMOSM 708
Aetna CVS Health Individual and Family Plans - ChicagoLand Illinois PPO Bronze S
Aetna CVS Health Individual and Family Plans - ChicagoLand Illinois PPO Bronze 1
Aetna CVS Health Individual and Family Plans - ChicagoLand Illinois PPO Bronze 4
Cigna Plus Bronze CMS Standard (This plan won't be offered in 2025.)
Cigna Plus with Northwestern Medicine Bronze 5000 Indiv Med Deductible - Rx Copay (This plan won't be offered in 2025.)

Silver

2024 Blue Choice Preferred Silver PPOSM 203
2024 Blue Choice Preferred Silver PPOSM 706
2024 Blue Choice Preferred Silver PPOSM 801 - Rx Copays
2024 Blue Precision Silver HMOSM 206
2024 Blue Precision Silver HMOSM 704 - Rx Copays
2024 Blue Precision Silver HMOSM 706
Aetna CVS Health Individual and Family Plans - ChicagoLand Illinois PPO Silver S
Aetna CVS Health Individual and Family Plans - ChicagoLand Illinois PPO Silver 5
Aetna CVS Health Individual and Family Plans - ChicagoLand Illinois PPO Silver 6
Aetna CVS Health Individual and Family Plans - ChicagoLand Illinois PPO Silver 7
Cigna Plus Silver CMS Standard (This plan won't be offered in 2025.)
Cigna Plus Silver-2 CMS Standard (This plan won't be offered in 2025.)
Cigna Plus Silver-3 CMS Standard (This plan won't be offered in 2025.)
Cigna Plus Silver-4 CMS Standard (This plan won't be offered in 2025.)
Cigna Plus with Northwestern Medicine Silver 3000 Indiv Med Deductible - Rx Copay (This plan won't be offered in 2025.)
Cigna Plus with Northwestern Medicine Silver-2 2500 Indiv Med Deductible - Rx Copay (This plan won't be offered in 2025.)
Cigna Plus with Northwestern Medicine Silver-3 350 Indiv Med Deductible - Rx Copay (This plan won't be offered in 2025.)
Cigna Plus with Northwestern Medicine Silver-4 100 Indiv Med Deductible - Rx Copay (This plan won't be offered in 2025.)
Cigna Plus with Northwestern Medicine Silver 5000 Indiv Med Deductible (This plan won't be offered in 2025.)
Cigna Plus with Northwestern Medicine Silver-2 3800 Indiv Med Deductible (This plan won't be offered in 2025.)
Cigna Plus with Northwestern Medicine Silver-3 700 Indiv Med Deductible (This plan won't be offered in 2025.)
Cigna Plus with Northwestern Medicine Silver-4 0 Indiv Med Deductible (This plan won't be offered in 2025.)

Gold

2024 Blue Choice Preferred Gold PPOSM 204 - Rx Copays
2024 Blue Choice Preferred Gold PPOSM 707
2024 Blue Precision Gold HMOSM 207
2024 Blue Precision Gold HMOSM 703 - Rx Copays
2024 Blue Precision Gold HMOSM 707
Aetna CVS Health Individual and Family Plans - ChicagoLand Illinois PPO Gold S
Aetna CVS Health Individual and Family Plans - ChicagoLand Illinois PPO Gold 3
Cigna Plus Gold CMS Standard - Rx Copay (This plan won't be offered in 2025.)

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 2024. 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

CHAMPUS
Medicare
Medicaid
Veteran Affairs Community Care Network administered by Optum
TriCare East Administered by Humana Military (Effective January 1, 2025, Tricare East Illinois has transitioned to TriWest Healthcare Alliance.)

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 
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 AARP® Medicare Advantage from UHC IL-0001
United HealthCare AARP® Medicare Advantage from UHC IL-0002
United HealthCare AARP® Medicare Advantage from UHC IL-0004
United HealthCare AARP® Medicare Advantage Walgreens from UHC IL-0005
United HealthCare AARP® Medicare Advantage from UHC IL-0003
United HealthCare AARP® Medicare Advantage Walgreens from UHC IL-0006
United HealthCare UHC Complete Care IL-001A
United HealthCare AARP® Medicare Advantage Patriot No Rx IL-MA01
Zing Choice (HMO)
Zing Choice Diabetes & Heart Complete (PPO C-SNP)
Zing Complete Select (HMO D-SNP)
Zing Complete Open Choice (PPO D-SNP)
Zing Complete Plus (HMO D-SNP)
Zing Elite Diabetes & Heart (HMO C-SNP)
Zing Elite Select (HMO)
Zing ESRD Select (HMO C-SNP)
Zing Essential Wellness Diabetes & Heart (HMO C-SNP)
Zing Open Choice (PPO)
Zing Open Choice Diabetes & Heart (PPO C-SNP)
Zing Select Care (HMO)
Zing Select Diabetes & Heart (HMO C-SNP)
Zing Select Diabetes & Heart Complete (HMO C-SNP)

Medicare/Medicaid Alignment Initiative Agreements (MMAI)

Blue Cross Blue Shield
Humana
Zing Health

Medicaid Managed Care Programs/HealthChoice Illinois

Blue Cross Blue Shield
CountyCare 
Meridian (Out-of-network at Northwestern Medicine as of January 1, 2025)