Blue Cross and Blue Shield of Illinois
Illinois • PPO, Medicaid, High-Deductible Health Plan (HDHP)
Under this PPO prefix, members are covered for both in-network and out-of-network care. The plan pays a higher percentage of allowed charges when members use participating providers. No gatekeeper or primary care referral is required. Verify the member's specific benefits for cost-sharing details.
This prefix is associated with Medicaid managed care. When a BCBS plan administers Medicaid, the claims process may differ from commercial coverage: different payer ID, different claims address, different prior authorization rules, and different timely filing limits. Always verify Medicaid-specific details before submitting.
Under this HDHP prefix, the member's plan has a higher deductible than traditional coverage. This affects patient cost-sharing but does not change how claims are submitted or processed. Use the same payer ID, claims address, and filing procedures listed above. Verify the member's remaining deductible before estimating patient responsibility.
State's only statewide customer-owned health insurer and independent licensee of the Blue Cross Blue Shield Association. Serves Illinois with commercial, Medicare, Medicaid and other plans.