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Update: Services Rendered by Contracted Providers to Immediate Family Members

Posted July 17, 2014

As a reminder, standard Blue Cross and Blue Shield of Illinois (BCBSIL) benefits are not available for services rendered by a contracted provider to their immediate family members. Currently, an immediate family member is defined as a(n):

  • Current spouse
  • Eligible domestic partner
  • Parents and step-parents
  • Children and grandchildren
  • Siblings (including natural, step, half or other legally placed children)

Effective Nov. 1, 2014, an immediate family member will also include any parent, child or sibling of a  spouse or domestic partner of a contracted provider.

For more information, please contact your BCBSIL Provider Network Consultant (PNC).

Verification of eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility, any claims received during the interim period and the terms of the member’s certificate of coverage applicable on the date services were rendered.