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Important News About Blue Precision HMOSM and Northwestern Medicine

Nov. 23, 2016

Blue Cross and Blue Shield of Illinois is committed to expanding access to quality health care to as many people as possible in Illinois through the individual marketplace. That’s why we offer a variety of health plans and networks to meet our members’ needs, like our Blue Precision HMOSM health plan. Here are a few key things to keep in mind:

  • As with any HMO plan, with the Blue Precision HMO, you must choose a medical group and a primary care physician (PCP) within that medical group. Your PCP provides basic health care needs and arranges any added care. If you need care beyond your PCP’s level of expertise, he or she will refer you to a specialist.
  • Before you go to a specialist, you will need to see your PCP first, even if the specialist is part of your PCP’s medical group.
  • Before you choose the Blue Precision HMO plan, it’s important to know how it relates to Northwestern Medicine and Northwestern facilities and specialists.

    As in prior years, Blue Precision HMO offers access to several medical groups in the Chicagoland area, including:
    • Medical Group/Site 475 Northwestern Medicine Physician Partners – Central DuPage (Cadence) Hospital
    • Medical Group/Site 477 Northwestern Medicine Physician Partners – Delnor Hospital

      If you choose one of these sites, you must get your primary care through the medical group and PCP you chose at that site. You must also get a referral from your PCP to get care from a specialist or any hospital.
  • If your medical group can’t provide the care you need, and your PCP refers you to a specialist, that care will be paid as in-network benefits. But, if you get treatment with Northwestern Medicine doctors without a referral, those services will be looked at as out of network. This means you will have to pay 100% of the out-of-network costs.
  • Before you choose any plan, you may want to search Provider Finder® to see if your current doctor or hospital is in the network.

Learn more about the Blue Precision HMO and other BCBSIL plans.