Update: Out-of-State Care Beyond Contiguous Counties Waiver Ends Jan. 1, 2027
Sept. 17, 2026
Effective Jan. 1, 2027, members with Blue Choice Preferred PPOSM and MyBlue Plus POSSM plans purchased on or off the marketplace exchange will no longer be able to request a waiver to receive care out of state or within the contiguous counties. This means that, beginning Jan. 1, these members will pay standard out-of-network rates for non-emergency and non-urgent services received outside the state service area.
What this means for you: For local claim filing, if you have a direct contract with us for our Blue Choice Preferred or MyBlue Plus networks, and you submit your claim to Blue Cross and Blue Shield of Illinois, your claim will be processed at the in-network benefit level.
Active waivers and exceptions: All existing out-of-state care waivers will expire Jan. 1, 2027, and no new waivers will be issued. Members may be eligible to receive PPO Network Exception waivers when they apply.
More information and reminders
Check members’ eligibility and benefits through Availity® Essentials or your preferred vendor portal prior to rendering services or recommending care.
When recommending members to other providers or reminding them how to find in-network care, refer to our provider directory.
Checking eligibility and/or benefit information and/or obtaining prior authorization 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 and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's ID card.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors.