Medicare Advantage Plans

Blue Cross Medicare AdvantageSM plans offer all the coverage of Original Medicare — plus benefits not covered by Medicare or most Medicare Supplement insurance plans, including built-in prescription drug coverage and extra health and wellness options. Blue Cross and Blue Shield of Illinois (BCBSIL) offers both HMO and PPO, individual and group Medicare Advantage plans.

Networks and Benefit Plans

Our strong brand recognition and our historical relationship with Medicare makes BCBSIL an excellent choice for Medicare-eligible individuals. We maintain and monitor a network of participating providers including physicians, hospitals, skilled nursing facilities, ancillary providers and other health care providers through which members obtain covered services.

Medicare Advantage plans offer health coverage to members who reside in certain counties. For more details about our Medicare Advantage plans including names, network summary and geographic areas, see the Government Programs Networks and Benefit Products

Medicare Group Plans

  • Our retiree group Medicare plans are Blue Cross Group Medicare Advantage (PPO)℠, Blue Cross Group Medicare Advantage Open Access (PPO)℠ and Blue Cross Group MedicareRx (PDP)SM.
  • Out-of-network providers: If you see Medicare members or accept Medicare assignment and are willing to bill BCBSIL, you may treat Blue Cross Group Medicare Advantage Open Access (PPO)SM as an out-of-network provider. Out-of-network providers will be paid the Medicare-allowed amount less any member cost-sharing. In-network providers will be paid at their contracted rate. 

Join the Illinois Medicare Advantage Network

To join our Blue Cross Medicare Advantage network, follow the process for Contracting

Pre-service Requirements


The fastest way to conduct business with BCBSIL throughout the entire claims process is via Electronic Data Interchange (EDI). Refer to the Claim Submission section for an introduction to filing claims with BCBSIL. Medicare Advantage claims must be submitted within 180 days of the date of service and/or discharge date.

Medicare Marketing Guidelines

All providers who contract with BCBSIL to provide Medicare Advantage services are expected to abide by the Centers for Medicare & Medicaid Services (CMS) rules for marketing when it involves BCBSIL or Blue Cross Medicare Advantage products or benefits. See the Medicare Marketing Guidelines on the CMS website.

Blue Cross Medicare Advantage plans are HMO, HMO-POS and PPO plans provided by Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association. HCSC is a Medicare Advantage organization with a Medicare contract. Enrollment in HCSC’s plans depends on contract renewal.