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Information > Accepted Managed
Care Insurance Plans
Accepted
Managed Care Insurance Plans
Loyola
University Health System participates in a number of
managed care insurance plans**. Below are listed the
names of the largest managed care plans contracting
with Loyola. Patients are advised to contact their insurance
company before any appointment to verify individual
physician participation. If the physician is not listed
with the plan, please contact Loyola University Physician
Foundation at (708) 216-5626. Those plans shown with
an * indicate that a primary care physician (PCP) may
be chosen at Loyola for that particular HMO/POS product.
Please note that this list is not all-inclusive and
is subject to change at any time. If your plan is not
listed here, please call (708) 216-5014 for additional
information.
| Largest
Managed Care Plans Accepted |
HMO |
POS |
PPO |
Blue Cross/Blue Shield of Illinois HMO (also
known as HMO Illinois)*
( May select a Loyola PCP)
( Excludes: Blue Advantage HMO) |
x |
|
|
Blue
Cross/ Blue Shield of Illinois Blue Choice POS*
|
|
x |
|
| Blue Cross/Blue Shield of Illinois PPO |
|
|
x |
Concentra/Beech Street/Capp Care PPO
(Excludes:
Best Benefits, CHBA, Christian Care Medi-Share,
Plan Plus ) |
|
|
x |
Concentra/ppoNext/PHN
(Preferred Health Network)
(Excludes:
New Dimension Medical PPO, American Health Benefits,
Family Care Health Savings Plan, Full Access,
Health One, IAB, National Healthcare Plan)
|
|
|
x |
| Coventry Health Care/First Health (For
McDonald's Corp. insureds only) |
|
|
x |
Cigna
Health Care (includes State of Illinois)*
(May select Loyola PCP) |
x |
x |
x |
Great West Healthcare*
(May select a Loyola PCP)
(Excludes: One Plan/Open Access)
|
x |
x |
x |
Harmony
Health Plan of Illinois
(May not select a Loyola PCP) |
x |
|
|
| Healthcare's
Finest Network (HFN) |
|
|
x |
Humana
(May select a Loyola PCP for “Humana
National HMO” only) |
x |
x |
x |
| Preferred
Network Access |
|
|
x |
Preferred Plan (PPI)
(Excludes: Pro Net, Pro America)
|
|
|
x |
Private
Health Care Systems (PHCS)
(Excludes: Capella Group, For Your Good
Health, Chamber Health, Advantage Care Plus) |
|
|
x |
| Providers First PPO |
|
|
x |
| Rockford
Health Plans, Inc. |
x |
x |
x |
Unicare
Health Plans
(May not select a Loyola PCP) |
x |
x |
x |
United
Health Care*
(May select a Loyola PCP (excludes United
Medicare replacement products) |
x |
x |
x |
| USA
Managed Care |
|
|
x |
*A Loyola
Primary Care Physician (PCP) may be chosen for the following
HMO/POS plans:
Blue Cross/Blue Shield HMO (excludes Blue Advantage
HMO)
Blue Cross/Blue Shield POS
Cigna Healthcare HMO/POS
Great-West Healthcare HMO/POS (excludes One Plan/Open
Access)
Humana National HMO only (excludes all other Humana
HMO/POS plans)
United Health Care HMO/POS (excludes United Medicare
replacement plans)
**In accordance with Illinois state legislation, Loyola
University Health System does allow open access to obstetricians
and gynecologists for women who have enrolled in an
HMO consistent with the HMO policy. Please contact your
insurance company for further information regarding
the insurer’s policy on open access to obstetricians
and gynecologists.
Obstetrics
Includes:
Services:
- an initial evaluation
- up to 12 subsequent
routine prenatal care visits
- any 23-hour admission
to rule out labor
- hospital admission for
delivery
- one postpartum visit
- emergency/emergent antenatal
admission for hypertension, metabolic disturbances,
pre-term rupture of membranes, third trimester bleeding,
preeclampsia
- genetic counseling with
amniocentesis for AMA, and/or abnormal triple testing,
and/or any other abnormalities
Tests:
- hemoglobin
- hemocrit
- blood type
- chlamydia
- hepatitis screen
- antibody screen
- Rapic Plasma Reagin
- rubella
- pap smear
- Gonococcus
- urine culture and sensitivity
- triple test if less
than 35 years
- amnio if over 35 years,
genetic counseling if amnio shows abnormalities
- 50 gram glucola
- rhogam x 1 if Rh negative
- perinatal strep screen
- one basic ultrasound
- repeat ultrasound for
third trimester bleeding, decreased fetal growth or
size greater than dates
- 3 hour glucose tolerance
test (GTT) if glucose screen abnormal
- 24 hour urine for proteinuria,
preeclampsia
- amniocentesis if history
of prior congenital or genetic abnormality
- targeted level II sonography
if prior history of congenital or genetic abnormalities
- Complete blood count
(CBC), liver function tests, fibrinogen and fibrin
split products for preeclampsia
- non-stress testing and/or
biophysical testing (may substitute contraction stress
test for biophysical profile) if post estimated date
of confinement, post dates, intrauterine growth retardation,
preeclampsia or decreased fetal movement
- HIV Testing
Gynecology
Includes:
Services:
Tests:
- pap smear
- cervical/vaginal culture
- CBC/HB/HCT
- UA
- urine culture
- pregnancy test
- quantitative serum HCG
- endometrial biopsy
- FSH/LH
- vulvar biopsy
- I and D abscess/cyst
- colposcopy (protocol
necessary)
- pelvic ultrasound
- routine mammogram over
the age of 50 years
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