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Important Notice

Springfield Clinic recently informed Blue Cross and Blue Shield of Illinois PPO, Blue Choice and HMO patients that in-network coverage for all Ambulatory Surgery and Endoscopy Center procedures will be terminated effective Aug. 19, 2021, and all other services at Springfield Clinic will be terminated effective Nov. 17, 2021. Blue Cross and Blue Shield patients can continue to access care at Springfield Clinic up to the date of network termination. However, after this date, some services at Memorial facilities that involve Springfield Clinic providers may be affected. We will provide more information as the termination date approaches.

Please note that Memorial Health System remains in-network for all Blue Cross and Blue Shield products and networks.

We hope that Springfield Clinic and Blue Cross and Blue Shield of Illinois can resolve this situation before the termination dates. In meantime, Memorial remains committed to providing our patients and communities with the latest information on how this may affect their benefits for healthcare. Please continue to check this site for additional updates.

Memorial Health System affiliates proudly accept a wide variety of health insurance plans to serve our community. The list provided below includes plans that each affiliate is currently participating. We encourage all patients to verify coverage and benefits with their plan administrator or insurance carrier.

 

Hospital Facilities

Memorial Medical Center – Springfield, Illinois

Note: Independent health care providers who practice at Memorial Medical Center may not be participating in the same insurance plans and networks as Memorial Medical Center. Independent providers’ services will be billed separately.

Commercial Insurance Plans

  • Aetna/Coventry
  • BlueCross BlueShield of Illinois HMO/PHAI (Site 314)
  • BlueCross BlueShield of Illinois PPO (Blue Distinction Center)

Blue Distinction® Center and Blue Distinction® Center + Designations: Cardiac Care +, Spine Surgery +, Bariatric Surgery +, Hip and Knee Replacement

What is a Blue Distinction Center? According to BlueCross BlueShield of Illinois, there are two levels of recognition. Blue Distinction Centers offer quality care, treatment expertise and better overall patient results. Blue Distinction Centers + offer more affordable care in addition to quality care, treatment expertise and better overall patient results.

Center of Excellence Designations: Bariatric Surgery, Cardiac Catheterization and Angioplasty, and Gallbladder Removal, Laparoscopic

What is a Center of Excellence? According to Cigna, a center of excellence is a designation is obtained after review. This review is based on two key things: patient outcomes, or how successful a hospital is at caring for patients undergoing a certain surgery or being treated for an illness, and cost-efficiency—the hospital's ability to deliver consistently excellent patient care while still keeping costs lower than average.

  • Consociate Group
  • CorVel
  • Current Health Network
  • Health Alliance
  • HealthLink
  • HFN
  • Humana
  • MultiPlan/PHCS (Physician-only plans not accepted)
  • Preferred Plan, Inc.
  • United Healthcare (Physician-only plans not accepted)

ACA/Exchange Plans

Medicare

  • Traditional Medicare Part A & B

Medicare Advantage Managed Care (Part C) Plans

  • Aetna/Coventry Advantra
  • BlueCross BlueShield of Illinois (effective January 1, 2021)
  • Health Alliance Basic 
  • Humana Choice

Medicaid

  • Illinois Traditional Medicaid

Medicaid Managed Care Plans (Health Choice Illinois)

  • Aetna Better Health of Illinois (previously IlliniCare)
  • Blue Cross Community Health Plans
  • Meridian Health
  • Molina Healthcare

Service Member Plans

  • Tricare/Humana Military
  • VA Community Care Network (VA CCN)

Decatur Memorial Hospital – Decatur, Illinois

Note: Independent health care providers who practice at Decatur Memorial Hospital may not be participating in the same insurance plans and networks as Decatur Memorial Hospital. Independent providers’ services will be billed separately.

Commercial Insurance Plans

  • Aetna/Coventry
  • Amish-Mennonite
  • BlueCross BlueShield of Illinois HMO
  • BlueCross BlueShield of Illinois PPO (Blue Distinction Center)

Blue Distinction® Center and Blue Distinction® Center + Designations: Hip and Knee Replacement + and Maternity Care +

What is a Blue Distinction Center? According to BlueCross BlueShield of Illinois, there are two levels of recognition. Blue Distinction Centers offer quality care, treatment expertise and better overall patient results. Blue Distinction Centers + offer more affordable care in addition to quality care, treatment expertise and better overall patient results.

Center of Excellence Designations: Cardiac Catheterization and Angioplasty, and Colon Surgery

What is a Center of Excellence? According to Cigna, a center of excellence is a designation is obtained after review. This review is based on two key things: patient outcomes, or how successful a hospital is at caring for patients undergoing a certain surgery or being treated for an illness, and cost-efficiency—the hospital's ability to deliver consistently excellent patient care while still keeping costs lower than average.

  • Consociate Group
  • CorVel
  • Health Alliance
  • HealthLink
  • Humana
  • MultiPlan/PHCS (Physician-only plans not accepted)
  • Plain Church Medical Group
  • United Healthcare (Physician-only plans not accepted)

ACA/Exchange Plans

Medicare

  • Traditional Medicare Part A & B

Medicare Advantage Managed Care (Part C) Plans

  • Aetna/Coventry Advantra
  • BlueCross BlueShield of Illinois  (effective January 1, 2021)
  • Health Alliance Basic 
  • HumanaChoice

Medicaid

  • Illinois Traditional Medicaid

Medicaid Managed Care Plans (HealthChoice Illinois)

  • Aetna Better Health of Illinois (previously IlliniCare)
  • Blue Cross Community Health Plans
  • Meridian Health
  • Molina Healthcare

Medicaid Managed Care Plans (Medicare-Medicaid Alignment)

  • MeridianComplete
  • Molina Healthcare

Service Member Plans

  • Tricare/Humana Military
  • VA Community Care Network (VA CCN)

Passavant Area Hospital – Jacksonville, Illinois

Note: Independent health care providers who practice at Passavant Area Hospital may not be participating in the same insurance plans and networks as Passavant Area Hospital. Independent providers’ services will be billed separately.

Commercial Insurance Plans

  • Aetna/Coventry
  • BlueCross BlueShield of Illinois HMO/PHAI (Site 314)
  • BlueCross BlueShield of Illinois PPO (Blue Distinction Center)

Blue Distinction® Center and Blue Distinction® Center + Designations: Hip and Knee Replacement and Maternity Care

What is a Blue Distinction Center? According to BlueCross BlueShield of Illinois, there are two levels of recognition. Blue Distinction Centers offer quality care, treatment expertise and better overall patient results. Blue Distinction Centers + offer more affordable care in addition to quality care, treatment expertise and better overall patient results.

Center of Excellence Designations: Delivery (C-Section, Vaginal Delivery) and Respiratory Conditions

What is a Center of Excellence? According to Cigna, a center of excellence is a designation is obtained after review. This review is based on two key things: patient outcomes, or how successful a hospital is at caring for patients undergoing a certain surgery or being treated for an illness, and cost-efficiency—the hospital's ability to deliver consistently excellent patient care while still keeping costs lower than average.

  • CorVel
  • Current Health Network
  • Health Alliance
  • HealthLink
  • HFN
  • Humana Health Plan
  • MultiPlan/PHCS (Physician-only plans not accepted)
  • United Healthcare (Physician-only plans not accepted)

ACA/Exchange Plans

Medicare

  • Traditional Medicare Part A & B

Medicare Advantage Managed Care (Part C) Plans

  • Aetna/Coventry Advantra
  • BlueCross BlueShield of Illinois  (effective January 1, 2021)
  • Health Alliance Basic
  • HumanaChoice

Medicaid

  • Illinois Traditional Medicaid

Medicaid Managed Care Plans (HealthChoice Illinois)

  • Aetna Better Health of Illinois (previously IlliniCare)
  • Blue Cross Community Health Plans
  • Meridian Health
  • Molina Healthcare

Service Member Plans

  • Tricare/Humana Military
  • VA Community Care Network (VA CCN)

Abraham Lincoln Memorial Hospital – Lincoln, Illinois

Note: Independent health care providers who practice at Abraham Lincoln Memorial Hospital may not be participating in the same insurance plans and networks as Abraham Lincoln Memorial Hospital.  Independent providers’ services will be billed separately.

Commercial Insurance Plans

  • Aetna/Coventry
  • BlueCross BlueShield of Illinois HMO/PHAI (Site 314)
  • BlueCross BlueShield of Illinois PPO
  • Caterpillar, Inc
  • Cigna PPO
  • Consociate Group
  • CorVel
  • Health Alliance
  • HealthLink
  • HFN
  • Humana
  • Multiplan/PHCS (Physician-only plans not accepted)
  • United Healthcare (Physician-only plans not accepted)

ACA/Exchange Plans

Medicare

  • Traditional Medicare Part A & B

Medicare Advantage Managed Care (Part C) Plans

  • Aetna/Coventry Advantra
  • BlueCross BlueShield of Illinois  (effective January 1, 2021)
  • Health Alliance Basic 
  • HumanaChoice

Medicaid

  • Illinois Traditional Medicaid

Medicaid Managed Care Plans (HealthChoice Illinois)

  • Aetna Better Health of Illinois (previously IlliniCare)
  • Blue Cross Community Health Plans
  • Meridian Health
  • Molina Healthcare

Service Member Plans

  • Tricare/Humana Military
  • VA Community Care Network (VA CCN)

Taylorville Memorial Hospital – Taylorville, Illinois

Note: Independent health care providers who practice at Taylorville Memorial Hospital may not be participating in the same insurance plans and networks as Taylorville Memorial Hospital. Independent providers’ services will be billed separately.

Commercial Insurance Plans

  • Aetna/Coventry
  • BlueCross BlueShield of Illinois HMO/PHAI (Site 314)
  • Blue Cross Blue Shield of Illinois PPO
  • Caterpillar, Inc
  • Cigna PPO
  • Consociate Group
  • CorVel
  • Health Alliance
  • HealthLink
  • HFN
  • Humana Health Plan
  • MultiPlan/PHCS (Physician-only plans not accepted)
  • United Healthcare (Physician-only plans not accepted)
  • United Mine Workers of America (UMWA)

ACA/Exchange Plans

Medicare

  • Traditional Medicare Part A & B

Medicare Advantage Managed Care (Part C) Plans

  • Aetna/Coventry Advantra
  • BlueCross BlueShield of Illinois  (effective January 1, 2021)
  • Health Alliance Basic
  • HumanaChoice

Medicaid

  • Illinois Traditional Medicaid

Medicaid Managed Care Plans (HealthChoice Illinois)

  • Aetna Better Health of Illinois (previously IlliniCare)
  • Blue Cross Community Health Plans
  • Meridian Health
  • Molina Healthcare

Service Member Plans

  • Tricare/Humana Military
  • VA Community Care Network (VA CCN)

Ambulatory Providers

Memorial Physician Services

Note: Memorial Physician Services sites of care are recognized by the National Committee for Quality Assurance (NCQA) as patient-centered medical homes. This model of care puts you and your loved ones at the center of care by enhancing communication, better coordinating your needed care and a continuous commitment to quality improvement.

Commercial Insurance Plans

  • Aetna/Coventry
  • BlueCross BlueShield of Illinois HMO/PHAI (Site 314)
  • BlueCross BlueShield of Illinois PPO
  • Cigna PPO
  • Consociate Group
  • CorVel
  • Health Alliance
  • HealthLink
  • HFN
  • Humana Health Plan
  • Multiplan/PHCS
  • United Healthcare

ACA/Exchange Plans

Medicare

  • Traditional Medicare Part A & B

Medicare Advantage Managed Care (Part C) Plans

  • Aetna/Coventry Advantra
  • BlueCross Blue Shield of Illinois (effective 1/1/21)
  • Health Alliance
  • HumanaChoice

Medicaid

  • Illinois Traditional Medicaid

Medicaid Managed Care Plans (HealthChoice Illinois)

  • Aetna Better Health of Illinois (previously IlliniCare)
  • Blue Cross Community Health Plans
  • Meridian Health
  • Molina Healthcare

Service Member Plans

  • VA Community Care Network (VA CCN)

DMH Medical Group

Note: DMH Medical Group sites of care are recognized by the National Committee for Quality Assurance (NCQA) as patient-centered medical homes. This model of care puts you and your loved ones at the center of care by enhancing communication, better coordinating your needed care and a continuous commitment to quality improvement.

Commercial Insurance Plans

  • Aetna/Coventry
  • Amish-Mennonite
  • BlueCross BlueShield of Illinois HMO
  • BlueCross BlueShield of Illinois PPO
  • Caterpillar, Inc
  • Cigna PPO
  • Consociate Group
  • CorVel
  • Health Alliance
  • HealthLink
  • Humana
  • MultiPlan/PHCS (Physician-only plans not accepted)
  • Plain Church Medical Group
  • United Healthcare (Physician-only plans not accepted)

ACA/Exchange Plans

Medicare

  • Traditional Medicare Part A & B

Medicare Advantage Managed Care (Part C) Plans

  • Aetna/Coventry Advantra
  • BlueCross BlueShield of Illinois  (effective January 1, 2021)
  • Health Alliance Basic 
  • HumanaChoice

Medicaid

  • Illinois Traditional Medicaid

Medicaid Managed Care Plans (HealthChoice Illinois)

  • Aetna Better Health of Illinois (previously IlliniCare)
  • Blue Cross Community Health Plans
  • Meridian Health
  • Molina Healthcare

Medicaid Managed Care Plans (Medicare-Medicaid Alignment)

  • MeridianComplete
  • Molina Healthcare

Service Member Plans

  • Tricare/Humana Military
  • VA Community Care Network (VA CCN)

Memorial Weight Loss & Wellness Center

We will work with you to verify insurance coverage, discuss payment options and answer general questions after completion of your online orientation. Each provider and plan is different, so we are here to provide individual consultation about your specific coverage.

If you have questions, please do not hesitate to contact us. This includes your initial quote, the addition of other diagnoses to your quote, what is covered and not covered, as well as discounted rates.

We are here to help you navigate this process and achieve a healthier lifestyle.

Memorial Behavioral Health

Commercial Insurance Plans

  • BlueCross BlueShield of Illinois HMO/PHAI (Site 314)
  • BlueCross BlueShield of Illinois PPO
  • CorVel
  • Health Alliance
  • HealthLink
  • Magellan
  • MultiPlan/PHCS

ACA/Exchange Plans

Medicare

  • Traditional Medicare Part B

Medicare Advantage Managed Care (Part C) Plans

  • Aetna/Coventry Advantra
  • BlueCross BlueShield of Illinois  (effective January 1, 2021)
  • Health Alliance Basic
  • HumanaChoice

Medicaid

  • Traditional Illinois Medicaid

Medicaid Managed Care Plans (HealthChoice Illinois)

  • Aetna Better Health of Illinois (previously IlliniCare)
  • Blue Cross Community Health Plans
  • Meridian Health
  • Molina Healthcare

Service Member Plans

  • Tricare/Humana Military
  • VA Community Care Network (VA CCN)

Memorial Home Services

Commercial Insurance Plans

  • Aetna/Coventry
  • BlueCross BlueShield of Illinois HMO/PHAI (Site 314)
  • BlueCross BlueShield of Illinois PPO
  • Cigna PPO
  • Consociate Group
  • CorVel
  • Health Alliance
  • HealthLink
  • Humana Health Plan
  • Multiplan/PHCS
  • Preferred Plan, Inc

ACA/Exchange Plans

Medicare

  • Traditional Medicare Part A & B

Medicare Advantage Managed Care (Part C) Plans

  • Aetna/Coventry Advantra
  • BlueCross Blue Shield of Illinois (effective 1/1/21)
  • Health Alliance
  • HumanaChoice

Medicaid

  • Illinois Traditional Medicaid

Medicaid Managed Care Plans (HealthChoice Illinois)

  • Aetna Better Health of Illinois (previously IlliniCare)
  • Blue Cross Community Health Plans
  • Meridian Health
  • Molina Healthcare

Service Member Plans

  • VA Community Care Network (VA CCN)

Affordable Care Act (ACA)

Fast Facts on the Health Insurance Marketplace

  1. As a provision of the Affordable Care Act (ACA), uninsured Americans can enroll in insurance plans through the Health Insurance Marketplace. In Illinois, the health insurance marketplace is named “Get Covered Illinois”.
  2. The Insurance marketplace is designed to help uninsured persons find a health insurance plan in their area that fits their needs and budget. The marketplace also helps determine if applicant qualify for Medicaid coverage.
  3. Memorial Health System participates in many options offered through the marketplace.
  4. Visit GetCoveredIllinois.gov or Healthcare.gov or call 800-318-2596 to get more information on enrolling.
  5. In-person counselors, or navigators, are available to assist with enrollment at no cost at a number of social service agencies in Central Illinois, including:

 

Springfield Area

Illinois Stewardship Alliance
230 Broadway St. I 217-720-0453

Springfield Urban League
100 N. 11th St. | 217-522-0407, ext. 1451

Family Guidance Centers
120 N. 11th St. | 855-328-6392

Central Counties Health Centers
2239 E. Cook St. | 217-788-2300

SIU Center for Family Medicine
520 N. Fourth St. | 217-545-8000

Sangamon County Department of Public Health
2833 South Grand Ave. E. | 217-535-3100

Decatur Area

Macon County Department of Public Health
1221 E. Condit St I 217-423-6988

Crossing HealthCare
320 Central Ave I 217-877-9117

SIU Center for Family Medicine
102 W. Kenwood Ave I 217-872-3800

Jacksonville Area

Jacksonville Area Center for Independent Living
15 Permac Road | 217-245-8371

Morgan County Health Department
345 W. State St. | 217-245-5111

Taylorville Area

Christian County Department of Public Health
902 W. Springfield Road | 217-824-4113

Visit GetCoveredIllinois.gov for more information and resources.

Can't find your health plan?

If you do not see your health plan listed, please contact the Memorial Health System Managed Care Department at 217-788-4448 or via email at ManagedCareDepartment@mhsil.com.

Below are links to common insurance plans accepted at Memorial Health System. While we cannot quote benefits or coverage, we hope these links can help direct you to your insurance payor for the information you require. 

For State of Illinois Members: 

Below are links for current State of Illinois Employees Group Insurance Plan participants and those who State of Illinois retirees accessing the Total Retiree Advantage (TRAIL) program. We are appreciative of the service you have, and continue to give, to our local communities and to the State of Illinois. Our desire is for the links below to help provide you with the necessary information to help you navigate your insurance coverage and benefit options, as well as your open enrollment period. Unfortunately, we are not able to quote you benefits and coverage for these plans. However, the links do contain information on how to contact the State of Illinois’ Department of Central Management Services for more information. 

For State Employees Group Insurance Plan Participants:

We understand life gets busy! To help remind you of the upcoming annual enrollment period click the calendar below to add a reminder on your personal calendar.




For Total Retiree Advantage Illinois (TRAIL) Plan Participants: 

For TRAIL enrollment, please consult the State of Illinois' CMS sit for more details.