Open enrollment is a good time to take a fresh look at your health plan choices. One option you may see is a Blue Cross and Blue Shield of Illinois HMO plan. HMO plans offer high-value health benefits at the lowest total cost of care compared to other types of plans.

HMO members may have savings every year over other health plans — including maternity and delivery care.*

In a member satisfaction survey,** 91 percent of respondents said they were satisfied with the overall value of their BCBSIL HMO plan and the customer service they received.

You might already have an HMO or a PPO. No matter where you’re starting, learning what an HMO plan offers can help you decide what’s right for you.

Care Starts with Your Primary Care Provider

With an HMO plan, you choose a medical group and a primary care provider. Your PCP is your first stop for most care. You see them for checkups, routine visits and when you don’t feel well.

Your PCP gets to know you and your health history. They help you stay healthy and guide your care over time. If you need to see a specialist or have tests, your PCP helps set that up. Your PCP also helps coordinate your care so each provider you see has the information they need to provide the best care for you. 

Many people like having one doctor who helps manage their care and answer questions along the way.

Using Doctors and Hospitals in Your Network

HMO plans focus on care from providers and hospitals and other care facilities in the plan’s network. When you use in-network providers, your care is covered based on your plan benefits. In most cases, your HMO plan won’t cover costs if you go to a provider or facility that is not in your plan’s network.

If you have a medical emergency, you can get care right away at the nearest hospital emergency room.

There are also options to help you get urgent care while you’re traveling, whether it’s a short trip or a longer stay  — like an extended work assignment or a student away at school.

Preventive Care to Help You Stay Healthy

Preventive care is a key part of an HMO plan. This includes annual checkups, vaccines, well-child visits and health screenings. These services help catch health issues early or even prevent them before they start.

If you have a long-term condition, like asthma or diabetes, your care team helps you manage it. Your PCP works with you to keep your condition under control over time.

A Large Illinois Provider Network

An HMO plan includes access to hospitals, clinics, labs, pharmacies and thousands of PCPs and specialists across the state. You can choose a medical group and PCP that work best for you.

An online member account makes it easy to search for doctors and hospitals. You can see locations, office hours, languages spoken and patient reviews to help you choose.

Prescription Drug Coverage that Fits Your Life

HMO plans include access to a wide pharmacy network. You can fill prescriptions at many local pharmacies. For long-term medicines, home delivery may also be an option.

Your online account lets you check which drugs are covered by your plan, find pharmacy locations and manage refills anytime.

Tools and Programs that Support You

You can access your member account online or through the BCBSIL App. You can see your benefits, check claims, find doctors and use your digital ID card.

Many plans also offer wellness programs, fitness options and health discounts. These programs are designed to support healthy habits and everyday wellbeing.

An Option Worth a Look

Everyone’s health needs are different. An HMO plan may be a good fit if you want lower costs and more coordinated care.

As you review your plan choices, take time to learn more about an HMO plan and see how it could work for you and your family.

Learn more about how an HMO works.

*2023 blended HMO savings data
**2023 and 2024 Commercial Member Satisfaction Survey