Get News & Updates Directly To Your Inbox
Download the BCBSIL App. Your coverage information in the palm of your hand.
Find A Doctor Or Hospital In Your Network.
When you sign up for an HMO, your first step is to pick a Medical Group. Then you will choose a primary care physician (PCP) in that group to manage your care. You may already have a PCP, such as your family doctor. A child’s pediatrician and a woman’s principal health care provider can also act as their PCP.
Your PCP will make sure you get the care you need, even when you see another doctor or go to the hospital. When you have a health issue, you’ll first go to your PCP. If the PCP thinks you need to see a specialist, they’ll arrange it for you by getting a referral.
The PCP will:
Three quick things you’ll want to make sure happen:
It’s your right to ask questions to make sure your doctors are using your HMO the right way. If you don’t have a referral or if you have tests that aren’t a covered benefit, your HMO may not cover the costs for you.
If you are getting ongoing treatment for a health issue, your PCP will put in a request for a standing referral. That way you can see your specialist as often as needed without having to request a new referral approval for each visit.
You can get more information about your HMO health plan at any time. Just log in or register for your member account, Blue Access for MembersSM. Visit the My Coverage tab to verify your coverage and identify your medical group and PCP.
Originally published February 17, 2015, Revised 2020
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association© Copyright 2021 Health Care Service Corporation. All Rights Reserved.
Telligent is an operating division of Verint Americas, Inc., an independent company that provides and hosts an online community platform for blogging and access to social media for Blue Cross and Blue Shield of Illinois.
File is in portable document format (PDF). To view this file, you may need to install a PDF reader program. Most PDF readers are a free download. One option is Adobe® Reader® which has a built-in screen reader. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com.