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Health Plans Accepted

Carle Foundation Hospital, Carle Physician Group and Hoopeston Regional Health Center may have separate contract arrangements in place and may or may not participate in all of the same insurance plans.

All patients are urged to verify their benefits and coverage with their insurance plan to determine whether services will be covered as in-network or out-of-network benefits.

Carle Health Plan Contracts - as of October 1, 2019.
Name Notes Carle Physician Group (CPG)
Carle Foundation  Hospital (CFH)
Carle Hoopeston Regional Health Center (CHRHC)
ALL
Aetna CFH & CPG: Select PPO Products only
CHRHC: All Non-Cap Products - including PPO, Work Comp, & Government Plans (i.e., Medicare, Medicaid, etc.)
      X
Beech Street CFH: Medicare Advantage PFFS and PPO only
CHRHC: PPO (excludes Work Comp, Long Term Care, and Auto Medical Plans)
  X X  
Benefit Support, Inc. TPA - Limited multiple employer groups X X    
Blue Cross/Blue Shield of IL Traditional PPO and Blue Choice Preferred PPO only Provider Partcipation Varies X X X
Central States Health & Welfare Fund Direct contract X (Par via BC/BS) (Par via BC/BS)  
CIGNA / Great West Healthcare PPO       X
Community Partners Health Plan, Inc. PPO network Provider Participation Varies through a separate agreement with HAMP X    
CorVel CPG: PPO Work Comp only
CFH: PPO Work Comp and Auto Liability
X X    
Coventry / Personal Care / First Health CPG: (effective 1/1/12)
Fully Insured PPO Products; HMO for tertiary care and approved care only; Work Comp
CFH: (effective 1/1/12)
Fully Insured PPO Products; Medicare Advantage and Worker's Comp;
CHRHC: May be designated by Coventry as a par provider in - HMO, POS, PPO, Self-Funded plans administered by health plan & member companies or by other payors, Work Comp, Medicare Advantage
      X
HealthSCOPE Benefits, Inc. Direct contract for employer groups:
1.     Central Illinois Pipe Trades
2.     Heat and Frost Insulators Local 18 Health & Welfare Fund
X (Par via BC/BS) (Par via BC/BS)  
Health Alliance Medical Plans All products       X
Health Alliance Medicare Advantage Medicare Advantage       X
HealthLink PPO CPG & CFH: PPO network
CHRHC: PPO, CompManagement, Open Access II
      X
HFN & HFN Platinum CPG: PPO
CFH: PPO and Work Comp
      X
Humana / Choice Care CHRHC: Hospital & Roberts Clinic only on physician contract   (Par via CPHP) X  
IlliniCare Health Medicaid Products & Medicare Duals Product       X
Insurance Administrators of America, Inc. [IAAI] PPO Network X      
McLane Company, Inc. Direct contract X (Par via BC/BS) (Par via BC/BS)  
Methodist First Choice PHO network   X    
Meridian Health Plan Medicaid Products & Medicare Duals Product       X
Molina Healthcare of Illinois Medicaid Products & Medicare Duals Product       X
MultiPlan / Private HealthCare Systems [PHCS]
(combined agreement)
PPO & Savility       X
Schlarman Health Fund Direct Employer Agreement Provider Participation Varies Par via BCBS Par via BCBS  
TriCare (CHAMPUS)
Administered by Humana Military
Due to recent change from HealthNet to Humana Military – must call to confirm all facility & physician participation.       X
UFCW National Health and Welfare (effective 1/1/12)
Direct Contract
X (Par via BC/BS) (Par via BC/BS)  
Union Pacific Railroad Employes™ Health Systems ONLY Direct Agreement Under CPG X

 
United Healthcare PPO       X
Wabash Memorial Hospital Association ONLY Direct Agreement Under CPG


X
Special Agreements
Name Notes ALL
Amish (now Plain Church Medical Group and Amish Hospital Aid) Letter of Agreement for the following counties only: Coles, Douglas, Moultrie & Crawford only. Must have Plain Church Medical Group card or Amish Hospital Aid card for contractual discount to be applied. All others are Self Pay. X
Mennonite Agreement for the counties of: Coles, Douglas, Moultrie and Crawford ONLY X
Med Cost Solutions Agreement for the counties of: Coles, Douglas, Moultrie and Crawford ONLY X
Samaritans Ministries International  Letter of Agreement X