Carle Health is in network with a variety of regional and statewide insurance plans. However, network inclusion and tier status can vary.
Patients should take an active role in reviewing their health insurance options. It is important to review all plan choices carefully, confirm if Carle Health is within their network, and understand the applicable tier of coverage. Patients are advised to verify their benefits and coverage with their insurance plan to determine if services are covered as in-network or out-of-network benefits.
Please note: While we strive to provide accurate and
up-to-date information, it's crucial to verify the details directly with your
chosen health plan. Selecting a Medicare Advantage PPO plan is more likely
to provide in-network access as Carle Heath is continuing to work with Medicare
Advantage payors on possible HMO plan availability. For the most current
information, please contact your benefit administrator. Information updated as
of October 2025
| Regional Descriptions | ||
|---|---|---|
| Central Region - inclusive of facilities located in Bloomington, Normal, El Paso, Eureka and surrounding communities East Region - inclusive of facilities located in Champaign, Urbana, Mahomet, Danville, Monticello, Rantoul, Mattoon/Charleston and Hoopeston and its surrounding communities South Region - inclusive of facilities located in Olney and surrounding communities West Region - inclusive of facilities located in Pekin, Peoria, Morton, Washington and surrounding communities in the Greater Peoria area |
| LISTING OF LARGER IN-NETWORK NATIONAL AND REGIONAL PAYORS | ||
| Payor Name | Plans/Products In-Network Includes All Regions: Please see regional descriptions above. |
Plans/Products In-Network Includes Only Select Regions: Please confirm coverage with plan administrator. |
| Aetna – Medicare Advantage |
Medicare Advantage PPO | Medicare Advantage HMO In-Network only for Central and West Region Hospitals. |
| Aetna | Commercial PPO, OAP, POS, CDHP, QCHP. Additional products: QPOS, Elect Choice, Open Choice, Managed Choice POS, Aetna Choice POS II, Aetna Select, Aetna Student Health, Aetna Signature Administrators, Joint Claims Administration, Meritain/Meritain Shared Adm Services, Passport Health and National Advantage Programs (NAP) | Commercial HMO, FEHB, EPO In-Network only for South, Central and West Regions Workers Comp In-Network only for East and South Regions. |
| Aetna Better Health | Medicaid & Medicare/Medicaid Duals (to be re-named as D-SNP eff 1/1/2026) | |
| First Health (Aetna Rental Network) | PPO Rental Network | |
| Blue Cross/Blue Shield of IL – Medicare Advantage |
Medicare Advantage PPO and HMO West Region up through 12/31/2025. Expanding to also include East, Central and South Regions effective 1/1/26. |
|
| Blue Cross/Blue Shield of IL | Commercial PPO, OAP, Blue Choice, BCBS Community & Medicaid. Medicare / Medicaid Duals (only through 12/31/2025) |
Commercial HMO In-Network only for Carle BroMenn Medical Center and Carle Eureka Hospital in Central Region and Methodist & Proctor Hospitals in West Region. |
| CIGNA | Commercial PPO and Self-funded | |
| Consociate Health | Direct agreement effective 1/1/26 | |
| Health Alliance Medical Plans - Closing 12/31/2025 |
Commercial PPO, HMO, POS, Self-funded, Exchange product. Medicare Advantage PPO & HMO. | |
| Humana - Medicare Advantage |
Medicare Advantage HMO & PPO Expanding to also include East Region effective 1/1/26 |
|
| Humana | Medicare / Medicaid Duals (D-SNP) Expanding to also include East and South Regions effective 1/1/26 |
|
| Meridian Health Plan | Medicaid & Medicare/Medicaid Duals and Youthcare Products Medicare/Medicaid DSNP – new 1/1/26 |
|
| Molina Healthcare of Illinois | Medicaid & Medicare/Medicaid Duals Products Medicare/Medicaid DSNP – new 1/1/26 |
|
| TriWest (Tricare) | East Region only | |
| United Healthcare - Medicare Advantage |
Medicare Advantage PPO & HMO in Central, West and South Regions. | |
| United Healthcare | Commercial PPO | |
| United Behavioral Health | West Region only | |
| Wellcare - Medicare Advantage |
Med Advantage HMO – Expansion to include Central, East and South Regions 1/1/26, contingent on finalizing a signed agreement. Wellcare will not be offering a PPO product in 2026. |
|
| OTHER IN-NETWORK PAYORS | ||
| Payor Name | Plans/Products In-Network Includes All Regions: Please see regional descriptions above. |
Plans/Products In-Network Includes Only Select Regions: Please confirm coverage with plan administrator. |
| Beech Street | Medicare Advantage PFFS and PPO Carle Foundation Hospital only in East Region. | |
| Benefit Support, Inc. | Employer group agreement In-Network for Covington Foods and Rogers Supply for Carle Foundation Hospital & Carle Physician Group only in East Region | |
| Caterpillar | Central and West Regions only | |
| Central States Health & Welfare Fund | Employer Group agreement In-Network for Carle Physician Group only in East Region | |
| Community Partners Health Plan, Inc. | PPO In-Network Agreement only for Central and East Regions. Hoopeston is limited to physicians only | |
| CorVel | Auto Liability, EPO, PPO-In Network for Carle Foundation Hospital only in East Region South Region-EPO, PPO, Work Comp |
|
| Evolutions Healthcare Systems | Work Comp, Self-Funded, Employee Welfare Benefit In-Network only for South Region. | |
| Healthlink | Commercial PPO | South Region - HMO and CompManagement also in-network CompManagement and Open Access II in-network only for Carle Hoopeston Hospital in East Region. Commercial HMO in-network for Central and West Regions. |
| HealthSCOPE Benefits, Inc. | Employer group agreement for Central Illinois Pipe Trades and Heat and Frost Insulators Local 18 Health & Welfare Fund In-Network for Carle Physician Group only in East Region | |
| HFN/Zelis | Commercial | Auto In-Network in West Region only Work Comp-South and West Regions only |
| Insurance Administrators of America, Inc. [IAAI] | PPO In Network for Carle Physician Group only in the East Region | |
| Multiplan/Private HealthCare Systems [PHCS] | Commercial PPO & Savility | Commercial HMO In-Network only in the South Region |
| Three Rivers Provider Network | HMO, PPO, Work Comp In-Network only for the South Region | |
| UFCW National Health and Welfare | Employer Agreement In Network for Carle Physician Group only in the East Region. | |
| USA MCO, Inc. | PPO & Workers Comp In-Network only in South Region | |
Other limited agreements in some service areas.