Ambetter – Illinois Plans


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2018 Ambetter Primary Care Physician List
2018 Ambetter Hospital List


Coverage Area: Cook County, DuPage County

Ambetter – Illinois Health Plans

Our Rating:

Ambetter is one of 4 carriers in Illinois for 2018, and one of 3 who is covering Cook & DuPage counties. They are currently only offering Silver & Gold plans, which can only be enrolled on the exchange. They also offer plans bundled with optional vision & dental plans.

Ambetter is a good choice for anyone who qualifies for Cost Sharing reductions, as well as for people who are more concerned about their prescription drug coverage (more copays then similar Blue Cross plans) vs gaining access to a wide provider & hospital network.

Hospital List – Chicago Area

Hospital Address Phone Number
Kindred Chicago Lakeshore 6130 North Sheridan Road Chicago, IL 60677 (773) 381-1222
Mt Sinai Hosp Med Ctr Chicago 2750 W 15th Place Chicago, IL 60608 (773) 542-2000
Thorek Memorial Hospital 850 West Irving Park Chicago, IL 60613 (773) 525-6780
Louis A Weiss Memorial Hospital 4646 North Marine Drive Chicago, IL 60640 (773) 878-8700
Kindred Hospital Chicago North 2544 W Montrose Avenue Chicago, IL 60618 (773) 267-2622
Kindred Chicago Central Hospital 4058 W Melrose Street Chicago, IL 60677 (773) 736-7000
Saint Bernard Hospital 326 W 64th Street Chicago, IL 60621 (773) 962-3900
Swedish Covenant Hospital 5145 North California Avenue Chicago, IL 60625 (773) 878-8200
Holy Cross Hospital 2701 W 68th Street Chicago, IL 60629 (773) 884-1602

2018 Plan Comparison

Note: Silver plans on the exchange may qualify for Cost Sharing Reduction, meaning you may see different deductibles and copayments based on if you qualify based on your income level.

Plans Ambetter Balanced Care 4 (2018): IlliniCare Health Network Ambetter Balanced Care 2 (2018): IlliniCare Health Network Ambetter Balanced Care 1 (2018): IlliniCare Health Network Ambetter Balanced Care 12 Standardized (2018): IlliniCare Health Network
Ambetter Secure Care 1 (2018) with 3 Free PCP Visits: IlliniCare Health Network
DEDUCTIBLE $7,050 $6,500 $5,500 $3,500 $1,000
MAX OUT OF POCKET $7,050 $6,500 $6,500 $7,350 $6,350
NETWORK HMO HMO HMO HMO HMO
METAL LEVEL Silver Silver Silver Silver Gold
COPAYS
PRIMARY CARE $30 $30 $30 $30
20% Coinsurance after deductible
SPECIALIST $60 $60 $60 $65
20% Coinsurance after deductible
GENERIC DRUGS $15 $15 $10 $15 $10
BRAND DRUGS $50 $50 $50 $50
$25 Copay after deductible
NON PREFERRED BRAND DRUGS No Charge after Deductible No Charge after Deductible 20% Coinsurance after deductible $100
$75 Copay after deductible
SPECIALTY DRUGS No Charge after Deductible No Charge after Deductible 20% Coinsurance after deductible 40% Coinsurance after deductible
30% Coinsurance after deductible