Provider Partners Illinois Advantage HMO SNP Plan
Provider Directory

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This directory is current as of January 7, 2019

This directory provides a list of Provider Partners Illinois Advantage HMO SNP’s current network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC).

This directory is for the following counties in Illinois: Cook.

You will have to choose one of our network providers who are listed in this directory to be your Primary Care Provider (PCP). The term “PCP” will be used throughout this directory. Generally, you must get your health care services from your PCP. Provider Partners Illinois Advantage HMS SNP is an Institutional Special Needs Plan (I-SNP) Health Maintenance Organization (HMO). Since we are an HMO, it is necessary for you to select a PCP to utilize while on the plan. We do not guarantee that each provider is still accepting new members.

The “network providers” listed in this directory have agreed to provide you with your health care, vision and dental services. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from non-network providers. If you get a bill from a non-network provider, please submit it to Provider Partners Illinois Advantage HMO SNP for processing. We can help determine how much you are responsible for paying, if any.

Emergency care can always be obtained in or out of the service area from the nearest available provider. When in the service area you must use plan providers for urgent care. When out of the service area, urgent care may be obtained from the first available provider. In addition, when out of the service area, you can obtain dialysis treatment from any qualified dialysis provider. You must use plan providers except in emergency or urgent care situations. If you obtain routine care from out-of-network providers neither Medicare nor Provider Partners Illinois Advantage HMO SNP will be responsible for the costs.

What is the service area for Provider Partners Illinois Advantage HMO SNP plan? This plan services the following in Illinois: Cook.

How do you find Provider Partners Illinois Advantage HMO SNP providers in your area?

This is a searchable online document and is updated at least monthly. You can enter areas in the fields to narrow down your search. For example, if you enter “Illinois” in the state field, and “Cook” in the county field, the search engine will generate a list of all providers, hospitals and pharmacies in Cook County, Illinois. You can also search by provider name, city, or specialty.

If you have questions about Provider Partners Illinois Advantage HMO SNP or require assistance in selecting a PCP, please call our Member Service Department at 1-800-405-9681, from 8 a.m. to 8 p.m. Monday through Friday. TTY users should call 711. Or, visit www.pphealthplan.com.