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State of Illinois Employees
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Nothing is more important than your health.
That's why we take your health care personally. At Coventry Health Care, we know the importance of health benefits that meet your needs and the needs of your family.
Since 1984, we have helped State of Illinois employees manage their most important asset - their health.
In addition to our attractive benefit plans, State employees will value Coventry Health Care's commitment to optimal cost and quality outcomes. As a testament to our results, Coventry Health Care was recognized by Consumer Reports and the National Committee for Quality Assurance (NCQA) as one of the top-ranked commercial health plans in Illinois, for the sixth consecutive year, in October 2011. If you have specific benefit questions or need help finding a provider, please call Customer Service during normal business hours at 800-431-1211 or visit the State of Illinois benefit page.
NEW! Weight Watchers® Online Discount for Coventry Members - click here for details!
Open Access Plan ("OAP") through June 30, 2012
The OAP administered by Coventry Health Care provides access to many of the same providers as the HMO, plus more, in our three-tier network model.
Tier One includes the same 220 hospitals and 3,200 physicians you can access through the HMO, while Tier Two expands to include the Coventry national network, with providers in all 50 states. Tier Three provides coverage for out-of-network physician visits. See "OAP Provider Network" for more information.
SOI Benefits - Description of Coverage for State of Illinois Employee's
LGHP Benefits - Description of Coverage for Local Government Health Plan
CIP Benefits - Description of Coverage for College Insurance Program
TRIP Benefits - Description of Coverage for - Teachers Retiree Insurance Program
Listing of Services Requiring our Prior Approval 2012
Coventry Health Care continues our discussions with prominent Illinois providers and hospitals to expand OAP members' options for quality care at an affordable price.
OAP Service Area
The Coventry Health Care OAP is available in all 120 counties throughout Illinois. Please click here for a map of our OAP service area.
OAP Provider Network
The three-tier provider network is a valuable feature of the OAP:
- Tier One — highest level of benefits, includes more than 220 hospitals and nearly 32,000 participating providers throughout the State of Illinois and neighboring communities
- Tier Two — includes coverage for services received from an additional 9,000 participating providers in Illinois, as well as nationwide access to more than 570,000 providers in the Coventry National Network
- Tier Three — includes out-of-network providers
Our provider lookup tool is a convenient and easy way for you to find the right in-network doctor or physician to suit your health care needs.
Click here for instructions on using our provider lookup tool.
Click here to locate a provider.
The provider directory does not include behavioral health providers. To locate a behavioral health provider, call 800-423-8070.
OAP Pharmacy Benefits
Medco administers the pharmacy benefits provided by the State of Illinois. For questions about OAP pharmacy benefits, call Medco at 800-735-4404 or visit www.medco.com.
Didn't find what you needed? Don't hesitate to call our Customer Service department during regular business hours at 800-431-1211.
Click here to find out how to enroll in the State of Illinois OAP.
Once enrolled in a Coventry Health Care health insurance plan, please complete a Transition of Care form to help ensure a smooth transition for you or any covered dependents that are receiving or may be receiving medical services involving the following:
Upcoming surgery or hospitalization
Recent transplant (within past 12 months), or in evaluation
Receiving dialysis
Pregnancy (second or third trimester) and under the care of an out-of-network provider
Under a current plan of care (post-operative surgical care, cancer care, etc.)
Using durable medical equipment (oxygen, c-pap machine, etc.)
Under the care of a mental health provider
Diagnosed with one of the following five health conditions, and would like to receive information on our disease management programs: asthma, diabetes, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF) and coronary artery disease (CAD).
*Please note that if you are a current State of Illinois member enrolled with Coventry Health Care you do not have to fill out a Transition of Care form, as your authorizations are currently on file.
HMO Benefit Plan Through June 30, 2012
The Coventry Health Care HMO offers the same great benefits as in years past; low out-of pocket costs, low-cost dependent coverage, and no referrals for most specialty care.
SOI Benefits - Description of Coverage for State of Illinois Employees
LGHP Benefits - Description of Coverage for Local Government Health Plan
CIP Benefits - Description of Coverage for College Insurance Program
TRIP Benefits - Description of Coverage for Teachers Retiree Insurance Program
Services Requiring Our Prior Approval 2012
HMO Service Area
The Coventry Health Care HMO is available in 60 counties throughout Illinois. Please see below for a map with our HMO service area.
Service Area Map
HMO Provider Network
The HMO's provider network includes 220 hospitals and 3,200 physicians. Our provider lookup tool is a convenient and easy way for you to find the right in-network doctor or physician to suit your needs.
Click here for instructions on using our provider lookup tool.
Click here to locate a provider.
The provider directory does not include behavioral health providers. To locate a behavioral health provider, call 800-423-8070.
HMO Pharmacy Benefits
Medco administers the pharmacy benefits provided by Coventry Health Care. For questions about the HMO pharmacy benefits, plese call PersonalCare at 800-431-1211, or visit the website at www.chcillinois.coventryhealthcare.com.
2012 Prescription Formulary
Click here to find out how to enroll in the State of Illinois HMO.
If you have specific benefit questions, or need assistance, please call Customer Service during normal business hours at 800-431-1211 or visit the State of Illinois benefit page.
Didn't find what you needed? Don't hesitate to call our Customer Service department during regular business hours at 800-431-1211.
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