The health insurance plans available to LGHP members differ in the benefit levels they provide, the doctors and hospitals you can access and the out-of-pocket costs. In general, managed care plans, such as
Health Maintenance Organizations (HMOs) and
Open Access Plans (OAP), deliver healthcare through a system of network providers and have a lower monthly premium than the Local Care Health Plan (LCHP). Members will find a listing of providers who participate in the health plan's network when they go to the provider directory page on the plan's website.
There are several managed care plans located throughout the state available to LGHP members. In addition to managed care, LGHP offers the FY21 Local Care Health Plan (LCHP) (FY22 LCHP - effective July 1, 2021), administered by Aetna, and allows plan participants to access any provider nationwide. Enhanced benefits are available for LCHP members who receive services from a
LCHP network provider. The FY21 Local Consumer Driven Health Plan (LCDHP) (FY22 LCDHP - effective July 1, 2021), administered by Aetna.
Health Plan Availability
New this plan year, effective July 1, 2021, members now have the option of choosing from three OAP plans. We are pleased to announce that these Open Access Plans (OAP) will now be offered by Aetna, HealthLink and BlueCross BlueShield of Illinois.
HealthLink Service Area Outside of Illinois
HealthLink members will continue to have network access in Missouri, Arkansas, Indiana, Kentucky, Ohio and Wisconsin. Network access outside of Illinois and the states listed here will be limited to emergency services.
For those enrolled in the Local Care Health Plan (LCHP) and the Local Consumer Driven Health Plan (LCDHP), your behavioral health provider network and claims will now be administered by Aetna. Please be sure to review the Aetna provider directory to ensure your provider is in-network, or contact Aetna to discuss transition of care.
Benefit recipients may view a map of the various plans’ coverage areas below:
The Affordable Care Act rules require health plans to provide a
summary of benefits and coverage and a
glossary of health coverage and medical terms, designed to make it easier for you to compare your options and understand exactly what you are buying. The new requirements will also make it easier for employers to compare health insurance options to provide for their employees. Members can view the summary of benefits and coverage for each plan.
Last Updated 04/26/2021