(BCBSIL) and Prime Healthcare are currently negotiating their contract, and the outcome could impact network access starting June 1, 2026.
Prime Healthcare has notified BCBSIL that it plans to have its hospitals, facilities, and doctors leave BCBSIL networks on June 1. BCBSIL is working to prevent this and has stated that Prime is required to remain in-network under their existing agreements.
If a new agreement is not reached, members who receive care at Prime Healthcare facilities after June 1 could be billed above normal in-network costs.
Hospitals that could be affected
The following Illinois hospitals are part of Prime Healthcare and may be impacted:
- Mercy Medical Center – Aurora
- Resurrection Medical Center – Chicago
- Saint Mary of Nazareth Hospital – Chicago
- Holy Family Medical Center – Des Plaines
- Saint Joseph Hospital – Elgin
- Saint Francis Hospital – Evanston
- Saint Joseph Medical Center – Joliet
- St. Mary’s Hospital – Kankakee
Doctors affiliated with Prime Healthcare Illinois Medical Group would also be included.
BCBSIL plans that may be impacted
If Prime leaves the network, it would affect these BCBSIL plans:
- PPO plans
- Blue Choice PPO plans
- HMO Illinois
- Blue Advantage HMO
- Blue Precision HMO
- MyBlue Plus POS
- Medicare Advantage (PPO and HMO)
- Blue Cross Community Health Plans
Member notifications
- Commercial members will receive notice at least 60 days before June 1
- Medicare members will receive notice at least 45 days before June 1
Why this matters
BCBSIL states its goal is to keep healthcare affordable and accessible for members. These negotiations typically involve pricing, access, and quality of care. BCBSIL is working to prevent members from being caught in the middle or facing unexpected bills.
What members can do
If Prime Healthcare leaves the network, members will still have access to other in-network hospitals and doctors.
Members can:
- Search for providers using the BCBSIL “Find Care” tool
- Log in to their member portal or mobile app
- Call the number on their insurance ID card
Continuity of care
Members currently receiving treatment at a Prime Healthcare facility may be eligible to continue care at in-network rates for a limited time if they are:
- Pregnant
- Being treated for a serious or acute condition
- Managing a life-threatening illness
- Receiving care for a disability
Members should call the number on their ID card to confirm eligibility.
What employers should do
Employers offering BCBSIL plans should:
- Identify employees who use Prime Healthcare providers
- Communicate the potential change early
- Review alternative in-network providers
- Be prepared to answer employee questions
Bottom line
Negotiations are ongoing, but this could be a significant network change for many Illinois members—especially in the Chicagoland area.
Now is the time to stay informed and prepare in case Prime Healthcare leaves the BCBSIL network on June 1, 2026.