Illinois/Outside of Wisconsin Medical Plan


Health Choices is the medical claims administrator for colleagues who reside in Illinois or outside of Wisconsin.

You have two Exclusive Provider Organization (EPO) medical options through HSHS:

  • Basic Option
  • High Option
  • Waive Coverage
     

Coverage Options

When you enroll in medical (including prescription drug coverage),you can choose from these coverage levels:

  • Colleague only
  • Colleague + Spouse/LDA
  • Colleague + Child(ren)
  • Colleague + Spouse and Child(ren)
     

Network

Depending on the zip code of your primary home residence, your network is:

  • HSHS/Live360 Provider Network

  • HSHS/Live360/ First Health


Prior Authorization

Out-of-network services will not be covered unless you first obtain a referral from your provider and prior authorization from Health Choices. Your provider will need to submit a referral request to Health Choices. If you have questions regarding the referral process, please contact Health Choices at 1-833-728-0538.



Excluded Providers

The HSHS medical plan will not pay benefits for services received from particular providers. HSHS is proud of our facilities and physicians, and we want to encourage colleagues to use HSHS facilities and physicians for their care. The utilization of our own providers invests in our people and our organization, helping to build a stronger system of care in the communities we serve. Click HERE to see the list of excluded providers and facilities.


Find a Provider

To locate network providers, follow these steps:

1. Go to www.live360healthplan.com
2. Determine your network service area. Your network is determined by your home ZIP code.
3. Based on your network service area, select Find a Live360 provider or First Health provider.


After you determine your Network Service Area, you can then find a doctor, specialist, hospital, or other providers that are covered by your HSHS Healthy Plan. Use the convenient Find a Provider tools below. You may need to enter your group number which is printed on the front of your ID card, or find it on the HSHS benefits website. The search results only show providers who are covered by your plan.

                             Inside the Service Area                           Outside the Service Area

                              Find a Provider                          Find a Provider

                             Live 360 Health Plan                                   Live 360 Health Plan

                                                                                                 Find a Provider

                                                                     First Health Network

Online Member Portal – My eLink

My eLink is a convenient, secure web portal offering online access to your personal health plan information 24/7. Register HERE

    

Traveling Outside Network Service Area

A referral is not required for urgent care when you are traveling outside your network service area and emergency care. For care required to treat an urgent situation while you are traveling outside your network service area or an emergency medical condition, the HSHS medical plan provides the same benefit level regardless of the provider who provides your care. 


Out-of-area Dependents

HSHS is committed to helping your dependents get the health care coverage they need when they need it. Students who attend college outside of the area and children living in communities outside the Live360 service area are common examples of out-of-area dependents. Designated out-of-area dependents have additional providers available to them in the First Health Network.  

To receive this benefit, you or your out-of-area dependent must complete and submit the Care Package Form listed below before receiving any services.


Additional Resources

2021 Flexplan Decision Guide
2022 HSHS Benefits Guide
Live360 Online Member Tools
Care Package Form