Medicare Select * Contracting Hospital Listing

How Medicare Select Works You can use any of the Medicare Select contracting hospitals for non-emergency care. If you do not use one of these hospitals, you agree to pay the Part A deductible. You are fully covered for emergency care at any hospital, and you can still choose your own doctors and specialists. Sometimes there are changes to the Medicare Select Hospital Network. If you have any questions about this listing, please call 1-877-384-9297.

ILLINOIS HOSPITALS

ALEDO BERWYN CENTREVILLE Genesis Medical Center Aledo MacNeal Hospital Touchette Regional Hospital 409 N.W. 9th Ave. 3249 S. Oak Park Ave. 5900 Bond Ave. Aledo, IL 61231 Berwyn, IL 60402 Centreville, IL 62207 1-309-582-9100 1-708-783-9100 1-618-332-3060 ARLINGTON HEIGHTS BLUE ISLAND CHICAGO Northwest Community Hospital MetroSouth Medical Center Aurora Chicago 800 W. Central Rd. 12935 S. Gregory St. Lakeshore Hospital Arlington Heights, IL 60005 Blue Island, 60406 4840 N. Marine Dr. 1-847-618-1000 1-708-597-2000 Chicago, IL 60640 1-773-878-9700 AURORA BOLINGBROOK Community First Copley Memorial Hospital Adventist Bolingbrook Hospital Medical Center 2000 Ogden Ave. 500 Remington Blvd. 5645 W. Addison St. Aurora, IL 60504 Bolingbrook, IL 60440 Chicago, IL 60634 1-866-426-7539 1-630-312-5000 1-312-282-7000 Mercy Medical Center *** CANTON Holy Cross Hospital 1325 N. Highland Ave. Graham Hospital 2701 W. 68th St. Aurora, IL 60506 210 Walnut St. Chicago, IL 60629 1-630-859-2222 Canton, IL 61520 1-312-471-8000 BARRINGTON 1-309-647-5240 Illinois Masonic Good Shepherd Hospital ** Medical Center ** 450 W. IL HWY 22 836 W. Wellington Ave. Barrington, IL 60010 Chicago, IL 60657 1-708-381-9600 1-312-975-1600 (continued) Current as of 6/13/19. Please visit bcbsil.com for an up to date listing. ILMSHL19 30189.0619 ILLINOIS HOSPITALS continued

Jackson Park Hospital Roseland Community Hospital University of Illinois 7531 S. Stony Island Ave. 45 W. 111th St. Medical Center Chicago, IL 60649 Chicago, IL 60628 1740 W. Taylor St. 1-312-947-7500 1-312-995-3000 Chicago, IL 60612 John H. Stroger, Jr. Hospital Schwab Rehabilitation Hospital 1-312-996-7000 of Cook County 1401 S. California Ave. CLINTON 1835 W. Harrison St. Chicago, IL 60608 Warner Hospital and Chicago, IL 60612 1-773-522-2010 Health Services 1-312-633-6000 Saint Anthony Hospital 422 W. White St. Louis A. Weiss Memorial 2875 W. 19th St. Clinton, IL 61727 Hospital Chicago, IL 60623 1-217-935-9571 4646 N. Marine Dr. 1-312-521-1710 Chicago, IL 60640 St. Joseph Hospital Chicago *** DANVILLE 1-312-878-8700 2900 N. Lake Shore Dr OSF Sacred Heart Mercy Hospital and Chicago, IL 60657 Medical Center Medical Center 1-312-665-3000 812 N. Logan Ave. 2525 S. Michigan Ave. Saints Mary and Elizabeth Danville, IL 61832 Chicago, IL 60616 Medical Center *** 1-217-443-5000 1-312-567-2000 2233 W. Division St. DECATUR Mount Sinai Hospital Chicago, IL 60622 Decatur Memorial Hospital 1500 S. Fairfield Ave. 1-312-770-2000 2300 N. Edward St. Chicago, IL 60608 Shirley Ryan Ability Lab Decatur, IL 62526 1-312-542-2000 345 E. Superior St. 1-217-876-8121 Northwestern Memorial Chicago, IL 60611 St. Mary’s Hospital 1-312-238-8020 Hospital 1800 E. Lake Shore Dr. 251 E. Huron St. Swedish Covenant Hospital Decatur, IL 62521 Chicago, IL 60611 5145 N. California Ave. 1-217-464-2966 1-312-908-2000 Chicago, IL 60625 Norwegian American Hospital 1-312-878-8200 DEKALB 1044 N. Francisco Ave. Thorek Memorial Hospital Kishwaukee Community Chicago, IL 60622 850 W. Irving Park Rd. Hospital 1-773-292-8200 Chicago, IL 60613 1 Kish Hospital Dr. Provident Hospital of 1-773-525-6780 DeKalb, IL 60115 Cook County Trinity Hospital ** 1-815-756-1521 500 E. 51st St. 2320 E. 93rd St. DES PLAINES Chicago, IL 60615 Chicago, IL 60617 Chicago Behavioral Hospital 1-312-572-2000 1-312-978-2000 555 Wilson Rd. Resurrection Medical Center *** University of Chicago Des Plaines 60016 7435 W. Talcott Ave. Medical Center 1-847-768-5430 Chicago, IL 60631 5841 S. Maryland Ave. Holy Family Medical Center *** 1-312-774-8000 Chicago, IL 60637 100 N. River Rd. RML Chicago 1-312-702-1000 Des Plaines, IL 60016 3435 W. Van Buren St. 1-708-297-1800 Chicago, IL 60624 1-312-265-7700 ILLINOIS HOSPITALS continued

DOWNERS GROVE FOREST PARK HINSDALE Good Samaritan Hospital ** Riveredge Hospital Adventist Hinsdale Hospital 3815 Highland Ave. 8311 W. Roosevelt Rd. 120 N. Oak St. Downers Grove, IL 60515 Forest Park, IL 60130 Hinsdale, IL 60521 1-708-963-5900 1-708-771-7000 1-708-856-9000 ELGIN GALESBURG RML Specialty Hospital 5601 S. County Line Rd. St. Joseph Hospital Elgin *** St. Mary Medical Center Hinsdale, IL 60521 77 N. Airlite St. 3333 N. Seminary St. 1-630-286-4223 Elgin, IL 60123 Galesburg, IL 61401 1-847-695-3200 1-309-344-3161 HOFFMAN ESTATES ** Sherman Hospital GENEVA St. Alexius Medical Center 1425 N. Randall Rd. 1555 Barrington Rd. Delnor Community Hospital Elgin, IL 60123 Hoffman Estates, IL 60169 300 Randall Rd. 1-847-742-9800 1-708-843-2000 Geneva, IL 60134 ELK GROVE VILLAGE 1-630-208-3000 Alexian Brothers Behavioral Health Hospital Alexian Brothers GLENDALE HEIGHTS 1650 Moon Lake Blvd. Medical Center Adventist GlenOaks Hospital Hoffman Estates, IL 60169 800 Biesterfield Rd. 701 Winthrop Ave. 1-708-882-1600 Elk Grove Village, IL 60007 Glendale Heights, IL 60139 1-847-437-5500 JOLIET 1-708-858-9700 *** ELMHURST St. Joseph Medical Center GLENVIEW 333 N. Madison St. Elmhurst Memorial Hospital Northshore Glenbrook Hospital Joliet, IL 60435 Main Campus 2100 Pfingsten Rd. 1-815-725-7133 155 E. Brush Hill Rd. Glenview, IL 60026 Elmhurst, 60126 KANKAKEE 1-708-657-5800 1-331-221-1000 HARVEY EVANSTON 350 N. Wall St. Ingalls Memorial Hospital Kankakee, IL 60901 Northshore Evanston Hospital 1 Ingalls Dr. 1-815-933-1671 2650 Ridge Ave. Harvey, IL 60426 *** Evanston, IL 60201 St. Mary’s Hospital 1-708-210-3012 1-708-570-2000 500 W. Court St. Kankakee, IL 60901 St. Francis Hospital *** HAZEL CREST 1-815-937-2400 355 Ridge Ave. South Suburban Hospital ** Evanston, 60202 17800 S. Kedzie Ave. LA GRANGE 1-708-316-4000 Hazel Crest, IL 60429 Adventist La Grange 1-708-799-8000 EVERGREEN PARK Memorial Hospital 5101 S. Willow Springs Rd. Little Company of Mary HIGHLAND PARK La Grange, IL 60525 Hospital Northshore Highland Park 1-708-352-1200 2800 W. 95th St. Hospital Evergreen Park, IL 60805 777 Park Ave. West 1-708-422-6200 Highland Park, IL 60035 1-847-432-8000 ILLINOIS HOSPITALS continued

LAKE FOREST OAK LAWN PEORIA Northwestern Lake Forest Christ Hospital Medical Center ** UnityPoint Health – Proctor Hospital 4440 W. 95th St. 5409 N. Knoxville Ave. 660 N. Westmoreland Rd. Oak Lawn, IL 60453 Peoria, IL 61614 Lake Forest, IL 60045 1-708-425-8000 1-309-691-1000 1-847-234-5600 OAK PARK OSF St. Francis Medical Center 530 N.E. Glen Oak Ave. MAYWOOD Rush Oak Park Hospital Peoria, IL 61637 Loyola University 520 S. Maple Ave. 1-309-655-2000 Medical Center Oak Park, IL 60304 2160 S. 1st Ave. 1-708-383-9300 PONTIAC Maywood, IL 60153 West Suburban Medical Center St. James Hospital 1-708-216-9000 3 Erie Court 2500 W. Reynolds St. MCHENRY Oak Park, IL 60302 Pontiac, IL 61764 1-708-383-6200 1-815-842-2828 Centegra Hospital McHenry 4201 W. Medical Center Dr. OLYMPIA FIELDS ROCK ISLAND McHenry, IL 60050 Franciscan Health Trinity Regional Health System 1-815-344-5000 Olympia Fields 2701 17th St. MELROSE PARK 20201 Crawford Ave. Rock Island, IL 61201 Olympia Fields, IL 60461 1-309-779-5640 Gottlieb Memorial Hospital 1-708-747-4000 701 W. North Ave. ROCKFORD Melrose Park, IL 60160 PALOS HEIGHTS St. Anthony Medical Center 1-708-681-3200 Palos Community Hospital 5666 E. State St. Westlake Hospital 12251 S. 80th Ave. Rockford, 61108 1225 W. Lake St. Palos Heights, IL 60463 1-815-226-2000 Melrose Park, IL 60160 1-708-923-4000 Van Matre Encompass Health 1-708-681-3000 PANA Rehabilitation Hospital 950 S. Mulford Rd. MOLINE Pana Community Hospital Rockford, IL 61108 UnityPoint Health Trinity 101 E. Ninth St. 1-815-381-8500 500 John Deere Rd. Pana, IL 62557 Moline, IL 61265 1-217-562-2131 SANDWICH 1-309-779-5000 PARK RIDGE Northwestern Medicine Valley West Hospital NAPERVILLE Lutheran General Hospital ** 1302 N. Main St. 1775 Dempster St. Sandwich, IL 60548 801 S. Washington St. Park Ridge, IL 60068 1-815-786-8484 Naperville, IL 60540 1-708-696-2210 1-708-355-0450 SILVIS PEKIN Genesis Medical Center Silvis NEW LENOX Pekin Hospital 801 Illini Dr. Silver Cross Hospital 600 S. 13th St. Silvis, IL 61282 1900 Silver Cross Blvd. Pekin, IL 61554 1-309-792-4271 New Lenox, IL 60451 1-309-347-1151 1-815-300-1100 ILLINOIS HOSPITALS continued

SKOKIE TAYLORVILLE WHEATON Northshore Skokie Hospital Taylorville Memorial Hospital Marionjoy Rehabilitation 9600 Gross Point Rd. 201 E. Pleasant St. Hospital Skokie, IL 60076 Taylorville, IL 62568 26W171 Roosevelt Rd. 1-847-677-9600 1-217-824-3331 Wheaton, IL 60187 1-708-462-4000 SPRINGFIELD URBANA Memorial Medical Center OSF Heart of Mary WINFIELD 701 N. 1st St. Medical Center Central DuPage Hospital Springfield, IL 62702 1400 W. Park St. 25 N. Winfield Rd. 1-217-788-3000 Urbana, IL 61801 Winfield, IL 60190 St. John’s Hospital 1-217-337-2000 1-630-933-1600 800 E. Carpenter St. WATSEKA WOODSTOCK Springfield, IL 62702 Iroquois Memorial Hospital Centegra Hospital Woodstock 1-217-544-6464 200 E. Fairman Ave. 3701 Doty Rd. Watseka, IL 60970 Woodstock, IL 60098 1-815-432-5841 1-815-338-2500

Only certain hospitals are network providers under this policy. Check with your physician to determine if he or she has admitting privileges at the network hospital. If he or she does not, you may be required to use another physician at time of hospitalization or you will be required to pay for all expenses. * The Medicare Select option requires that you live within 30 miles of any Medicare Select contracting hospital listed here. ** Advocate Health Care *** A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 30189.0619