Medicare Select * Contracting Listing

How Medicare Select Works You can use any of the Medicare Select contracting 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 . If you have any questions about this listing, please call 1-877-384-9297.

ILLINOIS HOSPITALS

ALEDO BERWYN CHICAGO Genesis Medical Center Aledo MacNeal Hospital Community First 409 N.W. 9th Ave. 3249 S. Oak Park Ave. Medical Center Aledo, IL 61231 Berwyn, IL 60402 5645 W. Addison St. 1-309-582-9100 1-708-783-9100 Chicago, IL 60634 1-312-282-7000 ARLINGTON HEIGHTS BOLINGBROOK Holy Cross Hospital Northwest Community Hospital Adventist Bolingbrook Hospital 2701 W. 68th St. 800 W. Central Rd. 500 Remington Blvd. Chicago, IL 60629 Arlington Heights, IL 60005 Bolingbrook, IL 60440 1-312-471-8000 1-847-618-1000 1-630-312-5000 Masonic AURORA CANTON Medical Center ** Copley Memorial Hospital Graham Hospital 836 W. Wellington Ave. 2000 Ogden Ave. 210 Walnut St. Chicago, IL 60657 Aurora, IL 60504 Canton, IL 61520 1-312-975-1600 1-866-426-7539 1-309-647-5240 Jackson Park Hospital *** 7531 S. Stony Island Ave. Mercy Medical Center CENTREVILLE 1325 N. Highland Ave. Chicago, IL 60649 Aurora, IL 60506 Touchette Regional Hospital 1-312-947-7500 1-630-859-2222 5900 Bond Ave. John H. Stroger, Jr. Centreville, IL 62207 Hospital of Cook County BARRINGTON 1-618-332-3060 1835 W. Harrison St. Good Shepherd Hospital ** Chicago, IL 60612 450 W. IL HWY 22 1-312-633-6000 Barrington, IL 60010 1-708-381-9600 (continued)

Current as of 1/23/20. Please visit bcbsil.com for an up to date listing. ILMSHL19 30189.0220 ILLINOIS HOSPITALS (continued) Louis A. Weiss Schwab Rehabilitation Hospital CLINTON Memorial Hospital 1401 S. California Ave. Warner Hospital and 4646 N. Marine Dr. Chicago, IL 60608 Health Services Chicago, IL 60640 1-773-522-2010 422 W. White St. 1-312-878-8700 Saint Anthony Hospital Clinton, IL 61727 Mercy Hospital and 2875 W. 19th St. 1-217-935-9571 Medical Center Chicago, IL 60623 2525 S. Michigan Ave. 1-312-521-1710 DANVILLE Chicago, IL 60616 St. Joseph Hospital Chicago *** OSF Sacred Heart 1-312-567-2000 2900 N. Lake Shore Dr Medical Center Mount Sinai Hospital Chicago, IL 60657 812 N. Logan Ave. 1500 S. Fairfield Ave. 1-312-665-3000 Danville, IL 61832 1-217-443-5000 Chicago, IL 60608 Saints Mary and Elizabeth 1-312-542-2000 Medical Center *** DECATUR Northwestern Memorial 2233 W. Division St. Decatur Memorial Hospital Hospital Chicago, IL 60622 2300 N. Edward St. 251 E. Huron St. 1-312-770-2000 Decatur, IL 62526 Chicago, IL 60611 Shirley Ryan Ability Lab 1-217-876-8121 1-312-908-2000 345 E. Superior St. St. Mary’s Hospital Norwegian American Hospital Chicago, IL 60611 1800 E. Lake Shore Dr. 1044 N. Francisco Ave. 1-312-238-8020 Decatur, IL 62521 Chicago, IL 60622 Swedish Covenant Hospital 1-217-464-2966 1-773-292-8200 5145 N. California Ave. Provident Hospital of Chicago, IL 60625 DEKALB Cook County 1-312-878-8200 Kishwaukee Community 500 E. 51st St. Thorek Memorial Hospital Hospital Chicago, IL 60615 850 W. Irving Park Rd. 1 Kish Hospital Dr. 1-312-572-2000 Chicago, IL 60613 DeKalb, IL 60115 Resurrection Medical Center *** 1-773-525-6780 1-815-756-1521 7435 W. Talcott Ave. Trinity Hospital ** DES PLAINES Chicago, IL 60631 2320 E. 93rd St. Chicago Behavioral Hospital 1-312-774-8000 Chicago, IL 60617 555 Wilson Rd. RML Chicago 1-312-978-2000 Des Plaines 60016 3435 W. Van Buren St. University of Chicago 1-847-768-5430 Chicago, IL 60624 Medical Center Holy Family Medical Center *** 1-312-265-7700 5841 S. Maryland Ave. 100 N. River Rd. Roseland Community Hospital Chicago, IL 60637 Des Plaines, IL 60016 45 W. 111th St. 1-312-702-1000 1-708-297-1800 Chicago, IL 60628 University of Illinois 1-312-995-3000 Medical Center 1740 W. Taylor St. Chicago, IL 60612 1-312-996-7000 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. Elgin, IL 60123 Delnor Community Hospital Hoffman Estates, IL 60169 1-847-742-9800 300 Randall Rd. 1-708-843-2000 Geneva, IL 60134 Alexian Brothers Behavioral ELK GROVE VILLAGE 1-630-208-3000 Health Hospital Alexian Brothers GLENDALE HEIGHTS 1650 Moon Lake Blvd. Medical Center Adventist GlenOaks Hospital Hoffman Estates, IL 60169 800 Biesterfield Rd. 1-708-882-1600 Elk Grove Village, IL 60007 701 Winthrop Ave. 1-847-437-5500 Glendale Heights, IL 60139 HUNTLEY 1-708-858-9700 ELMHURST Northwestern Medicine GLENVIEW Huntley Hospital Elmhurst Memorial Hospital Northshore Glenbrook Hospital 10400 Haligus Rd. Main Campus 2100 Pfingsten Rd. Huntley, IL 60142 155 E. Brush Hill Rd. Glenview, IL 60026 1-000-000-0000 Elmhurst, 60126 1-708-657-5800 1-331-221-1000 JOLIET *** EVANSTON HARVEY St. Joseph Medical Center Ingalls Memorial Hospital 333 N. Madison St. Northshore Evanston Hospital 1 Ingalls Dr. Joliet, IL 60435 2650 Ridge Ave. Harvey, IL 60426 1-815-725-7133 Evanston, IL 60201 1-708-210-3012 1-708-570-2000 KANKAKEE St. Francis Hospital *** HAZEL CREST 355 Ridge Ave. South Suburban Hospital ** 350 N. Wall St. Evanston, 60202 17800 S. Kedzie Ave. Kankakee, IL 60901 1-708-316-4000 Hazel Crest, IL 60429 1-815-933-1671 *** EVERGREEN PARK 1-708-799-8000 St. Mary’s Hospital 500 W. Court St. Little Company of HIGHLAND PARK Kankakee, IL 60901 Mary Hospital Northshore Highland Park 1-815-937-2400 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)

LA GRANGE NAPERVILLE PANA Adventist La Grange Pana Community Hospital Memorial Hospital 801 S. Washington St. 101 E. Ninth St. 5101 S. Willow Springs Rd. Naperville, IL 60540 Pana, IL 62557 La Grange, IL 60525 1-708-355-0450 1-217-562-2131 1-708-352-1200 NEW LENOX PARK RIDGE LAKE FOREST Lutheran General Hospital ** Northwestern Lake Forest 1900 Silver Cross Blvd. 1775 Dempster St. Hospital New Lenox, IL 60451 Park Ridge, IL 60068 660 N. Westmoreland Rd. 1-815-300-1100 1-708-696-2210 Lake Forest, IL 60045 1-847-234-5600 OAK LAWN PEKIN Christ Hospital Pekin Hospital MAYWOOD Medical Center ** 600 S. 13th St. Loyola University 4440 W. 95th St. Pekin, IL 61554 Medical Center Oak Lawn, IL 60453 1-309-347-1151 2160 S. 1st Ave. 1-708-425-8000 Maywood, IL 60153 PEORIA 1-708-216-9000 OAK PARK UnityPoint Health – Proctor Rush Oak Park Hospital 5409 N. Knoxville Ave. MCHENRY 520 S. Maple Ave. Peoria, IL 61614 Centegra Hospital McHenry Oak Park, IL 60304 1-309-691-1000 4201 W. Medical Center Dr. 1-708-383-9300 OSF St. Francis Medical Center McHenry, IL 60050 West Suburban Medical Center 530 N.E. Glen Oak Ave. 1-815-344-5000 3 Erie Court Peoria, IL 61637 Oak Park, IL 60302 1-309-655-2000 MELROSE PARK 1-708-383-6200 Gottlieb Memorial Hospital PONTIAC 701 W. North Ave. OLYMPIA FIELDS St. James Hospital Melrose Park, IL 60160 Franciscan Health 2500 W. Reynolds St. 1-708-681-3200 Olympia Fields Pontiac, IL 61764 Westlake Hospital 20201 Crawford Ave. 1-815-842-2828 1225 W. Lake St. Olympia Fields, IL 60461 Melrose Park, IL 60160 1-708-747-4000 ROCK ISLAND 1-708-681-3000 Trinity Regional Health System PALOS HEIGHTS 2701 17th St. MOLINE Palos Community Hospital Rock Island, IL 61201 UnityPoint Health Trinity 12251 S. 80th Ave. 1-309-779-5640 500 John Deere Rd. Palos Heights, IL 60463 Moline, IL 61265 1-708-923-4000 1-309-779-5000 ILLINOIS HOSPITALS (continued)

ROCKFORD SKOKIE WATSEKA St. Anthony Medical Center Northshore Skokie Hospital Iroquois Memorial Hospital 5666 E. State St. 9600 Gross Point Rd. 200 E. Fairman Ave. Rockford, 61108 Skokie, IL 60076 Watseka, IL 60970 1-815-226-2000 1-847-677-9600 1-815-432-5841 Van Matre Encompass Health SPRINGFIELD WHEATON Rehabilitation Hospital 950 S. Mulford Rd. Memorial Medical Center Marianjoy Rehabilitation Rockford, IL 61108 701 N. 1st St. Hospital 1-815-381-8500 Springfield, IL 62702 26W171 Roosevelt Rd. 1-217-788-3000 Wheaton, IL 60187 SANDWICH St. John’s Hospital 1-708-462-4000 Northwestern Medicine Valley 800 E. Carpenter St. WINFIELD West Hospital Springfield, IL 62702 1302 N. Main St. 1-217-544-6464 Central DuPage Hospital Sandwich, IL 60548 25 N. Winfield Rd. 1-815-786-8484 TAYLORVILLE Winfield, IL 60190 Taylorville Memorial Hospital 1-630-933-1600 SILVIS 201 E. Pleasant St. WOODSTOCK Genesis Medical Center Silvis Taylorville, IL 62568 801 Illini Dr. 1-217-824-3331 Centegra Hospital Woodstock Silvis, IL 61282 3701 Doty Rd. 1-309-792-4271 URBANA Woodstock, IL 60098 OSF Heart of Mary 1-815-338-2500 Medical Center 1400 W. Park St. Urbana, IL 61801 1-217-337-2000

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 30189.0220