Skip to main content

Northwestern Medicine Network

Faculty and staff enrolled in the Premier PPO, Select PPO and Value PPO plans will pay lower copayments when they visit a Northwestern Medicine physician. 

Northwestern Medicine participating doctors

  1. Navigate to the Northwestern Medicine Provider Finder (be sure NOT to log in)
  2. Select get medical care in the middle of the screen

Benefit coverage tiers

Using Northwestern Medicine

The chart below reflects the benefits of selecting an Northwestern Medicine physician when you or a covered family member needs medical attention.

Cost using the Northwestern Medicine network by health insurance plan type.
Premier PPO Select PPO Value PPO HMO Illinois
Deductible $150 individual, $450 family $250 individual, $750 family $1,300 individual, $2,600 family N/A
Out-of-Pocket Maximum $1,000 individual, $3,000 family $1,500 individual, $4,500 family $2,100 individual, $5,600 family N/A
Coinsurance 0% 10% 10% N/A
Office Visit Copay $10 physician / $20 specialist $10 physician / $20 specialist 10% after deductible N/A
Emergency Room Copay $100 (waived if admitted) + 10% coinsurance $100 (waived if admitted) + 20% coinsurance 20% after deductible N/A

 

Using in-network provider

Cost of using an in-network provider by health insurance plan.
Premier PPO Select PPO Value PPO HMO Illinois
Deductible $250 individual, $750 family $500 individual, $1500 family $1,400 individual, $2,600 family N/A
Out-of-Pocket Maximum $2,200 individual, $6,600 family $2,650 individual, $7,750 family $3,000 individual, $8,000 family $1,500 individual, $3,000 family
Coinsurance 10% 20% 20% N/A
Office Visit Copay $25 physician, $35 specialist $25 physician, $35 specialist 20% after deductible $25 PCP, $35 specialist
Emergency Room Copay $100 (waived if admitted) + 10% coinsurance $100 (waived if admitted) + 20% coinsurance 20% after deductible $100 (waived if admitted)
Outpatient Event Copay N/A N/A N/A $250
Impatient Event Copay N/A N/A N/A $500

 

Using out-of-network provider

Cost of using an out-of-network provider by health insurance plan.
Premier PPO Select PPO Value PPO HMO Illinois
Deductible $250 individual, $750 family $500 individual, $1,500 family $1,400 individual, $2,800 family N/A
Out-of-Pocket Maximum $4,400, $13,200 family $5,300 individual, $15,000 family $6,000 individual, $16,000 family N/A
Coinsurance 30% 40% after deductible 40% after deductible  N/A
Office Visit Copay 30% after deductible 40% after deductible 40% after deductible N/A
Emergency Room Copay $100 (waived if admitted) + coninsurance $100 (waived if admitted) + coinsurance 40% after deductible $100 (waived if admitted)