2018 Provider Directory for Vision/Dental/Hearing

Blue Cross Medicare Advantage (HMO)SM

Blue Cross Medicare Advantage (HMO-POS)SM

Blue Cross Medicare Advantage (PPO)SM

January 1, 2018 December 31, 2018

Y0096_BEN_IL_ANCDIR18_NM

Last updated 07/17 851379.0717

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HMO, HMO-POS and PPO plans are provided by Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association. HCSC is a Medicare Advantage organization with a Medicare contract. Enrollment in HCSCs plans depends on contract renewal.

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-877-774-8592 (TTY: 711) We are open between 8:00 a.m. and 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays.

ATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Llame al 1-877-774-8592(TTY: 711). Nuestro horario es de 8:00 a.m. a 8:00 p.m., hora local, los 7 das de la semana. Si usted llama del 15 de febrero al 30 de septiembre, durante los fines de semana y feriados, se usarn tecnologas alternas (por ejemplo, correo de voz).This document is available in other formats such as Braille and large print. For additional information, call us at 1-877-774-8592. (TTY/TDD users should call 711).

This directory is current as of August 19, 2017.

This directory provides a list of Blue Cross Medicare AdvantagesSM current network providers.

This directory is for the entire Blue Cross Medicare Advantage provider network offered to people that are Medicare eligibles and residing in Cook, DuPage, Kane and Will counties.

To access Blue Cross Medicare Advantages online provider directory, you can visit getblueil.com/mapd/providers. For any questions about the information contained in this directory (hardcopy or online), please call our Customer Service Department at 1-877-774-8592, 8:00 a.m. - 8:00 p.m., local time, 7 days a week. TTY/TDD users should call: 711.

Blue Cross Medicare Advantage

2018 Provider Directory

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Table of Contents

Section 1 Introduction ....................................................................................................................... iii

What is the service area for Blue Cross Medicare Advantage? ................................................... iii

How do you find Blue Cross Medicare Advantage providers in your area? .................................iv

Section 2 List of Network Providers .................................................................................................. 1

Dental ............................................................................................................................................ 1

Vision ......................................................................................................................................... 864

Hearing ...................................................................................................................................... 922

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Section 1 IntroductionThis directory provides a list of Blue Cross Medicare Advantage Choice Premier (PPO) and Blue Cross Medicare Advantage Choice Plus (PPO) network providers. To get detailed information about your health care services, please see your Evidence of Coverage.

The network providers listed in this directory have agreed to provide you with your dental, vision, and hearing services. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non-network providers. If you use providers within the Blue Cross Medicare Advantage network your co-pays and/or co-insurance will be less than going to non-network providers.

You do not need prior authorization to seek medical help in an urgent or emergency situation.

With the exception of emergencies or urgent care, it may cost more to get care from out-of-network providers.

If an out-of-network provider asks you to pay for covered services you receive, please call Customer Service at 1-877-774-8592 (TTY/TDD 711) or send the bill(s) with a note explaining the situation to:

Blue Cross Medicare Advantage P.O. Box 805107 Chicago, IL 60680

You should never pay any out-of-network provider more than what the provider is allowed by Medicare. Ask the out-of-network provider to bill us first. If you have already paid for the covered services, we will reimburse you for our share of the cost. If you get a bill for the services, you can send the bill to us for payment. We will pay your out-of-network provider for our share of the bill and will let you know the amount, if any, you must pay.

You must use network providers except in emergency or urgent care situations. If you obtain routine care from out-of-network providers neither Medicare nor Blue Cross Medicare Advantage will be responsible for the costs.

What is the service area for Blue Cross Medicare Advantage?The counties for the State of Illinois in our service area are listed below.

Cook

DuPage

Kane

Will

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How do you find Blue Cross Medicare Advantage providers in your area? The directory includes Dental, Vision, and Hearing providers participating in the Blue Cross Medicare Advantage network. Please refer to the provider listings for section names. Each section is organized alphabetically by city.

Within each city, the city and provider names are listed in alphabetical order along with the address and phone number. For the most updated Blue Cross Medicare Advantage provider information, please visit our Provider Finder at getblueil.com/mapd/providers. Although Blue Cross Medicare Advantage has identified those providers who were offering services at the time this directory was created, the services offered may have changed. For the most current information regarding the services of provider, please contact provider you have selected at the phone number listed in this directory.

If you have questions about Blue Cross Medicare Advantage or require assistance in selecting a PCP, please call our Customer Service Department at 1-877-774-8592, 8:00 a.m. - 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays. TTY/TDD users should call 711. Or, visit getblueil.com/mapd/providers

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HOW TO READ THE PROVIDER LISTINGExample:

CHICAGO (Alphabetical listing of towns and cities)

FAMILY PRACTICE (Specialty)

Smith, John, MD (Physicians name)

(555)123-4567 (Phone number)

This information changes on a frequent basis. Please refer to the online directory or call Customer Service below for current updates.

Participation by providers in this directory is not guaranteed and may be subject to change. Please ask your provider whether he/she is still participating in the network. If you have questions about Blue Cross Medicare Advantage, please call our Customer Service number at 1-877-774-8592 (TTY/TDD users should call 711). We are open 8:00 a.m. - 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays.

Dental Providers

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Dental Care Providers QUINCY ADAMS COUNTY

QUINCY ADAMS COUNTYGENERAL DENTISTAdenuga, Obafemi5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalBower, Roy D5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalCarroll, Sara E5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalCavitt, Mary5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalChampion Harris, Tina M5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalClark, Darlene5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalCummings, Christopher M5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalDague, Jolene5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen Dental

Dreier, Brandon E407 S 48th StQuincy, IL 62305(217) 228-9467Medical Group: Dental ProfessionalsFadel Rateb, Noura5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalFoley, Monica5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalHaddad, Brian5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalHowell, Richard5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalImadomwanyi, Anita O5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalIngle, Lindsey M1261 Maine StQuincy, IL 62301(217) 228-2828Medical Group: Apple White Dental PartnersIsabelle, Christopher5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen Dental

Isawumi, Ebun S5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalJalil, Hassan5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalJeboda, Oluleke S407 S 48th StQuincy, IL 62305(217) 228-9467Medical Group: Dental ProfessionalsKundnani, Bharat5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalLee, Hyo5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen DentalLodhi, Tania G5203 Broadway StQuincy, IL 62305(217) 577-2400Medical Group: Aspen