Frequently Asked Questions About Insurance 

Is My Doctor "In​ Network"?

Before a visit, we encourage families to contact their insurance company directly for this information. "In network" means your insurance company has a contract with the hospital, and our doctors and usually you have smaller out-of-pocket expenses. You may choose to see an "out of network" provider, but this usually means you pay more or all of the bills.

Who Can I Contact If My Health Plan Denies Coverage For My Child?

The Illinois Office of Consumer Health Insurance can be a helpful resource for families trying to navigate complex health insurance issues. The office can be reached at 877.850.4740 or doi.externalreview@illinois.gov.

What Do I Need Referr​als for?

Before a visit, we encourage families to contact their insurance company directly for this information. If you want your child to see a pediatric specialist, you need referrals for doctor visits and services provided. For example, to see a pediatric specialist, you need a referral from your primary care physician. Then, if that pediatric specialist orders tests (an X-ray, CT scan, MRI, lab tests, physical therapy), you need a referral for those tests.

Are My Doctors & Servic​es Covered by Insurance?

We do our best to understand the rules of all managed care plans but, before a visit, we encourage families to contact their insurance company directly to learn what services are covered by insurance before their visit. If services are not covered by insurance, the hospital asks for payment on the day of the visit.

What Should We Expect & D​o Before Our Visit?

  • We encourage families to contact their insurance company, Medicaid HMO or All Kids directly to see what co-payment they may owe at the time of service. We suggest also looking at your insurance card to see if your co-payments may be listed there.
  • For non-emergent care, contact your insurance company to verify covered services and to validate that the physician or facility you are going to is "in network."
  • If a referral is required, make certain that your primary care physician has made the needed referral. 
  • Be sure to bring your current insurance or enrollment card to every visit.
  • Co-payments are collected at check-in. 

Where Can I Get Help in Applying for Medicaid or Marketplace Exchange Plans?

Lurie Children’s offers free assistance with applying for Medicaid, healthcare exchange plans or food stamps (SNAP) with Patient Innovation Center (PIC) Navigators. Learn more.