Prime Healthcare and Blue Cross Blue Shield of Illinois Contract Negotiations Could Impact Patient Access
Illinois residents with Blue Cross and Blue Shield of Illinois (BCBSIL) insurance may face changes in their healthcare access as contract negotiations between BCBSIL and Prime Healthcare reach a critical point. Prime Healthcare, which owns eight hospitals in Illinois, has notified BCBSIL of its intention to leave the network on June 1, 2026, potentially impacting coverage for thousands of patients.
What’s Happening with the Negotiations?
BCBSIL and Prime Healthcare are currently engaged in contract negotiations that determine the terms of care for BCBSIL members who seek treatment at Prime facilities. These negotiations routinely cover pricing, access to care and quality standards. Prime Healthcare has stated its intention to have its hospitals, facilities, and affiliated doctors leave BCBSIL networks if a new agreement isn’t reached by the June 1, 2026 deadline .
BCBSIL maintains that existing agreements require Prime to remain in-network and is working to prevent the network disruption. Whereas, if a resolution isn’t achieved, patients could face higher out-of-pocket costs or limited access to care at Prime facilities .
Which Hospitals Are Affected?
The following Illinois hospitals owned by Prime Healthcare could be impacted by the potential network separation:
- Mercy Medical Center – Aurora
- Resurrection Medical Center – Chicago
- Saint Mary of Nazareth Hospital – Chicago
- Holy Family Medical Center – Des Plaines
- Saint Joseph Hospital – Elgin
- Saint Francis Hospital – Evanston
- Saint Joseph Medical Center – Joliet
- St. Mary’s Hospital – Kankakee
Doctors affiliated with Prime Healthcare Illinois Medical Group would also be affected .
How Will This Impact BCBSIL Members?
The impact on BCBSIL members will depend on their specific plan type:
- PPO Plans: Members with PPO plans could continue to receive care at Prime facilities, but would likely face higher out-of-pocket costs as the care would be considered out-of-network.
- HMO Plans: Members with HMO plans would generally lose coverage for non-emergency care at Prime hospitals if Prime leaves the network.
The following BCBSIL plans could be affected: PPO plans, Blue Choice PPO plans, HMO Illinois, Blue Advantage HMO, Blue Precision HMO, MyBlue Plus POS, Medicare Advantage (PPO and HMO), and Blue Cross Community Health Plans .
BCBSIL plans to notify commercial members at least 60 days before June 1, 2026, and Medicare members at least 45 days before the date .
Recent Developments and Concerns
Prime Healthcare recently acquired eight hospitals from Ascension in March 2025 . Since the acquisition, the company has faced scrutiny from lawmakers and the Illinois Nurses Association regarding changes made to some facilities, including the suspension of inpatient pediatric care at St. Joseph Medical Center in Joliet and the loss of Level II trauma center designation at Mercy Medical Center in Aurora .
Prime Healthcare has invested over $104 million in infrastructure, technology, and equipment upgrades at the acquired hospitals and plans to invest an additional $20 million in the Joliet facility this year . The company states it is focused on stabilizing previously struggling community hospitals.
What Should Patients Do?
BCBSIL assures members that they will still have access to other in-network hospitals and doctors if Prime Healthcare leaves the network. Members are encouraged to stay informed about the negotiations and check with BCBSIL for updates on network status.