Frequently Asked Questions About Insurance

Is My Doctor "In Network"?

Before a visit, we encourage families to contact their insurance company directly for more 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 Referrals for?

Before a visit, we encourage families to contact their insurance company directly for more information. For example, if your insurance is an HMO, 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 & Services Covered by Insurance?

We do our best to understand the rules of all managed care plans, and can often let families know what services are covered by insurance before their visit. However, since some pediatric specialists and specialty services may not be part of your benefits, we encourage families to contact their insurance company directly to find out. If services are not covered by insurance, the hospital asks for payment on the day of the visit.

What Should We Expect & Do Before Our Visit?

  • We encourage families to contact their insurance company, Medicaid or All Kids directly to see what payment they may owe at the time of service.
  • Be sure to bring your current insurance or enrollment card to every visit.
  • Co-pays and/or Estimates are collected at time of service.

Cost Estimate Tool

Lurie Children’s understands that pricing for healthcare services can be complicated based on insurance coverage and specific plan details. We provide a cost estimation tool for our patient families to use. For any questions regarding estimates, please call 312.227.1333.