Medicare coverage can be difficult to understand, especially with plans changing every year. Choosing between a Medicare Advantage plan or traditional Medicare is a personal decision.  We encourage you to use this page as a resource for plans that will be in-network for Endeavor Health and to access the various resources available to help determine the option that best meets your unique healthcare needs.

To ensure you have all the information you need to make an informed decision about your healthcare coverage, we’d like to share some important changes to the Medicare Advantage plans that Endeavor Health will be in-network for in 2025.

Medicare Advantage changes for 2025

In 2025, we will partner with Medicare Advantage companies that share our commitment to creating an exceptional, personalized healthcare experience. Patients will have access to a robust network of healthcare providers that prioritize their individual needs and provide comprehensive, coordinated care.

Endeavor Health will be in-network with the following Medicare Advantage companies for 2025*:

  • Essence Healthcare – New in 2025
  • Aetna
  • Blue Cross Blue Shield of Illinois
  • Cigna - primary care providers will be out-of-network March 1, 2025
  • Humana
  • UnitedHealthcare

*Not all plans are sold in all regions. 

Effective Jan. 1, 2025, Endeavor Health will no longer be an in-network provider for the following Medicare Advantage plans:

  • Clear Spring
  • Devoted
  • Wellcare
  • Zing Health

These changes were made with significant thought and consideration. By partnering with select Medicare Advantage plans, Endeavor Health can invest more in a patient-centered approach to care and our healthcare providers can prioritize your overall health, wellbeing and satisfaction above administrative burdens.

Effective March 1, 2025, Endeavor Health Primary Care Physicians will no longer be in-network for Cigna Medicare Advantage plans.

Cigna is in the process of selling it’s Medicare Advantage business to Health Care Service Corporation (HCSC), which is set to close in early 2025. Due to this transition, we are not able to get definitive answers from Cigna around the future of their plans. Uncertainty in an insurer’s coverage rules, claims submission process and payment terms means we must devote more time and resources on overcoming administrative hurdles instead of focusing on patient care. This change will only impact Primary Care Physicians. Endeavor Health specialists and hospital care will not be impacted and will still be considered “in-network” for patients on a Cigna Medicare Advantage plan.  

You can find more information about Cigna in the FAQs at the bottom of the page.

New Medicare Advantage plans for 2025

We know how important your relationship is with your healthcare providers, which is why we are excited to share that Endeavor Health is participating in new Medicare Advantage plans.

Endeavor Health has chosen Essence Healthcare as a new Medicare Advantage partner starting Jan. 1, 2025. For its initial launch in Chicagoland in 2025, Essence Healthcare’s Medicare Advantage plans will be available to residents of Cook, Will, and DuPage Counties.

To learn more about the Medicare Advantage plans offered by Essence Healthcare, you can request free information or ask questions by calling (855) 552-6473 or visiting essencehealthcare.com/endeavor.

Enrollment support

Access to high-quality healthcare begins with choosing the right insurance. We are here to support you.

Each year, it’s important to understand changes to your in-network coverage as well as other annually occurring changes like prescription coverage, premiums and/or copays and changes to supplemental benefits. These changes could increase your out-of-pocket costs. If Endeavor Health will no longer be in-network for your current plan in 2025, we encourage you to consider your options that will maintain in-network access to Endeavor Health in 2025.

Endeavor Health will accept traditional Medicare and several Medicare Advantage plans including those from the following insurance companies:

Benefits vary by plan and not all plans are available in all regions. Check with the specific insurance company to get comprehensive plan details.

Find a complete list of accepted 2025 plans

For additional enrollment support and to get a complete list of all your Medicare options:

Understanding Medicare

What’s the difference?

Original or traditional Medicare is healthcare operated and funded by the federal government. It is a health insurance program for people ages 65 and older, or for people with certain medical conditions or disabilities that qualify under government rules. Typically, traditional Medicare pays for 80% of covered healthcare costs and patients pay the remaining 20%. Traditional Medicare does not cover most prescription drug costs or vision, dental, hearing or long-term nursing home health needs.

Medicare Advantage plans are Medicare-approved plans from private companies offering an alternative to traditional Medicare for health and prescription drug coverage. Medicare Advantage plans include Medicare-covered services and may include extra benefits not covered by Medicare, such as dental, vision, hearing and alternative care. Medicare Advantage plans work to limit out-of-pocket costs while providing access to other essential health and wellness benefits.

Want to learn more? Check out these resources:

When can I enroll?

It is important to understand when you can enroll in Medicare and make changes to your plans. Here’s a breakdown of the different enrollment periods.

If you are already enrolled in traditional Medicare or Medicare Advantage: 

  • Annual Enrollment Period (AEP)
    • From Oct. 15 to Dec. 7 every year, you can make changes to your Medicare plan. This includes switching from traditional Medicare to Medicare Advantage, or vice versa, and enrolling in or changing Part D plans. Any changes made during this period take effect on Jan. 1 of the following year.
  • Medicare Advantage Open Enrollment Period
    • From Jan. 1 through March 31 every year, individuals enrolled in a Medicare Advantage plan can make a one-time election to go to either another Medicare Advantage plan with or without prescription drug coverage or Original Medicare. You’ll also be able to enroll in a Medicare prescription drug plan.  Your new coverage will start on the first day of the month following the month you make a change.

If you will be enrolling in traditional Medicare or Medicare Advantage for the first time: 

  • Initial Enrollment Period (IEP)
    • This period starts three months before you turn 65 and lasts until 3 months after the month you turn 65. If you enroll during this period, you avoid any late penalties. You can sign up for Medicare Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage) and Part D (prescription drug plan).

Want to learn more? Check out these resources: 

Who is eligible to enroll?

Medicare and Medicare Advantage are health insurance programs for people ages 65 and older. You may also be eligible for Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig’s disease).

Additional information

  • Medicare supplement (Medigap): If you choose traditional Medicare, you can buy a Medigap policy to cover additional costs. However, if you choose a Medicare Advantage plan, you can’t have a Medigap policy at the same time.
  • Dual eligibility (Medicare and Medicaid): If you qualify for both Medicare and Medicaid (low-income individuals), you may have access to Special Needs Plans (SNPs), which are Medicare Advantage plans specifically designed for dual-eligible beneficiaries.

Want to learn more? Check out these resources: 

Frequently asked questions

NorthShore University HealthSystem, Edward-Elmhurst Health, Northwest Community Healthcare and Swedish Hospital are now united under the name Endeavor Health, as one comprehensive, community-based health system. With nine top regional hospitals and over 300 care locations across Chicagoland, expert care is right around the corner (and in your neighborhood). Together, we’re committed to setting a new standard for healthcare by delivering a truly personal patient experience combined with convenient access to pioneering, world-class care.

To be treated by an Endeavor Health doctor or advanced practice provider as in-network, you would need to ensure that you are enrolled in a plan where Endeavor Health is in-network. To explore all your insurance options that maintain your in-network access to Endeavor Health:

Yes. You may switch to a Medicare Advantage plan during the annual enrollment period. Endeavor Health will also continue to participate as an in-network provider with traditional Medicare and all Medicare Supplemental plans.

Beginning March 1, 2025, patients with a Cigna Medicare Advantage will no longer be considered “in-network” with their Endeavor Health Primary Care Provider. Patients who are only treated by Endeavor Health Medical Group Specialty physicians and/or who use Endeavor Health hospital services will not be impacted by this change.

Yes. Patients that are enrolled in Medicare Advantage Plans can make changes again during Medicare Advantage Open Enrollment Period, which runs from Jan. 1 – March 31. During Medicare Advantage Open Enrollment, patients enrolled in a Medicare Advantage plan may switch to another Medicare Advantage Plan or return to Original Medicare. Coverage for the new plan would begin the first of the month after the plan gets your request.  After March 31, Medicare Advantage patients will not be able to make changes to their plan until the next annual enrollment period for a Jan. 1, 2026, effective date.

The following primary care disciplines will no longer be considered in-network on March 1, 2025 for Cigna Medicare Advantage plans:

  • Family medicine
  • Internal medicine
  • Pediatrics
  • Geriatric medicine

Yes, patients can still get in-network rates for outpatient and elective services with Endeavor Health providers, even if their Primary Care Provider is no longer in-network. We recommend calling the phone number on your insurance card to understand your specific coverage and payment responsibilities.

You should always go to the closest emergency room if you’re experiencing any type of emergency. Patients will always have access to Endeavor Health’s emergency department, regardless of network status, until patients are stable and can independently determine if they would like to be transferred to an alternate facility to be covered under in-network rates for the duration of their care.

Yes, Endeavor Health will schedule office visits and outpatient/elective services for patients on Medicare Advantage plans where Endeavor Health is no longer in-network. However, you may incur higher costs associated with out-of-network care and pre-payment might be required based on your out-of-network benefits. We recommend calling the phone number on your current insurance card to inquire about specific coverage and payment responsibilities.

Patients must apply for Continuity of Care through their insurance company. Your insurance company will review and approve or deny those applications on a case-by-case basis. Patients undergoing an active treatment plan for the following covered and approved services will continue to receive continuation of care treatment from Endeavor Health:

  • Receiving post-operative care
  • Have an urgent/emergency medical condition
  • In mid-treatment for a serious medical condition
  • Taking high-risk medications that require monitoring
  • Require regular infusions
  • Taking chronic controlled substances

We recommend calling the phone number on your current insurance card to inquire about eligibility, specific coverage, and payment responsibilities.

You are welcome to keep your appointments with Endeavor Health providers even if Endeavor Health is no longer an in-network provider. However, you may incur higher costs associated with out-of-network care and pre-payment might be required based on your out-of-network benefits.  We recommend calling the phone number on your current insurance card to inquire about specific coverage and payment responsibilities.

No. As the number of Medicare beneficiaries participating in Medicare Advantage (MA) plans increases — alongside the growing variety of MA plans and products offered — healthcare providers nationwide face new challenges and opportunities to maintain strong clinical, financial and operational performance. That is why Endeavor Health is modifying its participation in several Medicare Advantage health plans. By partnering with select Medicare Advantage plans, Endeavor Health can invest more in a patient-centered approach to care and our healthcare providers can prioritize your overall health, wellbeing and satisfaction above administrative burdens.

Out-of-network refers to a healthcare provider who does not have a contract with a particular health insurance plan. If you use an out-of-network provider, healthcare services could cost more.

Changes should be made during the Medicare annual enrollment period, which is Oct. 15 – Dec. 7, 2024. These changes will be effective Jan. 1, 2025.

Want to learn more about how to prepare for 2025 Medicare plan changes?

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