How does the provider network work?

Updated on December 12th, 2023

Carle health plans offer both in-network and out-of-network coverage 

Using in-network providers mean lower co-pays/coinsurance, deductibles and out-of-pocket maximums.

Your home address determines which in-network providers your covered family members have access to.  

Local Network

If your home zip code is within 35 miles of one of the locations listed below, your will have the Local Network; which includes in-network coverage with all Carle providers (including those affiliated with the Carle Health Physician Partners) plus Health Alliance contracted behavioral health/substance abuse providers.  

  • Carle Foundation Hospital, Urbana IL
  • Carle BroMenn Medical Center, Bloomington IL
  • Carle Eureka Hospital, Eureka IL
  • Carle Hoopeston Regional Health Center, Hoopeston IL
  • Carle Richland Memorial Hospital, Olney IL
  • Carle Health Methodist Hospital, Peoria IL
  • Carle  Health Proctor Hospital, Peoria IL
  • Carle Health Pekin Hospital, Pekin IL
  • FirstCarolinaCare, Pinehurst NC

If your zip code appears in the list below, you will fall under the Local Network for in-network coverage.  

IN-NETWORK ZIP CODES
27207
27208
27209
27213
27229
27237
27242
27247
27252
27256
27259
27281
27306
27316
27325
27330
27331
27332
27341
27356
27371
27376
27505
27546
27552
28091
28301
28302
28303
28304
28305
28307
28308
28309
28310
28311
28314
28315
28326
28327
28330
28331
28338
28343
28345
28347
28350
28351
28352
28353
28355
28357
28363
28364
28367
28368
28370
28371
28373
28374
28376
28377
28378
28379
28380
28386
28387
28388
28390
28394
28396
47524
47591
47665
47666
47917
47918
47921
47922
47932
47942
47944
47948
47951
47962
47963
47969
47970
47971
47974
47975
47977
47982
47986
47991
47993
60911
60912
60918
60924
60926
60927
60928
60930
60931
60932
60933
60936
60938
60939
60942
60945
60948
60949
60951
60952
60953
60955
60956
60957
60958
60959
60960
60962
60963
60966
60967
60968
60970
60973
60974
61311
61319
61321
61333
61334
61335
61336
61358
61364
61369
61375
61377
61421
61424
61426
61427
61428
61432
61433
61436
61449
61451
61458
61479
61483
61485
61489
61491
61516
61517
61519
61520
61523
61524
61525
61526
61528
61529
61530
61531
61532
61533
61534
61535
61536
61537
61539
61540
61541
61542
61543
61544
61545
61546
61547
61548
61550
61552
61553
61554
61555
61558
61559
61560
61561
61562
61563
61564
61565
61567
61568
61569
61570
61571
61572
61601
61602
61603
61604
61605
61606
61607
61610
61611
61612
61613
61614
61615
61616
61625
61629
61630
61633
61634
61635
61636
61637
61638
61639
61641
61643
61650
61651
61652
61653
61654
61655
61656
61701
61702
61704
61705
61709
61710
61720
61721
61722
61723
61724
61725
61726
61727
61728
61729
61730
61731
61732
61733
61734
61735
61736
61737
61738
61739
61740
61741
61742
61743
61744
61745
61747
61748
61749
61750
61751
61752
61753
61754
61755
61758
61759
61760
61761
61764
61770
61771
61772
61773
61774
61775
61776
61777
61778
61790
61791
61799
61801
61802
61803
61810
61811
61812
61813
61814
61815
61816
61817
61818
61820
61821
61822
61824
61825
61826
61830
61831
61832
61833
61834
61839
61840
61841
61842
61843
61844
61845
61846
61847
61848
61849
61850
61851
61852
61853
61854
61855
61856
61857
61858
61859
61862
61863
61864
61865
61866
61870
61871
61872
61873
61874
61875
61876
61877
61878
61880
61882
61883
61884
61910
61911
61913
61917
61919
61929
61930
61932
61936
61940
61941
61942
61943
61953
61956
62410
62413
62417
62419
62421
62424
62425
62426
62427
62432
62434
62436
62439
62443
62445
62446
62448
62449
62450
62451
62452
62454
62459
62460
62464
62466
62475
62476
62479
62480
62481
62512
62633
62635
62642
62643
62644
62655
62656
62664
62666
62671
62682
62806
62809
62811
62815
62818
62820
62823
62824
62833
62837
62839
62842
62843
62844
62850
62852
62858
62863
62868
62878
62879
62886
62899

Health Alliance Network

If you live in Illinois but beyond 35 miles from the listed facilities, your in-network providers include all Carle providers and Health Alliance-contracted providers (excluding Christie Clinic and OSF) plus the First Health complimentary network.

National Network

If you live outside Illinois or in Cook County, your in-network providers include those who contract with the First Health National network.

College Extended Network Program

Dependent children who leave our service area for 90 consecutive days or more to attend a college, university, technical school or vocational school can get access to in-network care through the First Health National network while at school for no additional cost. Your dependent student can search the FirstHealth network through YourHealthAlliance and apply to be placed on the College Extended Network by filling out the Application Form and returning it to Health Alliance using the methods listed at the bottom of the application. All other family members on the plan will continue using the standard provider networks. Please contact Health Alliance at membership@healthalliance.org or 800-322-7451 for more information.

ADDITIONAL ARTICLES