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01/25/18

Information Memo

In 2018 the Medicaid Managed Care Program is expanding and will cover all counties in Illinois. The expanded program is called HealthChoice Illinois. The program is member-focused and brings together the current Family Health Plan/Affordable Care Act (FHP/ACA) Managed Care Program, Integrated Care Program (ICP) and Long Term Services and Supports (LTSS) Program under one program. The program will also help individuals make smart healthcare decisions. Once expansion of the statewide managed care program has been completed, it is expected that 80% of all Medicaid beneficiaries will receive care through HealthChoice Illinois plans, with fewer patients accessing services through traditional Medicaid fee-for-service program. The following health plans are part of HealthChoice Illinois:

Choice of Health Plans Regions
Blue Cross Blue Shield of Illinois Statewide
CountyCare Available in Cook County only
Harmony Health Plan Statewide
IlliniCare Health Plan Statewide
Meridian Health Statewide
Molina Healthcare of Illinois Statewide
NextLevel Health Available in Cook County only

An updated managed care program map for January 1, 2018 can be found at the following link: https://www.illinois.gov/hfs/SiteCollectionDocuments/HFSMedicaidManagedCareProgramMapJanuary12018.pdf

HealthChoice Illinois Transition and Expansion Updates

  • Individuals currently enrolled in a managed care program (FHP/ACA, ICP and LTSS) with one of the health plans listed above will remain enrolled with the plan in the new program effective January 1, 2018. Member transition notices regarding the expansion of the HealthChoice Illinois Program and the transition to their current plan under the new program have been mailed to all members across the state. Sample member transition notices can be found at the following links:

FHP/ACA and ICP Member Same Plan Transition Notice:

https://www.illinois.gov/hfs/SiteCollectionDocuments/HealthChoiceIlliniosTransitionNoticeSamePlanEnglish.pdf  

LTSS Member Same Plan Transition Notice:

https://www.illinois.gov/hfs/SiteCollectionDocuments/SampleCESHealthChoiceIlliniosMLTSSTransitionNoticeSamePlanEnglish.pdf

  • Family Health Network (FHN), Community Care Alliance of Illinois (CCAI), Aetna and Humana will not be participating health plans in the HealthChoice Illinois program as of January 1, 2018. FHN, CCAI and Aetna have partnered with participating plans in the HealthChoice Illinois programs. Through these partnerships, their members have received notices of these partnerships and information regarding the transition to the partner MCOs for January 1, 2018. Humana did not partner with a participating MCO. As such, Humana members were transitioned to one of the HealthChoice Illinois plans listed above for January 1, 2018 based on the auto-assignment algorithm. All members in these plans have received notice of the transition process and plan assignments for January 1, 2018. Sample member transition notices can be found at the following links:

Humana Member Sample Transition Notice:

https://www.illinois.gov/hfs/SiteCollectionDocuments/HealthChoiceIlliniosTransitionNoticeNewPlanEnglish.pdf

FHN Member Sample Transition Notice:

CCAI Member Sample Transition Notice:

Aetna Member Sample Transition Notice:

  • Regardless of the HealthChoice Illinois plan that an individual has been transitioned to for January 1, 2018, all individuals will have a 90-day plan switch period (January 1, 2018 to March 31, 2018) to pick a different plan. An individual must call the Client Enrollment Broker Call Center at 1-877-912-8880 (TTY: 1-866-565-8576) or go online to the Enrollment Portal at www.enrollhfs.illinois.gov to get more information about their HealthChoice Illinois plan choices and to make a plan switch.
  • Newly eligible Medicaid clients, not currently enrolled with a HealthChoice Illinois plan as of January 1, 2018, will begin to receive enrollment packets the week of January 8, 2018. The enrollment packets will provide the individual with a 30-day choice period to select a plan and Primary Care Provider (PCP). The enrollment packet will include information about their plan choices, the PCP the individual will be auto-assigned to if no choice is made, and how to get more information and assistance with making a plan and PCP choice. Individuals making a plan and PCP selection during this expansion process will begin receiving services in their HealthChoice Illinois plan on April 1, 2018. Regardless of which plan an individual is enrolled with on April 1, 2018, all individuals have a 90-day period to switch to another plan. 
  • Special needs children are anticipated to begin enrolling into the HealthChoice Illinois Program in May and June of 2018, for a July 1, 2018 enrollment effective date.

The HealthChoice Illinois Transition and Expansion Mail Schedule for Transition Notices and Enrollment Packets is at the following link:  https://www.illinois.gov/hfs/SiteCollectionDocuments/HealthChoiceIllinoisTransitionandExpansionMailScheduleFinalOct162017.pdf 

Illinois Health Connect Program Ending

The Illinois Health Connect (IHC) Program will no longer be a plan option for individuals as of the end of this year(December 31, 2017). Individuals currently enrolled with a PCP in this program will begin to pick HealthChoice Illinois plans and PCPs for care coordination the week of January 8, 2018, for the April 1, 2018 enrollment effective date. IHC has mailed plan closure and transition notices to their members.  A sample notice can be found at the following link:

IHC Member Sample Plan Closure and Transition Notice:

https://www.illinois.gov/hfs/SiteCollectionDocuments/SampleIHCEnrolleeCloseoutNotice103017.pdf

Medicare-Medicaid Alignment Initiative (MMAI) Program

MMAI is not part of the HealthChoice Illinois Program. The MMAI program will continue to be a program in the counties it is currently in today, and will not be expanded to additional counties in 2018. The following health plans will continue to operate in MMAI in 2018: Aetna Better Health, Blue Cross Blue Shield of Illinois, Humana Health Plan, IlliniCare Health Plan, Meridian Health and Molina Healthcare of Illinois.

Questions

Please continue to check the Department's Care Coordination website for updates on the managed care program at: https://www.illinois.gov/hfs/MedicalProviders/cc/Pages/default.aspx/.

Questions regarding the managed care programs and participating plans can be directed to the Department's Bureau of Managed Care at 217-524-7478.

[signed copy on file]

James T. Dimas

Secretary, Illinois Department of Human Services

Felicia F. Norwood

Director, Illinois Department of Healthcare and Family Services