MR#24.03 Managed Care Program Types

01/24/2024

Obsoletes Policy Memorandum:

Changes in Prescription Drug Coverage for Persons Enrolled in Voluntary Medicaid Managed Care Plans, dated 05/31/2013.

Summary:

• Explains the different Managed Care Program Types:
  • HealthChoice Illinois Mandatory Managed Care Plans (MCP)
  • HealthChoice Illinois Mandatory Managed Long-Term Services & Support (MLTSS)
  • Medicare-Medicaid Alignment Initiative (MMAI)
  • YouthCare
• The Integrated Care Program (ICP) is no longer an active Managed Care Program.

  ---

This manual release updates the Managed Care programs. 

Managed Care Program Types

Illinois Healthcare and Family Services (HFS) currently has four types of statewide managed care programs:

1. HealthChoice Illinois Mandatory Managed Care Plans (MCP) cover children, pregnant women, FamilyCare, Affordable Care Act (ACA) Adults and Aid to the Aged, Blind or Disabled (AABD) Adults.
   
2. HealthChoice Illinois Mandatory Managed Long-Term Services and Support (MLTSS) plans cover Medicare eligible seniors and people with disabilities who get full Medicare and Medicaid benefits and live in a nursing home or long term care facility, or who get home-based waiver services.
   
3. Medicare-Medicaid Alignment Initiative (MMAI) plans cover customers who are categorically eligible for the AABD Program and are also eligible for both Medicare Part A and B (full dual eligible customer).
   
4. YouthCare plan covers DCFS Youth in Care and children in Foster Care, formerly in Foster Care or Adoption Assistance.
   

MANUAL REVISIONS

[signed copy on file]

Dulce M. Quintero

Secretary-Designate, Illinois Department of Human Services 

Elizabeth Whitehorn

Director, Illinois Department of Healthcare and Family Services