Mandatory Enrollment in a Health Plan
In the mandatory managed care counties, most seniors and persons with disabilities who are enrolled in the Integrated Care Program (ICP), and individuals enrolled in the ACA Adult and Family Health Plans (FHPs) will be required to enroll in a Managed Care Organization (MCO) or a Managed Care Community Network.
In the non-mandatory managed care counties, most individuals will be required to pick a Primary Care Provider (PCP) in the Illinois Health Connect Program, or an MCO, if there is an MCO plan option, in their county of residence.
The MCOs and MCCNs will also provide care coordination. Individuals enrolled in an MCO or MCCN will receive all of their health services from the MCO or MCCN and their PCP.
A New Managed Care Community Network (MCCN)-NextLevel Health
Healthcare and Family Services has added a new MCCN, called NextLevel Health. Individuals enrolled with NextLevel Health under the Care Coordination Entity (CCE) have been changed to NextLevel Health under the MCCN. This includes ICP and ACA Adults. NextLevel Health will send the individual a welcome packet and a member ID card as they are transitioned or enrolled into the MCCN.
Effective March 1, 2016, individuals living in Cook County and receiving medical benefits under FHP will have the option of selecting NextLevel Health (MCCN) as their health plan as they become eligible and during their open enrollment period.
Choice of health plans depends on the county where an individual lives. Enrollment in a health plan is mandatory for eligible individuals. The expanded MCOs and new MCCN health plans are available for an individual to choose. The new counties in which they operate are listed in the chart below.
|Managed Care Organization (MCO)
||Rockford Region (Winnebago, Boone and McHenry), Quad Cities (Rock Island, Henry and Mercer)
||Cook County only
|Managed Care Community Network (MCCNs)
||Cook County only
Individuals Transitioned to a New Plan
Individuals who were changed to an MCO health plan have received a transition letter explaining their new coverage. They have also received a member handbook and an identification card from their new MCO or MCCN health plan.
Individuals have 90 days from the date of enrollment in the MCO or MCCN to switch to a different health plan operating in the county where they live.
|If enrolled in...
||Your new plan is....
|Illinois Partnership for Health (IPH)
|MyCare Chicago and Loyola Family Care
|HealthCura and UI Health Plus
||Blue Cross Blue Shield
||Health Alliance Connect
|Be Well Partners in Health CCE
Lurie Children's Health Plan closed on December 31, 2015. The Lurie members were provided with a 60-day enrollment period to select a new health plan and PCP.
To enroll or switch your health plan, the individual must contact Illinois Client Enrollment Services at 1-877-912-8880 (TTY: 1-866-565-8576) or go online at www.EnrollHFS.illinois.gov/.
[signed copy on file]
James T. Dimas
Secretary-Designate, Illinois Department of Human Services
Felicia F. Norwood
Director, Illinois Department of HealthCare and Family Services