HealthChoice Illinois has expanded the landscape of Medicaid managed care programs across the state, ensuring that every county in Illinois is now covered. This initiative is designed to be member-focused, consolidating the former Family Health Plan/Affordable Care Act (FHP/ACA) Managed Care Program, the Integrated Care Program (ICP), and the Long Term Services and Supports (LTSS) Program into a unified system. A key goal of HealthChoice Illinois is to empower individuals to make informed decisions about their healthcare. With this expansion, it’s anticipated that a significant majority – around 80% – of Medicaid beneficiaries in Illinois will receive their care through HealthChoice Illinois plans, shifting away from the traditional fee-for-service Medicaid model. Among the prominent health plans available under HealthChoice Illinois, Blue Cross Blue Shield of Illinois (BCBS) stands out as a statewide option for managed care.
HealthChoice Illinois: A Streamlined Medicaid Program
HealthChoice Illinois represents a significant evolution in how Illinois delivers Medicaid services. By integrating multiple previous programs, it aims to create a more cohesive and user-friendly experience for beneficiaries. This consolidation means that individuals who were previously enrolled in programs like FHP/ACA, ICP, or LTSS with participating health plans automatically transitioned into HealthChoice Illinois with their existing plan on January 1, 2018. Members across Illinois received notifications detailing this transition to the HealthChoice Illinois Program and their continued enrollment with their current plan. For those interested in reviewing sample transition notices, the Illinois Department of Healthcare and Family Services provides access to these documents online, ensuring transparency and clarity for members.
Participating Health Plans: Is Blue Cross Blue Shield of Illinois Included?
Yes, Blue Cross Blue Shield of Illinois is a participating health plan in the HealthChoice Illinois program, offering its managed care services statewide. Alongside BCBS, several other health plans are part of this comprehensive program, providing beneficiaries with choices depending on their location and needs. The health plans available under HealthChoice Illinois include:
| 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 |
This diverse selection of plans ensures that most Illinois residents on Medicaid have access to managed care options, including the widely recognized Blue Cross Blue Shield of Illinois managed care program. For a visual representation of plan availability across the state, an updated managed care program map for January 1, 2018, is publicly accessible through the Illinois government website.
Transition and Enrollment: What You Need to Know
The implementation of HealthChoice Illinois involved a significant transition phase, particularly for members of plans that were not continuing under the new program, such as Family Health Network (FHN), Community Care Alliance of Illinois (CCAI), Aetna, and Humana. Members of FHN, CCAI, and Aetna were transitioned through partnerships with plans participating in HealthChoice Illinois, ensuring a smooth shift to new managed care organizations (MCOs). Humana members, as Humana did not partner with a participating MCO, were automatically assigned to HealthChoice Illinois plans based on a pre-defined algorithm. All affected members received notifications about their transition process and plan assignments for January 1, 2018.
Importantly, regardless of their assigned HealthChoice Illinois plan, all individuals had a 90-day period, from January 1, 2018, to March 31, 2018, to switch to a different plan if they preferred. This flexibility allowed members to choose a plan that best suited their healthcare needs, including options like Blue Cross Blue Shield of Illinois managed care. To explore plan choices and initiate a switch, individuals were directed to contact the Client Enrollment Broker Call Center or use the online Enrollment Portal.
For individuals newly eligible for Medicaid who were not enrolled in a HealthChoice Illinois plan by January 1, 2018, enrollment packets were distributed starting the week of January 8, 2018. These packets provided a 30-day window to select a plan and Primary Care Provider (PCP). Services under HealthChoice Illinois for these newly enrolled individuals began on April 1, 2018, with another 90-day period to switch plans if desired. Enrollment for special needs children into HealthChoice Illinois was anticipated to begin in May and June 2018, with an effective enrollment date of July 1, 2018. Detailed schedules for transition notices and enrollment packets were also made available by the Illinois Department of Healthcare and Family Services.
Illinois Health Connect Program Closure
The Illinois Health Connect (IHC) Program concluded at the end of 2017, meaning it was no longer a plan option moving forward. Individuals enrolled in IHC were guided to select HealthChoice Illinois plans and PCPs, with enrollment effective from April 1, 2018. IHC members received notifications regarding the program’s closure and their transition options, ensuring they could smoothly move to a new managed care arrangement within HealthChoice Illinois.
Medicare-Medicaid Alignment Initiative (MMAI) Program: A Separate Initiative
It is crucial to note that the Medicare-Medicaid Alignment Initiative (MMAI) Program is distinct from HealthChoice Illinois. MMAI continued to operate in its existing counties in 2018 without expansion. The health plans participating in MMAI, which include Blue Cross Blue Shield of Illinois, Aetna Better Health, Humana Health Plan, IlliniCare Health Plan, Meridian Health, and Molina Healthcare of Illinois, remained unchanged in 2018. Therefore, while Blue Cross Blue Shield of Illinois is a part of both MMAI and HealthChoice Illinois, these are separate programs serving different populations and needs.
Further Information and Support
For the most current information and updates on the managed care program, individuals are encouraged to regularly check the Illinois Department of Healthcare and Family Services’ Care Coordination website. Any specific questions about the managed care programs and participating plans, including Blue Cross Blue Shield of Illinois managed care program, can be directed to the Department’s Bureau of Managed Care.
This expansion of HealthChoice Illinois represents a significant step towards providing comprehensive and accessible healthcare to Medicaid beneficiaries throughout Illinois, with established providers like Blue Cross Blue Shield of Illinois playing a key role in this enhanced system.
