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Illinois' Managed Care Programs

 

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Illinois’ Managed Care Programs
 

Welcome to the Managed Care section of the Illinois Department of Healthcare and Family Services (HFS) website.  

In 2018, HealthCare and Family Services expanded their Managed Care program to cover all counties in Illinois.  This program is a member-focused program called HealthChoice Illinois. 

 

Latest News
 

The Department of Healthcare and Family Services (HFS) stated that youth in the care of the Department of Children and Family Services (DCFS) will move to the new YouthCare program on September 1, 2020. DCFS youth in care will be automatically enrolled in the YouthCare health plan.

YouthCare is a special HealthChoice Illinois Health Plan for DCFS youth, designed to improve access to care through care coordination and provide a stronger provider network.  With YouthCare, DCFS youth will receive more benefits, such as care coordination for behavioral health and special programs for adoptive families.

Who are Youth in Care?

Youth in care are youth for which the Illinois Department of Children and Family Services has legal responsibility, living with foster parents, in group homes, or in residential settings. YouthCare will begin giving benefits for youth in care on September 1, 2020. The September 1, 2020 launch of YouthCare for youth in care has no impact on the continued coverage for former youth in care, which began February 1, 2020.

Who are Former Youth in Care?

Former youth in care are youth who have been adopted, are living with kinship providers, have returned to biological parents, and/or have left the DCFS system. All these youth were in the care of DCFS previously. YouthCare has been managing benefits for former youth in care since February 1, 2020.

Continuity of Care Period

For six months after the rollout date, YouthCare will pay for healthcare services provided to DCFS Youth in Care even if those providers are not part of the YouthCare provider network.  YouthCare will work with out-of-network providers during this period to ask them to join the YouthCare network, develop a contract for the the member or find a different provider in the YouthCare network who will accept the child as a new member.  YouthCare members will have a YouthCare ID Card.

Current Youth in Care who would like to switch health plans can request a change through the DCFS Advocacy Office. Youth over 18 years of age can choose their own HealthChoice Illinois Health Plan. For youth under 18 years of age, the DCFS Guardianship Administrator can choose a new health plan if she determines they can be better served.

DCFS Advocacy Office at 800-232-3798

Please contact the DCFS Advocacy Office at 800-232-3798 or DCFS.HealthPlan@illinois.gov if your member has the following issues:

       To request an alternate HealthChoice Illinois managed care plan (Blue Cross Blue Shield, CountyCare, IlliniCare, Molina)

       To share questions or concerns regarding the managed care transition

       If you need any support making decisions about your healthcare coverage

       If your healthcare provider refuses to see you

To determine whether your healthcare provider is in the YouthCare network or for help finding a new healthcare provider, please contact YouthCare at 844-289-2264 or ILYouthCare@Centene.com

If you would like to request your Member Handbook and ID card by phone, please call YouthCare Member Services at 844-289-2264 (TTY: 711); if you would like to request a new ID card by email, please visit www.ILYouthCare.com.   YouthCare can fax a temporary ID card directly to your provider, if necessary.

Updates and important links about the transition into the YouthCare Health Plan on September 1, 2020 are available at https://dcfshealthplan.illinois.gov/.

Please contact your health plan directly to get answers to your questions about enrollment, provider coverage, etc.

HealthChoice Illinois Health Plan Contact Information:

· YouthCare
www.ilyouthcare.com |1-844-289-2264

· Blue Cross Community Health Plan 
www.bcbsil.com/bcchp/ | 1-877-860-2837

· CountyCare Health Plan (Cook County only)
www.countycare.com | 1-855-444-1661

· IlliniCare Health
www.illinicare.com | 1-866-329-4701

· Meridian Health Plan (Former Youth in Care Only)
corp.mhplan.com/en/member/illinois | 1-866-606-3700

· Molina Healthcare
www.molinahealthcare.com | 1-855-687-7861 

 

What is Managed Care?

Managed care is a kind of health insurance program.   When you enroll in Managed Care, you become a member of a Health Plan.  You will have at least four (4) Health Plans to choose from, depending on where you live.  The Health Plan you choose will offer you a full range of services while helping you coordinate your health care.

What is Care Coordination and why is it important?

Serving members through care coordination is an effective way to provide health care services to you.   Included here are some of the ways care coordination through your Health Plan can help you:  

-        Find a primary care provider (PCP) who will get to know you and your health care needs

-        Help you manage your health care conditions like diabetes, high blood pressure, or asthma

-        Give you information you need to stay healthy

-        Help you identify your health goals and create a care plan to achieve those goals

 

What can a Care Coordinator help me do?

Some individuals get a care coordinator to help you reach your goals.  A care coordinator can:

-        Answer questions about your care

-        Help you find a doctor or specialist

-        Help you transition out of a hospital or facility

-        Help connect you with community resources

 

This site will include information on the two Medicaid Managed Care programs offered in Illinois, how to enroll, and who to contact if you have questions about your Health Plan.