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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. 

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 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.

2019 Update regarding Harmony Wellcare-

WellCare Health Plans, the company that owns Harmony Health Plan of Illinois, has purchased Meridian Health Plan of Illinois.

 

Is Harmony Health Plan still an option for me?

As of January 1, 2019, Harmony Health Plan merged with Meridian Health Plan of Illinois.  After January 1st, Harmony will no longer provide services to members.

 

What will happen to my Harmony Health Plan? 

Unless you change to a different health plan, Meridian will provide services beginning January 1, 2019.  To stay in Meridian, you do not have to do anything at all.

 

You will work with Meridian to find providers, make appointments, get transportation and get answers to your questions.

 

Will I be able to keep my primary care provider (PCP)?

Meridian will make every effort to keep you with the same Primary Care Provider (PCP). If a you want to change your PCP, you may do so at any time by calling Meridian Member Services at 1-866-606-3700 (TTY: 711) after December 31, 2018.

 

What plan will I call for billing issues?

Billing issues for dates of service before January 1, 2019- Harmony Health Plan-1-800-608-8158

 

Billing issues after date of service after January 1, 2019- Meridian Health Plan-1-866-606-3700