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Welcome to HealthChoice Illinois: Medicaid managed care
Beginning January 1, 2018, Illinois transitioned their Managed Care program into a more streamlined, accountable, and integrated program.  The goal of the member-centric HealthChoice Illinois Program is to provide enhanced quality and improved outcomes, all while managing cost.  Statewide, providers have an opportunity to contract with each of the 4 (6 in Cook County) qualified, experienced, and financially sound Managed Care plans that have been chosen to provide services.  
Latest News
 
Special Needs Children in HealthChoice Illinois – Enrollment begins effective February 1, 2020
 
Beginning in mid-September, families of Special Needs Children will begin receiving enrollment packets from Illinois Client Enrollment Services to enroll in a HealthChoice Illinois plan.  Special Needs Children include:
 
·        Children receiving Supplemental Security Income (SSI)
 
·         Children enrolled in the Division of Specialized Care for Children (DSCC) CORE program
 
·         Children with a physical disability category
 
These children have historically been excluded from Managed Care, but they and their families will now be able to receive the care coordination and other benefits provided by the Department’s HealthChoice Illinois Managed Care plans. 
 
Please make sure you read the enrollment letter and the health plan information that is sent in the enrollment packet carefully.  It is better if you choose a health plan for your child because you know your child’s healthcare needs best. 
 
 
Please note that children in the Medically Fragile/Technology Dependent (MFTD) waiver and children enrolled in the Nursing Personal Care Services program remain excluded from Managed Care enrollment and should not receive an enrollment packet.
Frequently Asked Questions
 
1.    What population of Special Needs Children will participate in Managed Care?
Children under the age of 21
·         with a physical disability category, or
·         enrolled in the Division of Specialized Care for Children (DSCC) CORE program, or
·         receiving Supplemental Security Income (SSI)
 
2.     Will these Special Needs Children be required to participate in Managed Care?
Yes, there is no opt out
 
3.      Will Medically Fragile Technology Dependent (MFTD) waiver members and Nursing and Personal Care Services Program (NPCS) continue to be excluded from Managed Care?
Yes, children who are enrolled in MFTD and who receive NPCS will continue to be excluded from Managed Care
 
4.      How are children on a Developmental Disability (DD) waiver or residing in a DD facility impacted by the Special Needs Children enrollment?
Service Package III is not part of the current changes.  DHS will continue to coordinate waiver services for children enrolled in the DD waiver
 
5.     How will the enrollment process work for Special Needs Children?
HFS will mail an enrollment packet in mid-December.  The letter will allow members to choose from a list of health plans that are available. If they do not choose a health plan by the deadline, one will be chosen for them.  Members have an additional 90 days after 02/01/2020 to make a one-time switch.  After ninety (90) days have passed, the member will be locked in to their health plan for a year.
 
6.      What services will the Special Needs Children be receiving from the Managed Care health plans?
Special Needs Children will receive all the Medicaid covered services and medical care coordination from the health plan
·       Managed Care provides services for clients statewide, reaching approximately 80% of Medicaid enrollees
·        Uniform credentialing process makes it easy for providers to enroll.  There do not need to credential separately through each plan individually.  Providers only need to credential once through IMPACT.    
       For more on these and other benefits, see the “Succeeding with the new Managed Care Program” notices
       Strategies to help clients transition to HealthChoice Illinois are also included
 
 

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