HFSInfo CenterCare Coordination

Welcome to new Managed Care members (February 1, 2020)

HealthChoice Illinois guide for DCFS former Youth in Care and Special Needs Children
 
Coordinating care. Whole-person treatment. Ensuring the right care at the right time and place.
 
Those are the goals of HealthChoice Illinois.
 
Now these managed care benefits are being extended to DCFS former Youth in Care and Special Needs Children.
 
The transition date is February 1, 2020.
 
Special Needs Children include those:
 
·       who are receiving Supplemental Security Income (SSI),
 
·       who are enrolled in the Division of Specialized Care for Children (DSCC) CORE program
 
·       with a physical disability
 
DCFS Former Youth in Care include youth who:
 
·       have been adopted
 
·       are under a subsidized guardianship arrangement
 
·       have emancipated from DCFS and are under the age of 21
 
·       have been reunified with their families in previous 12 months
 
Starting in December 2019, families of Special Needs Children and DCFS Former Youth in Care began receiving enrollment packets from Illinois Client Enrollment Services to enroll in a HealthChoice Illinois plan. Enrollment of these groups will continue.  Clients who are required to enroll in managed care will receive an enrollment packet in the mail.  Please follow the instructions contained in the packet in order to make a voluntary choice of a health plan that best fits the child’s needs.   
 
Those who have already made their health plan choice can learn answers to your questions by contacting your health plan directly.
 
The Illinois Association of Medicaid Health Plans (IAMHP) is hosting an educational webinar to help providers with the implementation of this transition on Feb. 5 at 2 pm. Register here:  https://attendee.gotowebinar.com/register/9145850274130054669
 
 Frequently Asked Questions about Special Needs Children and former Youth in Care enrollment:
 
 
       What populations will participate in Managed Care as of February 1, 2020?What populations will participate in Managed Care as of February 1, 2020?
 
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) Youth who have been adopted
AND
 
DCFS Former youth in care who:
·                 are under a subsidized guardianship arrangement
·                 have emancipated from DCFS and are under the age of 21
·                 have been reunified with their families in previous 12 months
 
      What about DCFS Youth in Care who are currently under the guardianship of DCFS?What about DCFS Youth in Care who are currently under the guardianship of DCFS?
 
This population is set to enroll April 1, 2020.
      Will these children be required to participate in Managed Care?Will these children be required to participate in Managed Care?
 
Yes, there is no opt out.
      Will Medically Fragile Technology Dependent (MFTD) waiver members and Nursing and Personal Care Services Program (NPCS) continue to be excluded from Managed Care? 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.
      How are children on a Developmental Disability (DD) waiver or residing in a DD facility impacted by the Special Needs Children enrollment?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.
      How will the enrollment process work for DCFS FORMER Youth in Care and Special Needs Children?How will the enrollment process work for DCFS FORMER Youth in Care and Special Needs Children?
 
HFS mailed an enrollment packet in 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 90 days have passed, the member will be locked into their health plan for a year. 
     What services will these children be receiving from the managed care health plans?What services will these children be receiving from the managed care health plans?
 
Special Needs Children and DCFS Former Youth in Care will receive all the Medicaid covered services and medical care coordination from the health plan.
      How do I contact my health plan?How do I contact my health plan?
 
Contact information for each health plan (including the phone number and website link) can be found here.  https://www.illinois.gov/hfs/SiteCollectionDocuments/CONTACTInformationforHealthPlansforMembers.pdf   
      If I have questions about the HealthChoice Illinois program or my Medicaid benefits, who should I call?If I have questions about the HealthChoice Illinois program or my Medicaid benefits, who should I call?
 
You can call the HFS Health Benefits Hotline at: 1-800-266-0768
 

Care Coordination

 

 Need Assistance?