For additional background on the State’s policy decisions regarding the Medicaid Expansion option, see: Background
Medicaid in Illinois:
The IL Department of Healthcare and Family Services administers the state’s Medicaid program.
Providers must enroll in the Medicaid fee-for-service program to receive payments for covered services. Information about enrolling in the Medicaid fee-for-service program can be found at: http://www2.illinois.gov/hfs/Pages/default.aspx.
In order to retain access to all Medicaid patients in the state, providers must also connect to the managed care plans individually.
Medicaid Managed Care:
Medicaid Beneficiaries Participating in Managed Care:
Managed care plans participating in the managed care program offer detailed information about covered benefits for individuals enrolling in their plans. This information is available on the managed care websites shown below.
The state Medicaid office is primarily responsible for examining and addressing issues with the Medicaid Managed Care plans offered in the state, and for working with the companies that offer them. If you are experiencing problems as a medical provider
with the Managed Care plans or companies operating in the state, or if your patients are experiencing problems
with the Managed Care plans or companies in the state, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act
, please report these problems to the state Medicaid Office:
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM
, so that we may track issues affecting our members, and seek additional policies remedies.
Managed Care Plans Participating in Medicaid:
Aetna Better Health
Provider Enrollment: http://www.aetnabetterhealth.com/Illinois/providers/provider-resources/faqs/
Be Well Partners in Health
Blue Cross Blue Shield of Illinois
Community Care Alliance of Illinois
Family Health Network
Plan Website: http://www.fhnchicago.com/
Provider Enrollment: http://www.fhnchicago.com/contactus.html
Harmony Health Plan
Plan Website: https://www.harmonyhpi.com/
Provider Enrollment: https://www.harmonyhpi.com/prospective_providers/new
Health Alliance Connect
Plan Website: https://www.healthalliance.org/
Provider Enrollment: https://www.healthalliance.org/content/Customer_Center/HCProfessionals
HealthSpring of IL (Cigna)
Provider Enrollment: http://www.myhealthspring.com/Plans
Humana Medical Plan, Inc.
Plan Website: https://www.humana.com/medicare/
Provider Enrollment: https://www.humana.com/provider/
Illinicare Health Plan (Centene Corporation)
Plan Website: http://www.illinicare.com/
Provider Enrollment: http://www.illinicare.com/for-providers/become-a-provider/
La Rabida's Children's Hospital (La Rabida's Coordinated Care Network for Children with Complex Medical Needs
Provider Enrollment: N/A
Lurie Children's Hospital of Chicago (Lurie Children's Health Partners Care Coordination Entity)
Provider Enrollment: N/A
Meridian Health Plan
Plan Website: http://www.mhplan.com/il/corporate/index.php?location=corporate&page=home
Provider Enrollment: http://www.mhplan.com/index.php?page=providerhelp&stateAbbrv=IL
Molina Healthcare of IL (Medicare Medicaid Alignment Initiative)
Plan Website: http://www.molinahealthcare.com/Pages/index.aspx
Provider Enrollment: http://www.molinahealthcare.com/medicaid/providers/il/Pages/home.aspx
My Health Care Coordination
Precedence Care Coordination (Unity Point Health)