MEDICAID IN ILLINOIS

The IL Department of Healthcare and Family Services administers the state’s Medicaid program.
Information about the state Medicaid program, including beneficiary information, can be found at: http://www2.illinois.gov/hfs/Pages/default.aspx.

MEDICAID EXPANSION

Illinois is fully participating in the Medicaid Expansion under provisions of the Affordable Care Act (ACA).

For additional background on the State’s policy decisions regarding the Medicaid Expansion option, see: Background.

PROVIDER PARTICIPATION

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.
The IL Medicaid website provides information about services covered by fee-for-service payments and payment amounts: 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

Some IL Medicaid beneficiaries are enrolled in managed care plans. Basic information can be found at: http://www2.illinois.gov/hfs/ManagedCare/Pages/default.aspx.
Some managed care plans cover individual Illinois counties and independent cities. The Medicaid website has jurisdictional information: http://www2.illinois.gov/hfs/Pages/default.aspx.

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.

REPORTING PROBLEMS

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:

Illinois Medical Assistance Program:
www.hfs.illinois.gov/
800-843-6154

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
Plan Website: http://www.aetnabetterhealth.com/Illinois/default.aspx
Provider Enrollment: http://www.aetnabetterhealth.com/Illinois/providers/provider-resources/faqs/

Be Well Partners in Health
Plan Website: http://bewellpartnersinhealth.com/
Provider Enrollment: http://bewellpartnersinhealth.com/providers/

Blue Cross Blue Shield of Illinois
Plan Website: http://www.bcbsil.com/
Provider Enrollment: http://www.bcbsil.com/provider/network/join_bcbsil_network.html

Community Care Alliance of Illinois
Plan Website: https://www.ccaillinois.com/
Provider Enrollment: https://www.ccaillinois.com/providers/for-medicaid-providers

CountyCare
Plan Website: http://www.countycare.com/
Provider Enrollment: http://www.countycare.com/for-providers/become-a-provider/

EntireCare
Plan Website: http://www.hcionline.org/entirecare/
Provider Enrollment: http://www.hcionline.org/contact-us/

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)
Plan Website: http://www.healthspring.com/agentillinois
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
Plan Website: https://www.illinoishealthconnect.com/clients/ChildrenCCE.aspx
Provider Enrollment: N/A

Lurie Children’s Hospital of Chicago (Lurie Children’s Health Partners Care Coordination Entity)
Plan Website: https://www.luriechildrens.org/en-us/for-healthcare-professionals/clinically-integrated-network/Pages/index.aspx
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
Plan Website: http://myhealthcarecoordination.com/
Provider Enrollment: http://myhealthcarecoordination.com/network-providers/

NextLevel Health
Plan Website: http://www.nextlevelhealthil.com/
Provider Enrollment: http://www.nextlevelhealthil.com/

Precedence Care Coordination (Unity Point Health)
Plan Website: https://www.unitypoint.org/quadcities/precedence-cce.aspx
Provider Enrollment: https://www.unitypoint.org/quadcities/medical-professionals.aspx

Together4Health
Plan Website: http://www.t4hillinois.org/
Provider Enrollment: http://www.t4hillinois.org/contact-us.html