In 2018, Illinois significantly expanded its Medicaid Managed Care Program to encompass every county in the state. This expansion introduced HealthChoice Illinois, a member-focused program designed to streamline and enhance healthcare access for Medicaid beneficiaries. This initiative consolidated the existing Family Health Plan/Affordable Care Act (FHP/ACA) Managed Care Program, the Integrated Care Program (ICP), and the Long Term Services and Supports (LTSS) Program under a single umbrella. A key question for many seeking clarity on their healthcare options is often “Which Is A Bcbs Managed Care Program“. This article aims to clarify the role of Blue Cross Blue Shield (BCBS) within HealthChoice Illinois and provide a comprehensive overview of this expanded program.
What is HealthChoice Illinois?
HealthChoice Illinois is the unified name for the state’s Medicaid Managed Care Program, representing a significant step towards integrated and coordinated healthcare for Illinois residents. The primary goal of HealthChoice Illinois is to empower individuals to make informed decisions about their healthcare while ensuring a broader reach of managed care services. With the completion of this statewide expansion, it is anticipated that approximately 80% of all Medicaid beneficiaries in Illinois will receive their healthcare services through HealthChoice Illinois plans, marking a shift from the traditional Medicaid fee-for-service model.
Participating Health Plans in HealthChoice Illinois
HealthChoice Illinois partners with several health plans to deliver comprehensive care across the state. For those wondering “which is a bcbs managed care program“, it’s important to note that Blue Cross Blue Shield of Illinois is indeed a participating health plan within HealthChoice Illinois. This means that individuals eligible for HealthChoice Illinois may have the option to select Blue Cross Blue Shield of Illinois as their managed care provider. The program offers a choice of health plans depending on the region:
| Choice of Health Plans | Regions |
|---|---|
| Blue Cross Blue Shield of Illinois | Statewide |
| CountyCare | Available in Cook County only |
| Harmony Health Plan | Statewide |
| IlliniCare Health Plan | Statewide |
| Meridian Health | Statewide |
| Molina Healthcare of Illinois | Statewide |
| NextLevel Health | Available in Cook County only |
Image: The Illinois Department of Human Services (IDHS) logo, representing the state agency overseeing the HealthChoice Illinois program.
As you can see from the table, Blue Cross Blue Shield of Illinois offers statewide coverage within the HealthChoice Illinois network, providing accessibility for Medicaid beneficiaries across Illinois.
Transition and Expansion Updates for HealthChoice Illinois
The rollout of HealthChoice Illinois involved a smooth transition for individuals already enrolled in existing managed care programs. Members enrolled in FHP/ACA, ICP, and LTSS programs with participating health plans automatically remained with their current plan under HealthChoice Illinois starting January 1, 2018. These members received notifications about the program expansion and their continued enrollment.
For members of plans not participating in HealthChoice Illinois – namely Family Health Network (FHN), Community Care Alliance of Illinois (CCAI), Aetna, and Humana – transitions were carefully managed. FHN, CCAI, and Aetna partnered with participating HealthChoice Illinois plans, ensuring a seamless transition for their members to these partner organizations. Humana members, without a partner plan, were transitioned to other HealthChoice Illinois plans based on an auto-assignment process. All affected members received detailed notices regarding their transition and new plan assignments.
To ensure member choice, HealthChoice Illinois provided a 90-day plan switch period from January 1, 2018, to March 31, 2018. This allowed individuals to change their assigned plan if desired by contacting the Client Enrollment Broker Call Center or using the online Enrollment Portal.
Newly eligible Medicaid clients, who were not enrolled in a HealthChoice Illinois plan as of January 1, 2018, began receiving enrollment packets in January 2018. These packets provided a 30-day period for selecting a plan and Primary Care Provider (PCP). Services under their chosen HealthChoice Illinois plan commenced on April 1, 2018, with a subsequent 90-day period to switch plans if needed. Enrollment for special needs children into HealthChoice Illinois was scheduled to begin in May and June 2018, with an effective date of July 1, 2018.
Illinois Health Connect Program Ending and HealthChoice Illinois
The Illinois Health Connect (IHC) Program concluded at the end of 2017. Individuals enrolled in IHC transitioned to HealthChoice Illinois, beginning the process of selecting new plans and PCPs in January 2018, with an enrollment effective date of April 1, 2018. IHC members also received notifications regarding the program’s closure and their transition options.
Medicare-Medicaid Alignment Initiative (MMAI) Program: A Separate Entity
It’s crucial to understand that the Medicare-Medicaid Alignment Initiative (MMAI) program is distinct from HealthChoice Illinois. MMAI continued to operate in its existing counties in 2018 without expansion. Participating plans in MMAI, which include Blue Cross Blue Shield of Illinois alongside others, remained unchanged. Therefore, while both programs involve BCBS, they cater to different populations and operate under different structures.
Seeking More Information
For the most current updates and detailed information about the managed care program, individuals are encouraged to visit the Department’s Care Coordination website. Any specific questions regarding HealthChoice Illinois and participating plans can be directed to the Department’s Bureau of Managed Care.
In conclusion, HealthChoice Illinois represents a significant enhancement to Medicaid managed care in Illinois, offering a wider range of services and choices. And to directly answer the question, for those wondering “which is a bcbs managed care program“, Blue Cross Blue Shield of Illinois is indeed a key participating health plan within the comprehensive HealthChoice Illinois program, providing statewide coverage and expertise to Medicaid beneficiaries.
