Provider Notice issued 06/30/12

​All Kids Application Agent - Alert June 2012

This Alert is to inform you of several changes to the medical program in Illinois as result of legislation designed to reduce HFS’s budget.

1. Technical Assistance Payments (TAP) will not be paid on applications received after June 30, 2012.  AKAAs who are currently operating under agreements that allow for TAP will not receive information about applications submitted after June 30, 2012, unless they complete a No-TAP agreement. AKAAs who are not medical providers will no longer have access to MEDI after June 30, 2012, unless they complete a No-TAP agreement.  A letter and a No-TAP agreement will be mailed to each AKAA that needs a No-TAP agreement to continue in the program.

2. Effective July 1, 2012, FamilyCare income limits will drop to 133% of the FPL, or the Assist level.  All adults who were enrolled in Family Care Share, Premium or Rebate have been canceled effective July 1, 2012, and will receive cancellation notices.

1. Note:  The Moms & Babies income limit for pregnant women remains at 200% FPL and has not changed.

2. Adults with high and recurring medical expenses should talk to the Department of Human Services (DHS) Family Community Resource Center about a Spenddown case. Visit DHS Web site to find the location of the office nearest you or call the DHS Helpline at 1-800-843-6154 (TTY 1-800-447-6404.)  

3. A Letter of Creditable Coverage will be sent to affected individuals when coverage ends. Families may use this letter to avoid a waiting period if they get other health insurance.

4. Information about other sources of insurance may be found at the Department of Insurance Web site or by calling 1-877-527-9431.

3. Co-payments for adults will increase to $2.00 for generic drug prescriptions and $3.65 for doctor visits and brand name prescriptions on July 1, 2012. All Kids Assist and Moms & Babies enrollees do not have any new co-pays for prescriptions.

4. Effective July 1, 2012, children on Assist will pay $3.65 for using the emergency room for non-emergency medical treatment. For children under All Kids Share the co-pay for using the emergency room for non-emergency medical treatment will increase to $10.00. For Children under All Kids Premium Level 1 and 2 there will not be a change. Copayments for children on All Kids Share will increase from $2.00 to $3.65 for all services except generic prescriptions which will remain $2.00.  All Kids Share and Premium will pay the generic co-pay for any over-the-counter prescription.

5. Children and adults who need more than four prescriptions per month must get prior approval for most medications. Encourage families who express concern about the prescription drugs limit to talk to their doctor about whether it will affect them.

6. Adult services that will no longer be covered include chiropractic care, dental care (except emergency extractions), and podiatry (except for diabetics).

7. Adults are eligible for only one pair of eyeglasses every two years.

8. Charity Care:  A new law will allow eligible uninsured people who need medically necessary healthcare services at a hospital to get free services for any amount exceeding $300 of hospital charges in any one inpatient admission or outpatient visit.  Persons eligible for the Charity Care program will be required to apply for the program at the hospital and their family income must be below certain limits, 200% of the Federal Poverty Level in the Chicago area ($38,180 for a family of 3) and 125% of the Federal Poverty Level in rural or critical access hospitals ($28,863 for a family of 3.) Contact the financial assistance counselor at your hospital for more information.

9. There will be other changes for medical providers as a result of the legislation recently passed. Medical providers interested in receiving notices and bulletins to learn about revisions or clarifications of the medical programs may register to receive E-mail notifications when new information is posted to the HFS Web site by completing the  Provider Releases and Bulletins E-mail Notification request.

HFS will also post updates on budget implementation for the general public on the HFS Budget Web page.

For additional assistance AKAAs should contact their All Kids liaisons.

AKAA Liaison for those located North of I-80

Phone:  1-312-793-5270

Fax: 1-312-793-5278

AKAA Liaison for those located South of I-80

Phone: 1-217-524-7156

Fax: 1-217-557-4274