Integrated Care Program Information Guide

The Integrated Care Program is a program for older adults, and adults with disabilities who are enrolled in Medicaid but not enrolled in Medicare.

This program promotes your health and wellness. Under the program you must pick a health plan and a doctor or clinic as a Primary Care Provider (called PCP) for your medical home.

The Integrated Care Program is for older adults and, adults with disabilities in these counties:

• Suburban Cook

• DuPage

• Kane

• Lake

• Kankakee

• Will

Under the Integrated Care Program, a team of providers and case managers will work with you, to help you reach the health goals that are important to you. You will get to choose a health plan and PCP. You will pick a PCP in one of these two health plans to manage and coordinate your healthcare.

With either health plan you will have:

• Choices of doctors, specialists and hospitals;

• A team of people working with you to help you live an independent and healthy life;

• Control of your healthcare, supports and service needs; and

• Extra services to promote your health and wellness.

Read on to learn more about your health plan choices. Please read all of the information in this guide. It will help you make the best choice for you. 

You can get information in another language or format (like a CD).
Free interpretation services! Call 1-877-912-8880 (TTY 1-866-565-8576). The call is free.

Hay información en español. Servicio de intérprete gratis!
Llame al 1-877-912-8880 (TTY 1-866-565-8576)

Your medical home is the doctor’s office or clinic where you go first when you need healthcare or are sick. Your medical home is the doctor’s office or clinic where you go to see your PCP. Your medical home will join a team of doctors, nurses, pharmacists and care managers who work closely with you, and each other, to keep you well and independent. They will help you reach the health goals that are important to you. 

Having a medical home means:

• All your medical records are kept there in one place.

• Your PCP gets to know you well.

• You get better healthcare because your PCP knows your healthcare needs.

• You get the quality healthcare you need to stay healthy.

Even if you are healthy and never get sick, it is good to have a medical home.

Your PCP is your family doctor, nurse or other healthcare provider at your medical home who takes care of you. Your PCP will:

• Take care of you when you are sick or need medical attention;

• Help you manage diseases and other conditions like diabetes, high blood pressure, and asthma;

• Answer questions you have about your healthcare;

• Give you the information you need to stay healthy;

• Work with you to get the healthcare you need, and send you to specialists or other healthcare providers when you need to go. This is called a referral. 

You will receive all of the same services you now get in Medicaid. The health plan you pick in the Integrated Care Program will work with you to coordinate and manage these services. Each health plan also offers extra services. Please see the attached comparison chart to see the covered services, and extra services, that each health plan offers. You will not have to pay co-payments.

• Pick a PCP.

• Think about where you get your healthcare now.

• Do you want to stay with your doctor, or clinic, or do you want to pick a different doctor or clinic?

• You can find out if a doctor, or clinic, is in the health plan you want to pick and get the doctor’s, or clinic’s information by calling Illinois Client Enrollment Services at 1-877-912-8880 (TTY: 1-866-565-8576) or by visiting Illinois Client Enrollment Services Web site.

• Pick a health plan. There are two choices:

• Aetna Better Health or IlliniCare Health Plan

• Each health plan has PCPs ready to work with you.

• Enroll. You can enroll two ways:

• By Phone: Illinois Client Enrollment Services at 1-877-912-8880 (TTY: 1-866-565-8576). The call is free. Enrolling by phone is quick and easy!

  or

• Online: Go to the Illinois Client Enrollment Services Integrated Care Program Web site and select “Enroll.”

Older adults and adults with disabilities who are enrolled in Medicaid but not enrolled in Medicare and live in suburban Cook, Lake, Kane, DuPage, Will and Kankakee counties have to enroll in the Integrated Care Program.

You do NOT have to enroll if you:

• Are under 19 years of age;

• Get Medicare;

• Are an American Indian/Alaskan Native (you may choose to voluntarily enroll);

• Are enrolled in the Spenddown program;

• Get temporary medical benefits;

• Are in the Illinois Breast and Cervical Cancer program; or

• Already have insurance that covers hospital and doctor visits.

You will be given 60 days to choose your health plan and PCP. If you do not choose one, you will be assigned to a health plan and PCP. Once you are enrolled with your health plan, you may switch health plans within the first 90 days. After that you cannot change health plans for 12 months, except “for cause” in certain circumstances.

Once each year, you will have a 60-day period to change the health plan in which you are enrolled. This is called an “open enrollment period.” This is the only time each year you are allowed to switch health plans. The Illinois Client Enrollment Broker will send you a letter to let you know when it is time for your open enrollment period.

You may change your PCP by calling your health plan.

Call the Illinois Client Enrollment Broker at 1-877-912-8880. If you use a TTY, call 1-866-565-8576. The call is free. The Illinois Client Enrollment Broker can:

• Give you more information about the Integrated Care Program;

• Help you pick a health plan and PCP for your medical home;

• Find out if a certain doctor is in one or both of the health plans;

• See if you are eligible to change your health plan;

• Help you get in touch with your health plan;

• Update your contact information, like your address or phone number.

Aetna Better Health 1-866-212-2851

Aetna TTY Number TTY: Illinois Relay 711

IlliniCare Health Plan 1-866-329-4701

IlliniCare TTY Number TTY: Illinois Relay 711