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Integrated Care Program Frequently Asked Questions
What is the Integrated Care Program?
The Integrated Care Program is one of Illinois' mandatory managed care programs. This program is for seniors and persons with disabilities that have Medicaid but do not have Medicare. The Integrated Care Program started in Illinois in 2011. It operates in five different regions. You can see the mandatory counties under the Integrated Care Program here.
Why is the Integrated Care Program important for me?
In the Integrated Care Program, you choose a health plan that is best for you. The health plan will help you receive quality health care and services and help you reach your health goals. You will be able to select a primary care provider, also called a PCP, who will get to know you and all your medical needs.
Do I have to enroll in the Integrated Care Program?
You have to enroll in the Integrated Care Program if you are:
Age 19 and older
An adult with disabilities receiving Medicaid benefits but not Medicare benefits
Live in one of the counties where the Integrated Care Program exists. Click here to see if
you live in a mandatory county.
You do not have to enroll in the Integrated Care Program if you are:
18 or younger
Enrolled in Medicare
An American Indian and/ or Native of Alaska
In a Spenddown Program
Receiving temporary medical benefits
Getting care in the Illinois Breast and Cervical Cancer Program
Receiving private insurance through your employer that pays for hospital and doctor visits
What services do I get in the Integrated Care Program?
| All members of the Integrated Care Program get the same important health services you get now. Some examples include: |
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You will receive education and help with all your services through care coordination. Your health plan has a Nurse Helpline that is available to you 24 hours a day to help answer your questions. You may also get extra services from your health plan.
How do I know which health plan is the right plan for me?
To choose the best health plan for you, you should think about your answers to these questions:
Do I want to keep my doctor or clinic, or do I want a new doctor or clinic?
Does the health plan have the doctors, hospitals, and specialists I use?
Does anyone in my family have special health needs?
What extra services does the health plan have?
You can also visit the website for Illinois’ Client Enrollment Services. Go to: www.enrollhfs.illinois.gov to compare health plans.
How do I enroll in the Integrated Care Program?
We will send you an enrollment packet when it is time to enroll. Enrollment packets are sent to the address we have on file for you, so make sure your Department of Human Services caseworker has the address where you live right now.
What happens after I enroll in the Integrated Care Program?
Once you enroll in a health plan, you will get a health plan member handbook and a member ID card. Look for them in the mail. You will work with your plan to get the healthcare services you need. To learn more, call your Health Plan member services number.