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Elizabeth M. Whitehorn, Director

Managed Long Term Services & Support Frequently Asked Questions

1. What is the Managed Long Term Services and Supports Program?

The Managed Long Term Service and Supports program is one of Illinois' mandatory managed care programs. This program is for seniors and persons with disabilities who have full Medicaid and Medicare benefits and opt-out of the Medicare-Medicaid Alignment Initiative.

 

The Managed Long Term Services and Supports program started in Illinois in 2016. It operates in the Greater Chicago Region. Click here to see the counties with Managed Long Term Services and Supports health plans.

2. Why is the Managed Long Term Services and Supports Program important for me?

In the Managed Long Term Services and Supports program, you choose a health plan that is best for your long term services and supports, behavioral health, and non-emergency transportation services. The health plan will help you receive quality health care and services and help you reach your health goals.

 

All Managed Long Term Services and Supports health plans have care coordinators to help you manage all of your health care and long term services and supports needs. The Managed Long Term Services and Supports health plan will cover the waiver services you get at home, such as a personal assistant, homemaker, adult day care, or a home emergency response system.

3. Do I have to enroll in the Managed Long Term Services and Supports Program?

You have to enroll in the Managed Long Term Services and Supports program if you are:

  • Getting full Medicaid and Medicare benefits (Medicare Parts A and B and Medicaid without a spenddown),
  • Not enrolled in the Medicare-Medicaid Alignment Initiative*,
  • Living in a nursing home or getting services from one of these five Home and Community Based Services (HBCS) Waiver programs:
  • Persons with Disabilities (Home Services Program),
  • Persons with Brain Injury (Home Services Program),
  • Persons with HIV or AIDS (Home Services Program),
  • Persons who are Elderly (Community Care Program), or
  • Supportive Living Facilities,
  • Age 21 or older,
  • Enrolled in the Medicaid Aid to the Aged Blind and Disabled (AABD) category of assistance, and
  • Living in a one of the counties where the Managed Long Term Services and Supports program exists. Click here to see if you live in a county with a Managed Long Term Services and Supports health plan.

 

*You can choose to enroll in the Medicare-Medicaid Alignment program instead of the Managed Long Term Services and Supports program.

 

You cannot enroll in the Managed Long Term Services and Supports program if you are:

  • Age 20 or younger,
  • Getting developmental disability institutional services,
  • Enrolled in the Adults with Developmental Disabilities HCBS Waiver,
  • In a Spenddown Program,
  • Getting temporary medical benefits,
  • Getting care in the Illinois Breast and Cervical Cancer Program, or
  • Getting private insurance through your employer that pays for hospital and doctor visits.

4. What services do I get in the Managed Long Term Services and Supports Program?

​All members of the Managed Long Term Services and Supports program get the same important health services you get now. Some examples include:

  • ​Nursing Home Care
  • ​Supportive Living
  • ​Mental Health Services
  • Substance Abuse Services​
  • Adult Day Services​
  • Home Health Care​
  • Personal Assistant Services​
  • Emergency Home Response​
  • Non-Emergency Transportation to Medicare and Medicaid covered Services​

 

​You will receive education and help with all your services through care coordination. You may also get extra services from your Managed Long Term Services and Supports health plan. Click here to compare the extra services by health plan.

 

You will keep getting all of your Medicare benefits the way you do now. You will stay in the Medicare prescription drug plan you are in now.

5. 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:

  • Are my long term services and supports providers in the health plan’s network?
  • Are my mental health or substance use providers in the health plan’s network?
  • 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.

6. How do I enroll in the Managed Long Term Services and Supports Program?

You can enroll in the Managed Long Term Services and Supports program at any time. You also can choose to enroll in the Medicare-Medicaid Alignment Initiative instead of the Medicaid Managed Long Term Services and Supports program at any time. The Medicare-Medicaid Alignment Initiative brings together all of your Medicare, Medicaid and prescription drug benefits into one health plan.

 

To enroll in the Managed Long Term Services and Supports Program or the Medicare Medicaid Alignment Initiative, call Illinois Client Enrollment Services at 1-877-912-8880 (TTY 1-866-565-8576). Call Monday to Friday, 8 a.m. to 7 p.m. The call is free!

7. What happens after I enroll in the Managed Long Term Services and Supports Program?

Once you enroll in a Managed Long Term Services and Supports Program 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 health plan care coordinator to get the health care services you need. To learn more, call your health plan member services number.