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Integrated Care Program

Regions, Health Plans, and Services Provided

The Illinois Department of Healthcare and Family Services (HFS) implemented the Integrated Care Program (ICP) on May 1, 2011, for seniors and persons with disabilities who are eligible for Medicaid but not eligible for Medicare. ICP is mandatory managed care that began as a pilot program in the greater Chicago region including suburban Cook, DuPage, Kane, Kankakee, Lake and Will counties. It now operates in 29 counties in five regions of Illinois. Those regions include the Rockford region (July 2013), the Central Illinois region (Sept 2013), the Metro East region (Sept 2013) and the Quad Cities region (November 2013). You can view the Health Plans by region.

Service Packages

Service Package I – Implemented May 1, 2011.  All standard Medicaid medical services, such as physician and specialist care, emergency care, laboratory and X-rays, pharmacy, mental health and substance abuse services

Service Package II – Implemented February 1, 2013. This package includes Nursing Facility services and the care provided through some of the Home and Community-Based Service (HCBS) waivers operating in Illinois (excluding Developmentally Disabled/DD waiver services).

Nursing Facility Services are long term care services covered by the Department for Medicaid-eligible residents and include Skilled Nursing Facilities and Intermediate Care Facilities (SNF and ICF).

Home and Community-Based Service (HCBS) waivers allow participants to receive non-traditional services in the community or in their own homes, rather than being placed in an institutional setting. Illinois currently operates nine HCBS waivers, five of which will be included during Service Package 2.  The remaining three Developmentally Disabled (DD) waiver services will be included during Service Package III. The MFTD waiver services will be discussed at a later date.

Service Package III – DD Waiver services; will begin approximately one year after Service Package II implementation.

Eligible and Excluded Populations

Eligible Populations (Aged, Blind, Disabled) = approximately 36,000

Excluded Populations:

Illinois Client Enrollment Broker

HFS contracts with MAXIMUS, Inc. to operate Illinois’ Client Enrollment Services. Illinois’ Client Enrollment Services will:

Enrolling Clients

Client enrollments are handled by Illinois’ Client Enrollment Services. There are two ways clients can enroll:

An initial client enrollment packet is mailed to households with potential enrollees. The packet includes:

A second client enrollment packet is mailed to clients who have not responded to the initial client enrollment packet within 30 days.  The packet includes a cover letter with the name of the health plan and PCP to whom the client will be assigned if they don’t make a choice within the next 30 days.

Quality Programs

Quality Indicators

Integrated Care Contracts

Integrated Care Rates

MORE INFORMATION

To get more information about Illinois’ Integrated Care Program, please contact: