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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:

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.

Aetna Better Health or IlliniCare Health Plan

With either health plan you will have:

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)

What is a Medical Home?

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:

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

What is a Primary Care Provider (PCP)?

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

What Services Will I Get in the Integrated Care Program?

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.

How Do I Enroll?

  1. Pick a PCP.
  1. Pick a health plan. There are two choices:
  1. Enroll. You can enroll three ways:

Who Must 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:

Can I Change My Health Plan?

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.

How Do I Change My PCP?

You may change your PCP by calling your health plan.

Need help?

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:

Health Plan Contact Information

Aetna Better Health 1-866-212-2851
Aetna TTY Number TTY: Illinois Relay 711
Aetna Web site 

IlliniCare Health Plan 1-866-329-4701
IlliniCare TTY Number TTY: Illinois Relay 711
IlliniCare Web site