To apply for medical assistance, visit the nearest Illinois Department of Human Services (DHS) office. Staff will help you submit an application. You can also apply online for SNAP (food stamps), Medical and Cash Benefits through Illinois Web Benefits.
If you are unable to go to a DHS office because of health reasons, you may call and ask that an application be mailed to you. After you complete and return the application, the DHS staff will arrange an interview by telephone. Human Services offices in your area or you may call DHS at 1-800-843-6154, TTY 1-800-447-6404.
Applications may also be completed at the time of service at hospitals and clinics. Pregnant women and children under age 19 may be enrolled by All Kids Application Agents.
If you and your family are found to be eligible for Medicaid, you have two basic decisions to make on how your healthcare will be delivered.
Each member of your family can choose his or her own medical option or medical home.
Everyone in your family can have a different doctor, clinic or managed care program, or your family can be with one doctor, a clinic or a managed care plan.
Choosing a medical home does not mean you have to change doctors. You may pick your current doctor.
You and your family will receive the same covered medical services under both options. Additional benefits may be available to you and your family under a managed care plan.
If you choose the regular fee-for-service program, you must find your own doctor or clinic that accepts Medicaid clients.
The doctor may be in a private practice in an office; the doctor may work with a community health center or a health department clinic; the doctor may work with a hospital-based clinic, or the doctor may work with a managed care plan.
If you want to go to a certain hospital, you must find out if your doctor has made arrangements with that hospital. You can do this by asking your doctor or his staff if he can have you admitted to the hospital you want.
If you choose a managed care plan, you and your family receive their basic healthcare through a primary care doctor associated with a managed care plan. Medical care will be arranged through the managed care plan that you chose, and you must receive medical care with the doctors, hospitals, pharmacies associated with that managed care plan.
A managed care plan manages the health needs of you and your family.
There are two types of managed care plans: Health Maintenance Organizations (HMOs) and Prepaid Health Plans (PHPs).
HMOs have been available to Medicaid clients in the Chicago area since 1974 and are primarily sponsored by insurance companies, which have both Medicaid and private patients.
PHPs are organized by hospitals or medical schools and only have Medicaid patients.
With a managed care plan, you should call your doctor about your health needs, when you don't feel good or have a child who is sick. If you need to see a specialist, the doctor who manages you care will make a referral. The doctor can also make arrangements for medical supplies or equipment.
Unless it is an emergency, you should always call the doctor you have chosen and coordinate your care before you go to another doctor or to a hospital emergency room. Your doctor will provide you with a 24-hour medical assistance number you can call.
A managed care plan may offer benefits in addition to those covered by Medicaid, such as dental and vision care for adults. You may have to pay for a part of these services.
You can choose a managed care plan by completing an enrollment form provided by the plan or by calling the plan. The representatives of the managed care plan will provide you with the information about the plan and help you choose a primary care provider.