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Medicare-Medicaid Alignment Initiative Frequently Asked Questions

What is the Medicare-Medicaid Alignment Initiative?

The Medicare-Medicaid Alignment Initiative is one of Illinois' managed care programs.  This program is for seniors and persons with disabilities who have full Medicaid and Medicare benefits.  

The Medicare-Medicaid Alignment Initiative started in Illinois in 2014.  It operates in the Greater Chicago and Central Illinois Regions.   Click here to see the counties with Medicare-Medicaid Alignment Initiative health plans.

Why is the Medicare-Medicaid Alignment Initiative important for me?

The Medicare-Medicaid Alignment Initiative brings together all of your Medicare, Medicaid, and prescription drug benefits into one health plan.  In the Medicare-Medicaid Alignment Initiative, 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 of your medical needs.  All Medicare-Medicaid Alignment Initiative health plans have care coordinators to help you manage all of your health care and long term services and supports.

Can I enroll in the Medicare-Medicaid Alignment Initiative?

You can enroll in the Medicare-Medicaid Alignment Initiative if you are:           

  • Getting full Medicaid and Medicare benefits (Medicare Parts A and B and Medicaid without a spenddown),

  • Age 21 and 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 Medicare-Medicaid Alignment Initiative exists. Click here to see if you live in a county with a Medicare-Medicaid Alignment Initiative health plan.

You cannot enroll in the Medicare-Medicaid Alignment Initiative if you are:

  • Age 20 or younger,

  • Get developmental disability institutional services,

  • Enrolled in the Adults with Developmental Disabilities Home and Community Based Services (HCBS) Waiver,

  • In a Spenddown Program,

  • Get temporary medical benefits,

  • Get care in the Illinois Breast and Cervical Cancer Program, or

  • Get private insurance through your employer that pays for hospital and doctor visits.

What services do I get in the Medicare-Medicaid Alignment Initiative?

​All members of the Medicare-Medicaid Alignment Initiative get the same important Medicare, Medicaid, and prescription drug benefits you get now under one health plan.  Some examples include:
​     
    • ​Hospital Services
  • ​Lab Tests and X-Rays
  • Doctor Services​
  • Transportation​
  • Medical Supplies​
  • Mental Health Services​
  • Prescriptions​
  • Home Health Services​
  • Hearing and Vision Services​
  • Dental Services​
  • Substance Use Services​
  • Nursing Home Care​
  • Supportive Living​
  • Adult Day Service​
  • Emergency Home Response​
​​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.    Most health plans also offer extra benefits such as more dental care and lower prescription co-pays. Click here to compare the extra services by 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?

  • Do I 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 Medicare-Medicaid Alignment Initiative?

You can enroll in the Medicare-Medicaid Alignment Initiative at any time. To enroll in this program, 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!

What happens after I enroll in the Medicare-Medicaid Alignment Initiative?

Once you enroll in a Medicare-Medicaid Alignment Initiative 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.


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Illinois Department of Healthcare and Family Services

JB Pritzker, Governor • Theresa Eagleson, Director