More than 1.5 million people in Illinois who were uninsured in 2013 are now are guaranteed access to affordable, quality health insurance coverage. Consumers now need to understand how to navigate the healthcare system and the new health insurance marketplace in order to access coverage, and make use of the healthcare protections and benefits now available.
Why am I receiving letters saying I have to choose a plan and a primary care physician?
Illinois state law requires that 50% of Medicaid beneficiaries are enrolled into coordinated care by 2015. This means that a managed care organization (health insurance company) or provider group will be coordinating your physical and behavioral healthcare. A primary care physician will refer you to appropriate services and will typically be the first person you go to for healthcare. If you plan to enroll and have received letters in the mail you should go to enrollhfs.illinois.gov
or call the client enrollment broker at 1-877-912-8880 to pick a plan. If you want to learn more about coordinated care in Illinois please visit our Medicaid Care Coordination
Can a health insurance policy be purchased on the marketplace at any time?
No. You can purchase a plan at GetCoveredIllinois.gov during open enrollment or if you qualify for a special enrollment period. The next open enrollment period starts November 15th. However, if you experience a qualifying life event like having a baby, getting married, or moving, you may qualify for a special enrollment period. To find out if you qualify for a special enrollment period answer the questions on the healthcare.gov screening tool.
Do you have questions about issues like how health care reform impacts people with disabilities or children with pre-existing conditions? Learn from the experiences of others—or, submit your question here.
Dual Eligibles with Developmental Disabilities
If a person with developmental disabilities receives financial benefits from SSDI and/or SSI, that may have an impact on their Medicare/Medicaid benefits. This August 2014 fact sheet from The Arc of Illinois covers frequently asked questions about eligibility for the Medicare-Medicaid Alignment Initiative, and what is different when the dual eligible person also has a developmental disability in Illinois.
Understanding Your Family’s Insurance Options
This one-pager from the Children’s Specialized Hospitals can help you ask questions so you will understand what each plan will and will not cover, and be able to anticipate your out-of-pocket costs. It includes a downloadable health plan evaluation form to record information about your child’s particular healthcare needs.
Medicaid Applications and SSI Recipients
If you were approved for Supplemental Security Income and are applying to Medicaid, this fact sheet from The Arc of Illinois helps to break down the application process. It covers the ways you can apply for Medicaid after you have been approved for SSI, and includes links to other resources to make the process easier.