The IAMHP Redetermination Toolkit serves as a guide for legislators and their staff, healthcare providers, and community-based organizations to know what to expect from the Medicaid redetermination process and where to refer enrollees for resources. The resources in this Toolkit are applicable to both the HealthChoice Illinois and Medicare-Medicaid Alignment Initiative (MMAI) programs.
MEDICAID REDETERMINATIONS IN ILLINOIS
In December 2022, a federal omnibus package was passed which sunsets the continuous eligibility requirement for Medicaid beginning on April 1, 2023.In Illinois, paperwork to redetermine Medicaid eligibility will start to be sent out at the end of April, and this process will continue monthly until all redeterminations are complete.
It is critical that Medicaid members update their addresses as soon as possible if they have not already done so by calling 877-805-5312 or visiting medicaid.illinois.gov. This will ensure that Medicaid members are able to receive their redetermination paperwork. Illinois enrollees can also update their address via the HFS website here:
https://www2.illinois.gov/hfs/MedicalClients/Pages/addresschange.aspx.
Medicaid members should watch for the Medicaid Benefits Renewal Form from HFS in the mail. Members can complete the form or create a Manage My Case account to apply for benefits online or make any changes to their case by visiting abe.illinois.gov.
Medicaid members can also call the DHS Hotline (1- 800-843-6154) for assistance or questions about paperwork. Community-based application agents will also be available to assist with questions or completing paperwork.
IAMHP and its member plans are also here to assist with answering any questions and helping providers and enrollees navigate this process. If you require assistance please email support@iamhpteam.org.
FAQ's:
https://www.molinahealthcare.com/-/media/Molina/PublicWebsite/PDF/Providers/il/Docs-and-Forms/MHIL_2023_Medicaid_Redetermination_%20FAQ_Final508
https://www.aetnabetterhealth.com/content/dam/aetna/medicaid/illinois/providers/pdf/ABHIL_
Medicaid_Redetermination_FAQs_011723.pdf
https://www.bcbsil.com/bcchp/join-our-plan/keeping-my-care
https://countycare.com/members/keeping-your-coverage/
For more information visit:
https://hfs.illinois.gov/medicalclients/addresschange/readytorenewmessagingtoolkit.html
News Links:
http://austintalks.org/2023/04/as-many-as-700000-illinoisans-at-risk-of-losing-medicaid-coverage-this-year/
https://www.chicagobusiness.com/health-care/medicaid-coverage-risk-thousands-when-pandemic-protections-end
https://www.chicagotribune.com/business/ct-biz-losing-medicaid-illinois-20230228-ejk35vntbzbqdieuqd6hm7bwnu-story.html
https://www.chicagotribune.com/business/ct-biz-illinois-medicaid-lost-coverage-redeterminations-20230802-kh74zazx5zcenpiyfzaqrnikba-story.html
https://news.wttw.com/2023/04/25/hundreds-thousands-medicaid-recipients-illinois-risk-losing-coverage
https://pantagraph.com/news/state-regional/government-politics/illinois-residents-lose-medicaid-eligibility-redetermination/article_b791aef4-318d-11ee-8469-ef0d228b93a8.html
https://www.wbez.org/stories/thousands-of-illinois-residents-at-risk-of-losing-medicaid/b93cca6c-6b8a-4b2c-8bd3-f8b5228c4912
https://www.wbez.org/stories/thousands-of-illinois-residents-get-kicked-off-medicaid-plans/f640c5a2-4bb3-464b-bf70-21d020f74a23
https://www.wbez.org/stories/thousands-of-illinois-residents-just-lost-their-medicaid-coverage-more-will-lose-it-in-the-coming-months/8c2a1652-66ff-45a8-87e1-e61b7c4d466a
https://wgntv.com/news/illinois/more-on-the-changes-and-medicaid-reenrollment-for-illinois-residents/
https://wgntv.com/news/illinois/pritzker-state-health-officials-call-attention-to-medicaid-change/
Redetermination Press Release:
https://storage.googleapis.com/msgsndr/0zKOzOiENFf9ML4voMc9/media/64cc23d18f6026ea77c87685.pdf
https://iamhp.org/resources/Documents/IAMHP%20Redeterminations%20Press%20Release%20UPDATED.pdf
For INDIVIDUALS
ILLINOIS MEDICAID MCO TRANSPORTATION TOOLKIT (June 2024 Update)
The Illinois Association of Medicaid Health Plans (IAMHP) and our member plans have pulled together a Toolkit specifically for Medicaid plan members as a resource to aid with scheduling of transportation for medical appointments.
IAMHP MEDICAID BENEFIT BROCHURE
The Illinois Association of Medicaid Health Plans (IAMHP) developed a Medicaid Benefit Brochure to serve as a guide for current and future Medicaid members to understand the comprehensive benefit provided by the Medicaid program, the added benefits of being enrolled in Medicaid managed care, and how to enroll in each program.
MCO MATERNAL BENEFITS TOOLKIT
Understanding benefits is a critical part of accessing the full continuum of healthcare for pregnant people and their families. To help pregnant people on Medicaid understand their maternal health benefits, IAMHP and FIMR Chicago have partnered to create the Illinois Medicaid Managed Care - Maternal Health Toolkit. This resource includes maternal health benefits covered by Medicaid, how to pick a doctor, and more.
MCO MATERNAL MENTAL HEALTH TOOLKIT
Mental health conditions arising during and after pregnancy are common, and there are resources to provide support through these challenges. As a resource for pregnant people and families on Medicaid, IAMHP and FIMR Chicago have pulled together the Illinois Medicaid Managed Care - Maternal Mental Health Toolkit.
MCO MEMBER TRANSIT BROCHURE
Ensuring access to transportation for Medicaid members remains a top priority for IAMHP and our member health plans. As such, IAMHP has pulled together a Member Transit Brochure in partnership with Fetal Infant Mortality Review (FIMR) Chicago. This is a resource to help Medicaid members with scheduling of non-emergency transportation for medical appointments.
Avoiding the ER as a Result of Care Management
A 57-year old female with behavioral health issues ran out of medication and began to become confused when her care manager called for a wellness check. With no access to transportation and unable to pay for the pharmacy delivery fee, Humana care manager reached out to the pharmacy and convinced the store manager to deliver the medication to the member’s home. During a follow up visit a week later it was determined the member qualified for non-medical transportation and daytime support services.
Less Focus on Forms, More Focus on Patient Care
A 52-year old male became frustrated after being turned away from a specialist to treat his umbilical hernia because he didn’t have an authorization for the visit. Member was also told he needed a colonoscopy but the gastroenterologist would not perform it until the hernia repair was complete. The care manager called the doctor’s office with the member and walked through them through the authorization process. As a result the member had his hernia repair arranged scheduled his colonoscopy and has authorizations approved to see an ophthalmologist for glaucoma treatment.
Sounding Board & Education Source for Cancer Treatment
Following several routine tests it was revealed the member had a lung nodule that had grown in size and the doctor needed the member’s consent to biopsy the nodule. The member opted to refuse because he was hesitant about undergoing the procedure. A case manager RN, using her medical expertise, discussed his fears, explained the procedure and made sure he knew his options and the possible outcomes involved in each option. The member did consent to the biopsy but unfortunately it was cancerous. While he underwent treatment, the case manager RN spoke with him frequently to offer continued encouragement, education and support. The member has finished treatment and as of his last MRI he is cancer free.