Public Benefits Update

Over the past year, the Public Benefits Practice Group has been busy tracking the terrific new health insurance opportunities for our clients and making sure that they are able to navigate the changes. And it isn’t slowing down yet!

On September 8, Illinois began sending out notices to Medicaid recipients in Cook County to enroll in managed care plan. This is an effort to transition from the Medicaid fee-for-service model to a capitated payment system. With the exception of certain populations, such people eligible for Medicare and Medicaid both, this enrollment is mandatory and consumers will not be able to opt out of the program.

Consumers will receive an enrollment package titled “Your Health Plan Choices,” at which point, they will have a 60 day voluntary enrollment period to pick a health plan with a Primary Care Provider (PCP). They can do so either online at www.enrollHFS.Illinois.gov, or by calling Client Enrollment Services (1-877-912-8880) from 8 a.m. to 7 p.m., Monday through Friday, and from 9 a.m. to 3 p.m. Saturday. If they don’t select their plan within 30 days of when the enrollment package is sent, then a second letter will be sent notifying them to which plan and PCP they will be auto-assigned if they not choose in the next 30 days. Once a client is enrolled in a managed care plan, they have 90 days in which they can switch to a different plan, after which they are required to remain with their plan for 12 months until their next open enrollment period.

Luckily, LAF’s Public Benefits Practice Group, Ombudsman Project and Client Screening Unit are working together to make sure that consumers have guidance when navigating enrollment and to advocate for clients on individual and systemic issues that may arise with such a substantial change to Medicaid.

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