Public Benefits Update

The saga of the Managed Care roll-out in Illinois continues!

After some delays, last week DHS began sending out the first batch of MMAI enrollment letters to individuals in Cook County who are receiving Long Term Services and Supports (LTSS).

MMAI is a managed care program specifically designed for the population known as dual eligible (those who are eligible for both Medicare and Medicaid). Unlike other managed care programs, MMAI is not mandatory, and dual eligibles have the ability to change their plan or opt out of the program at any time, whether during this initial enrollment period, or later.

Dual eligibles who receive LTSS services have the same right to opt out of MMAI at any time as their counterparts who do not receive such services. However, those who do choose to opt out will receive an enrollment package at a later date (possibly this winter) for a managed care plan specifically for their long term care. Medical services will still be covered by their traditional fee-for-service Medicaid and Medicare, but all LTSS services will be covered by the MLTSS managed care plan, and consumers will not have the ability to change MLTSS plans at will, or to opt out of the program.

We remind consumers that if they receive a package or letter titled “Your Health Plan Choices” they will have a 60 day voluntary enrollment period to pick a plan with a Primary Care Provider (PCP). They can go online or call Client Enrollment Services at 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 in order to enroll. If they don’t choose a plan within 30 days of when the enrollment package is sent, then a second letter will be sent containing the plan and PCP to which they will be auto-assigned if they do not choose in the next 30 days. Once a client is enrolled in a managed care plan, they will have 90 days to switch to a different plan, after which they are “locked in” to the plan for a year.

You can learn more about MMAI and other Managed Care programs here, and you can donate to support our work with public benefits here.

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