Resource Center

The Resource Center contains links to information and documents that are arranged by subject title. Click on the subject title or the link within the description.

Care Coordination Services

Your health plan will offer education and help. This is called Care Coordination. With Care Coordination, you will have a Care Coordinator who can help you get the care you need. Click the link to find more  information about Care Coordination.

Enrollment Materials

You can find example enrollment letters and materials to assist you with choosing a health plan if you click the link above.

News

Looking for News you can use? Click the "News" link to discover what is going on in health news. If you have questions, head over to the FAQs (Frequently Asked Questions) to get the answers you need and more.

Health Plans' Preferred Drug Lists

A Health Plans' Preferred Drug List (PDL) is a list of prescription drugs and over-the-counter (OTC) medicines the health plan covers. It is also called a Drug Formulary. To be covered, medications on the PDL must be prescribed by providers in the plan’s network. Health plans do not all have the same drugs on their PDLs.

Illinois Medicaid Managed Care Health Plans Report Card

The 2015 Illinois Medicaid Plan Report Card is for people in the Illinois Medicaid Managed Care Program, which includes Family Health Plan clients, Affordable Care Act clients, and the Integrated Care Program for seniors and people with disabilities.

The report card shows how all health plans in the state rate for care and services. Not all health plans on the report card may be available to you. Available plans depend on your program and the county you live in.

Redetermination

Medicaid checks each year to make sure you still qualify for benefits. This is called Medicaid redetermination, or “rede.”  Rede is different from enrolling in a health plan.

Appeals & Fair Hearings

An appeal is a complaint you make when you think an action about your benefits or covered services is wrong.

Grievances

A grievance is a written complaint. You can file a grievance if you think you were treated unfairly.

Grievances and Appeals if Not in a Health Plan

If you are not enrolled with a health plan and want to file a grievance or an appeal for a fair hearing, learn more at the Illinois Department of Healthcare and Family Services’ website at:

http://www.illinois.gov/hfs/MedicalPrograms/AllKids/Pages/HandbookIndex.aspx