HealthChoice Illinois pays for personal care, adult day care, and transportation assistance (as well as many other supportive services) for elderly, Medicaid-eligible, Illinois residents.
Services are provided via managed care organizations, also referred to as Medicaid health plans. At the time of this writing, there are four health care plans that are available throughout the state: Blue Cross Community Health Plans, IlliniCare Health, Meridian Health Plan, and Molina Healthcare. There are also two additional health care plans, but they are only available in Cook County: CountyCare Health Plan and NextLevel Health. Please note that a public notice has been released that NextLevel Health is being acquired by Molina Healthcare. This is scheduled to take place in the first quarter of 2020.
This program is the consolidation of several programs, including the Managed Long-Term Services & Supports (MLTSS) Program, the Integrated Care Program, and the Family Health Program. Although HealthChoice Illinois is for state residents of all ages, it is still relevant for aging Illinoisans. This is particularly true since long-term care supports are often needed to delay or prevent nursing home placement.
HealthChoice Illinois is a mandatory program for seniors and physically disabled persons who are Medicaid and Medicare eligible (dual eligible), reside in a nursing home or receive long-term home and community based services, and are not enrolled in the IL Medicare-Medicaid Alignment Initiative Program.
For Illinois residents, aged 65 and older, in 2020, Medicaid’s financial eligibility criteria are as follows.
The income limit is $1,063 / month (100% of the current Federal Poverty Level), and the asset limit is $2,000. However, it must be taken into consideration that several assets are exempt from this figure. This includes an applicant’s primary home, as long as he or she (or his or her spouse) lives in it and the equity value is under $595,000, household furnishings, personal items, such as clothing, and a pre-paid burial plot.
Being over the limit for income and / or assets does not automatically disqualify an individual from Medicaid. However, it is strongly advised one consult a professional Medicaid planner for advisement on how to reallocate income and / or assets for exemption purposes. This is complicated and is not suggested one attempt without professional assistance.
In addition to care coordination, a variety of services are available and may include the following:
Additional information about HealthChoice Illinois can be found on the Illinois Department of Healthcare & Family Services (IHFS) website and a program brochure is also available. One can enroll online or by calling HealthChoice Enrollment at 877-912-8880. To see which health care plans are available in the area in which you live, click here.