HealthChoice Illinois: Benefits for Aging & Eligibility Criteria 

Program Description

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 five health care plans that are available throughout the state: Blue Cross Blue Shield of Illinois, Harmony Health Plan, IlliniCare Health Plan, Meridian Health, and Molina Healthcare of Illinois. There are also two additional health care plans, but they are only available in Cook County: CountyCare and NextLevel Health.

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.

 Alternate Program
Note another Medicaid managed care option (for seniors and disabled adults who are eligible for both Medicaid and Medicare) is the Medicaid-Medicare Alignment Initiative (MMAI). However, unlike HealthChoice Illinois, MMAI is not available statewide. Learn more about this program here.

 

Eligibility Guidelines

HealthChoice Illinois is a mandatory program for persons who are Medicaid eligible and for dual eligibles (persons eligible for both Medicare and Medicaid).

For Illinois residents, aged 65 and older, in 2018, Medicaid’s financial eligibility criteria are as follows.

The income limit is $1,012 / month (100% of the current Federal Poverty Level).
The asset limit is $2,000, although it must be taken into consideration that several assets are exempt from this figure. This includes one’s primary home in which they live, 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 consultation on how to reallocate income and / or assets for exemption purposes. This is complicated and is not suggested one try to do without professional assistance.

 

Benefits and Services

In addition to care coordination, a variety of services are available and may include the following:

  • Adult Day Care
  • Doctor / Hospital Services
  • Eye / Dental / Hearing Services
  • Home Health Care
  • Hospice
  • Medical Supplies
  • Mental Health Services
  • Personal Care Assistance
  • Personal Emergency Response Systems (PERS)
  • Prescription Medications
  • Transportation
  • X-Rays / Lab Work

 

How to Apply / Learn More

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.