Mmai illinois. Illinois Medicaid Long-Term Care Definition.
Mmai illinois. Urbana, Illinois 61801-3347.
Mmai illinois Learn About Your Rights. This is not a complete list. Illinois MMAI Plan Choices Author: Illinois Department of Healthcare and Family Services Subject: Illinois MMAI Plan Choices Keywords: Illinois Client Enrollment Services; Illinois Department of Healthcare and Family Services; HFS; EnrollHFS, Medicare-Medicaid Alignment Initiative; health plan; Medicare; Medicaid Created Date : 3/26/2024 12:26:36 PM Medicaid members! Don't risk losing your health insurance. Blue Cross and Blue Shield of Illinois (BCBSIL) would like to outline the below benefit preauthorization processes for our independently contracted providers treating Blue Cross Community Health Plans SM (BCCHP SM) and Blue Cross Community MMAI (Medicare services are provided according to Centers for Medicare & Medicaid Services (CMS) and Illinois Department of Healthcare and Family Services (HFS) coverage policies. If you do not intend to Meridian of Illinois Announces Provider Relations Team Reorganization; Meridian of Illinois Partners with Jeremiah Development for LOVE Rockford Event; UPDATE PRACTICE INFORMATION USING THE MERIDIAN PROVIDER UPDATES TOOL; SUPPORT & RESOURCES FOR THOSE IMPACTED BY THE HIGHLAND PARK TRAGEDY ON JULY 4; Maximus uses cookies and other tracking technologies, including session replay tools (“Cookies”), to gather information about you and your device to improve our services, conduct analytics to gain insights about how you interact with our websites and services, evaluate and improve advertising, and enhance performance and functionality. illinois. The Managed Care map provides more information about the MCOs that are operating in the MMAI program by county. (30 ILCS 500/50-39)The current Medicare-Medicaid Alignment Initiative (MMAI) contracts expire on The Illinois Medicare-Medicaid Alignment Initiative (MMAI) is a managed care program for individuals who are eligible for both Medicaid and Medicare (referred to as “dual eligibles”). Learn More: HBIA/HBIS Members: Welcome Molina Members! Getting started with your Molina benefits is easy with the Quick Start Guide! HealthChoice Illinois : HealthChoice Illinois MLTSS : Need a little extra help? We’re here when Discover a variety of documents available for healthcare providers about the Illinois Demonstration and provider expectations from Humana. benefit, what kind of Illinois Medicaid. Medicare and Medicaid services that you get now, such as: 24/7 nurse line Home health care Prescriptions Behavioral health services Hospice care Therapy Doctor services Hospital services Eye care services Lab tests and X-rays necessary 2024 Meeting Schedule (pdf) × Time-Sensitive Content. Facts & Figures. Maxine Wallner, Director, Contracting & Provider Services 217-337-8117 Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. MMAI combines both medical care and non-medical home and community-based services into a single program. Humana IL MMAI. However, you will still have Medicare and Medicaid benefits, including prescription drugs. Aetna Better Health Premier Plan MMAI was approved by the State of Illinois and the Centers for Medicare & Medicaid Services (CMS) to provide you services as part of the Medicare-Medicaid Alignment Initiative. What These providers are contracted with Blue Cross and Blue Shield of Illinois to provide medical services to members. You are now leaving Aetna Better Health Premier Plan MMAI. TTY: Illinois Relay at 7-1-1 or 1-800-526-0844. The MMAI is a groundbreaking joint effort to reform the way care is delivered to clients eligible for both Medicare and Medicaid Services (called “dual eligibles”). The move will begin with the Medicare-Medicaid Alignment Initiative (MMAI) demonstration contracts for individuals who are dually eligible for both Medicaid and Medicare. Our call center is open Monday Sample HealthChoice Illinois Enrollment Packet Materials and Comparison Chart Information Medicare-Medicaid Alignment Initiative Managed Care Community Networks You want to be your healthiest. Interested in learning more about this? Call Illinois Client Enrollment Services at 877-912-8880 (TTY: 866-565-8576) Monday through Friday, 8 a. O. Brochures & Forms. Accredited. And a brighter outlook, knowing you and your family are covered. %PDF-1. Public: Your yearly HealthChoice Illinois open enrollment period is here! Your open enrollment Note: Completion of this form does not guarantee inclusion into the provider network. ATTENTION: If you speak English, language assistance services, free of charge, are available to you. This will affect Illinois residents enrolled in Medicare and Medicaid, including those with long-term services and support. Tazewell and Vermilion; Aetna Better Health : Health Alliance Connect: Blue Cross Community: Molina Healthcare: Cigna-Healthspring: Humana: IlliniCare: Meridian: Each MMAI plan has a team of providers and care coordinators that will We’re here to help If you have questions about your COVID-19 coverage, or any benefits available to you through your medical plan, call Aetna Member Services at 1-855-339-9731 (TTY: 711), Monday–Friday, 7 AM–5 PM CT. The health plans were selected based on their demonstrated ability to offer a holistic approach to delivering coordinated care for clients eligible for both Medicare and Illinois MMAI Plan Choices The call is free! All Medicare-Medicaid Alignment Initiative (MMAI) plans have the same . The MMAI demonstration The MMAI is a groundbreaking joint effort to reform the way care is delivered to clients eligible for both Medicare and Medicaid Services (called “dual eligibles”). In Illinois, MMAI plans combine all of a member’s health care and prescription drug benefits under a single set of benefits. Some advantages include: You get the coverage of original Medicare Every year, the Illinois Department of Healthcare and Family Services (HFS) conducts a review of all Medicaid beneficiaries’ finances and family situations. cms. CountyCare Health Plan Illinois HCI. Understanding your coverage. You can get this information in other languages or formats, such as large print or audio. ilmeridian. , Central time; If Illinois Medicaid does not have a current asegurados de MMAI: No permita que la gripe lo sorprenda. On February 22, 2013, the Department of Health and Human Services announced that the State of Illinois will partner with the Centers for Medicare & Medicaid Services (CMS) to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience. The MMAI The Medicare-Medicaid Alignment Initiative is one of Illinois' managed care programs. 0823 . For pharmacy authorization requests, visit Pharmacy. All Illinois residents who are eligible to receive Medicare and Medicaid coverage and benefits can enroll in our health plan. Illinois' Medicare-Medicaid Plan is Statewide! Molina Healthcare of Illinois is participating in a program with the Centers for Medicare & Medicaid Services (CMS) and the Illinois Department of Healthcare and Family Services (HFS) called the Medicare-Medicaid Alignment Initiative (MMAI). 7 %âãÏÓ 9933 0 obj >stream hÞ´Wmo›H þ+û±U•cßw‘ªHŽÝ¤Vë¦ Iswˆ Ô¦ :‚- Róïof°cCLœ¦wBØÃÌî°ì3ϳ»ÞIË8óN:&BøW!3 Ÿ=3 ’" "ØT f© òÌ ôhÁB/ÑPLheÐâL8¯±•c’Czð &Qhi&ñ ¢’É0¤´Š)î=Zš)¡Ég˜ÒB e™²†2K°,Yà %Fµ KSfÏ4çä Á28r £æ^°÷ïƒIV75ó ÞÃÙÅñq,8t “ aÈðÆŠ ¡ÑH ßIZg§Ë² >_Ÿ]ü}ýnTåi1» >”óå"/o APPENDIX M: Illinois Department on Aging Elder Abuse and Neglect Program . • 68 CVS MinuteClinics® providing general medicine, urgent care and telehealth services in Illinois. How is this different from Medicare Advantage? MMAI plans offer a seamless experience for both enrollees and providers. Please note, the Blue Cross Community MMAI plan may cover more providers than displayed in the search results. Member Services: (855) 398-8412. Illinois is one of the states affected by the Centers for Illinois MMAI Plan Choices Author: Illinois Department of Healthcare and Family Services, Illinois Client Enrollment Services Subject: Illinois MMAI Plan Choices Keywords: Illinois Client Enrollment Services, Illinois Department of Healthcare and Family Services, HFS, EnrollHFS, Medicare-Medicaid Alignment Initiative, health plan, Medicare, Medicaid, MMAI Created Date: MMAI Contact Information. Verifique si aún es elegible para Medicaid. Care Coordination Home. The Centers for Medicare & Medicaid Services and/or Illinois Department of Healthcare and Family Services requires that we make training on MMAI and BCCHP topics available to you. Next Review Date . It is one of the MMAI plans offered in Illinois. Once the offered date and time has passed and if adequate information still has not been received, the request will be sent to a BCBSIL medical director for review and final decision. Learn more. It also offers care coordination to assist enrollees in meeting their care plan goals. Dear Jane Q. Become part of the Business Enterprise Program (BEP) for the state of Illinois . Molina Healthcare IL HCI & MMAI. For more information, visit 1 Aetna Better Health Premier Plan MMAI Chapter 1: Getting started as a member MEMBER HANDBOOK Aetna Better Health Premier Plan MMAI Member Handbook January 1, 2024 – December 31, 2024 The program did not expand to additional counties in 2018. 1-877-723-7702. The plan will be delivered by a managed care organization, which has a network of care providers. , CT, except holidays. The The MMAI demonstration project will be available to provide coordinated care to more than 135,000 Medicare-Medicaid enrollees in the Greater Chicago area and throughout central Illinois. ) Resources. Application Due Date: 12:00 PM CST, Friday, January 25, 2023 Deliver Applications via Email to: HFS. com CMS. TTY users should call 1-877-486-2048. This call is free. PLEASE NOTIFY MOLINA UPON ADMISSION. Obtenga su vacuna contra la gripe hoy mismo por un copago de $0 en un profesional de la red de su farmacia. Your new coverage starts April 1, 2021. Providers who provide Medicaid benefits are required to enroll and revalidate trough the Illinois Medicaid Program Advanced Cloud Technology (IMPACT). 18,318 The Department of Healthcare and Family Services (HFS) has selected eight health plans to serve clients in the Medicare-Medicaid Alignment Initiative (MMAI) and other initiatives in two regions of the state. MAPD members. Integrated Health Homes. Online – The eviCore Web Portal is available 24x7. 4 This Contract, made on _____, 2013, is between the Department of Health and Human Services, acting by and through the Centers for Medicare & Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. We will outreach to the contact person listed once a review of your data of Illinois Humana Health Plan Meridian Health Plan Molina Healthcare County Total MMAI Enrollments— September (continued) County Aetna Better Health Blue Cross/ Blue Shield of Illinois Humana Health Plan Meridian Health Plan Molina Healthcare County Total Hardin 7 * * * 9 16 Henderson 7 * 6 * 15 28 Henry 88 28 53 37 55 261 Iroquois 56 32 49 43 102 282 Jackson June 2019 Medicaid Providers: Benefit Preauthorization Tips and Peer-to-Peer Discussion Process. Update your address at Illinois Medicaid. Member Resources. Our Medicare Advantage plans (HMO and PPO) offer all of the coverage of Original Medicare, plus other . Member Services: (855) 343-7398. Meridian Health Plan. Molina Healthcare of Illinois MMAI. For more information contact the plan or read the Meridian Member Illinois Client Enrollment Services . Enroll on the phone or online! Find Plans | Get Facts. Instead, their coverage will be under one Illinois received approval for the MMAI program from CMS in 2013 and the program was implemented in Central Illinois and the Chicagoland area. (Note: See Medicaid page for BCCHP and MMAI Provider Finder links. Insurance Type . gov . Plan Details As a Blue Cross and Blue Shield of Illinois member, you have access to our secure, online resource tool that can help make your life easier. The Humana Gold Plus Integrated plan combines your Medicare and Medicaid services, PLUS it includes coverage for prescription drugs. Does MMAI cover outpatient and inpatient drugs? Yes. 2024 LIST OF COVERED DRS . MMAI providers will be notified by phone of potential adverse determinations and offered a date and time in which a pre-service, peer-to-peer discussion is available. Look for them in the mail. gov, haga Central Illinois: Champaign, Christian, DeWitt, Ford, Logan, Macon, McLean, Menard, Peoria, Piatt, Sangamon, Stark. Questions? Visit . basic. Under the demonstration, also called the Prior Authorization Instructions. Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Failure to accurately complete the form will significantly extend this processing time. MMAI. Some of these services may have guidelines of when they can be used. Write to us at: Blue Cross Community Health Plans Appeals and Grievances P. Radiation, Sleep, Molecular Tests : Medicaid Fax: (877)731-7218 MMP Fax: (844)251-1451 ***PA NOT REQUIRED FOR PLANNED ADMISSIONS. Complete revalidation when you receive email notification from the Illinois Department of Healthcare and Family Services (HFS). The table below has some of the services covered under your plan. Plans Medicare Advantage and Part D Plans Facts Get the Facts on Medicare Enroll Live help. mmai-illinois. For more information contact the plan or read the Meridian Member Illinois Department of Healthcare and Family Services Medicaid Managed Care Program Map August 1, 2021 Medicare-Medicaid Alignment Initiative (MMAI) Plans Aetna Serving all counties statewide Blue Cross Serving all counties except: Champaign, E˜ngham, and Massac Humana Serving all counties except: Jo Daviess, Macon, Massac and Rock Island Meridian Serving all What is MMAI? MMAI is a healthcare plan that covers Medicare, Medicaid, and prescription drug benefits. Refer to our Medicaid prior authorization summary for more details. The call is free! You can get this information in All Medicare-Medicaid Alignment Initiative (MMAI) plans have the same basic Medicare and Medicaid services that you get now, such as: 24/7 nurse line Behavioral health services Doctor services Eye care services Hearing services Home health care Hospice care Hospital services Lab tests and x-rays Medical supplies Prescriptions Therapy Transportation to medically Mandatory training due by end of year: All MMAI and BCCHP contracted providers must complete required annual training by Dec. Your MMAI plan will cover your Medicare, Medicaid and prescription drug benefits, including September 9, 2024 – The Illinois Department of Healthcare and Family Services (HFS) has announced its plan to rebid its Medicaid managed care contracts for the years 2025 and 2026. Medicare and Medicaid services that you get now, such as: 24/7 nurse line Home health care Prescriptions Behavioral health services Hospice care Therapy Doctor services Hospital services Eye care services Lab tests and X-rays necessary You are now leaving Aetna Better Health Premier Plan MMAI. The CEB program website offers more information about the managed care If you have questions, please call Aetna Better Health Premier Plan MMAI at 1-866-600-2139 ek. Providers, don’t risk being terminated from Medicaid. And we want to help. Searching for a dentist? Let's go. pdf Author: amy. You Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Unless you opt-out of the deeming, you will automatically be added to the MMAI Statewide Network. Members Enrolled. 2025 Encounter Data Sanctions. Illinois Medicaid Long-Term Care Definition. – 4:30 p. This week, our In Focus section from the HMA Weekly Roundup highlights the Illinois Department of Healthcare and Family Services request for proposals (RFP) for a dual-eligible special needs plan (D-SNP) to replace its current Medicare-Medicaid Alignment Initiative (MMAI) demonstration. Benefits of the MMAI include physician Premier Plan MMAI Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. FAQ. Illinois. Last update: 12/15/2024 Ratings are updated annually (September) Health Plan Rating. Save and compare. Coming soon, MMAI members will no longer carry two separate insurance cards. Aetna Better Health of Illinois is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. ) Step-by The MMAI is for people who meet all of the following requirements: Live in any county in Illinois, except Champaign and Massac county Have both Medicare Part A and Medicare Part B; Are eligible for Medicaid; Are a United States citizen or are lawfully present in the United States; Are age 21 and older when you enroll The Illinois Client Enrollment Broker (CEB) provides unbiased education and enrollment assistance to potential enrollees, as well as performs plan switches for those already enrolled. Our Mission, Vision, and Values; About Us ; Careers; Director Whitehorn; Executive Staff; Phone Directory; Boards and Commissions; Office of Inspector General ; More Elizabeth M. TTY user call Illinois Medicaid Renewals Info Center; About Us. Member Resources . Enrollment in HCSC’s plan Illinois Department of Healthcare and Family Services Medicaid Managed Care Program Map January 1, 2021 Medicare-Medicaid Alignment Initiative (MMAI) Plans Aetna Better Health Premier Plan Cook, DuPage, Kane, Kankakee, Will Blue Cross Community MMAI Cook, DuPage, Kane, Kankakee, Lake, Will Humana Health Plan Cook, DuPage, Kane, Kankakee, Lake, Will Illinois Blue Cross Blue Shield HCI & MMAI. TY . You pay nothing ($0) when you go to a doctor or health care provider in the plan's network. So, we believe that managing your health care doesn’t need to be hard. To access the BCCHP and MMAI digital lookup tool, refer to the Prior Authorization Support Materials (Government Programs) page in our Utilization Management section. In addition to nursing home care, Illinois Medicaid pays for non-medical support services to help frail seniors live at Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. EnrollHFS. Overview. For more information contact the plan or read the Meridian Member If you are hearing impaired, call the Illinois Relay at TTY: 711. The call is free! What happens after I enroll in the Medicare-Medicaid Alignment Initiative? Once you enroll in a Medicare-Medicaid Alignment Initiative health plan, you will get a health plan member handbook and a member ID card. Member Services: (844) 284-8822. Your MMAI plan will cover your Medicare, Medicaid and prescription drug benefits, including Yes. Urbana, Illinois 61801-3347. gov -https://www. Reimbursement Forms You may opt out of MLTSS at any time if you choose to enroll in a Medicare-Medicaid Alignment Initiative (MMAI) plan. Skip to main content three-way partnership between HFS, the federal Centers for Medicare and Medicaid Services (CMS), and health plans. docx Author: Roberts, Amy Created Date: 1/14/2025 12:04:55 PM Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. básicos. MMAI reformed the way care is delivered to customers who are eligible for both Medicare and Medicaid services MMAI reformed the way care is delivered to customers who are eligible for both Medicare and Medicaid services (dually eligible) by providing coordinated care and became a statewide program on July 1, 2021. For OTC + Flex card Benefit Services. Were ailable seven‚ays a week. www. 280 APPENDIX N: Illinois Department of Healthcare and Family Services Incident Reporting for Supportive Living Facilities. Call 1-866-600-2139 (TTY: 711), 24 hours a day, 7 days a week. 301 S Vine Street. Health care professionals for example, primary care physicians, specialists, mental health providers, Qualified Family Planning Providers (QFFPs), dentists and vision care providers; Facilities for example, hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health (Note: See Medicaid page for BCCHP and MMAI Provider Finder links. Report Center. Medicare Advantage. Clinical Guideline Criteria Blue Cross and Blue Shield of Illinois uses To join the Aetna Better Health Premier Plan MMAI network, please contact us at AetnaDualsContracting@AETNA. That’s why we designed Aetna Better Health Premier Plan MMAI (Medicare-Medicaid plan) to be convenient for you. That means the plan will change, but members will keep the same insurance group. This review, called redetermination, is to ensure that beneficiaries still qualify for healthcare coverage through Medicaid. While not included in the digital lookup tool, some services always require prior authorization, such as inpatient facility admissions. Prior Auth Check Tools: Ambetter | Medicaid | Medicare-Medicaid Plan | Wellcare | YouthCare Prior authorization (PA) is required before certain services are rendered to confirm medical necessity. The CEB is open Monday to Friday, 8am-7pm, and the toll-free number is: 1(877)912-8880 (TTY 1-866-565-8676). or call . The call is free. 5 of 5. We see you as our ally in providing high-quality health care services to our Aetna Better Health Premier Plan MMAI members. Visite MMAI Lifetimes para aprender sobre las vacunas contra la gripe y cómo mantenerse saludable durante la temporada de gripe. Call Monday to Friday, 8 a. receive services from one of the following Home and Community-Based Services (HCBS) Waiver Programs: Persons who are Elderly; Persons with Disabilities; Persons with Brain Injury; Person with HIV or AIDS; Illinois Illinois’ Medicaid-Medicare Alignment Initiative (MMAI) combines Medicaid and Medicare benefits for dual eligible beneficiaries into one streamlined plan that includes medical, personal, behavioral and long-term care services. Please be As a Blue Cross Community MMAI (Medicare-Medicaid Plan)℠ member, you will be involved in every decision about your health care. If your practice already uses Availity, simply contact your administrator to request a username. For more information contact the plan or read the Meridian Member MMAI Members. Please contact Customer Service at 1-877-723-7702 (TTY: 711) for additional information. Rate/Fee Schedule Updates: January 2025. Beginning July 1, 2021, the program will be available to all dually eligible individuals statewide. HMO. If you do not intend to leave our site, please click Close. Enrollment Totals in Managed Care Health Plans. Medicare-Medicaid Alignment Initiative . With MMAI, you get all your Medicare and Medicaid benefits in one plan. We take care of You are now leaving Aetna Better Health Premier Plan MMAI. Selecting an EVV solution that fits your provider agency. com Illinois MMAI Plan Choices The call is free! All Medicare-Medicaid Alignment Initiative (MMAI) plans have the same . 9 million members in all 102 counties across the state. Keep in mind that you may need to get approval for BlueCross BlueShield of Illinois MMAI. The Medicare-Medicaid Alignment Initiative is a demonstration program jointly run by Illinois and the Sample HealthChoice Illinois Enrollment Packet Materials and Comparison Chart Information Medicare-Medicaid Alignment Initiative Managed Care Community Networks FAQs on the Illinois Medicare- Medicaid Alignment Initiative ( MMAI) and Medigap Page 1 of 2 CMS has received a number of questions about how private Medicare Supplement Insurance (Medigap) policies relate to Illinois’ Medicare-Medicaid Alignment Initiative (MMAI). Under MMAI there are no coinsurance fees for Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. are enrolled in the Medicare Medicaid Alignment Initiative (MMAI) and receive services from a managed care organization (MCO); or. Molina MMAI EUM 2024 Eval 4 Sanction - 01152025 (pdf) Meridian MMAI EUM 2024 Eval 4 Sanction – 01152025 (pdf) M02 0822 ENG. Initiative (MMAI)! To help your Medicare and Illinois Medicaid benefits work better for you, we are enrolling you in an MMAI health plan. Register for January Provider Webinars. This enrollment form is designed to capture information about your agency in order for HHAeXchange to collect and report EVV data for all personal care services (PCS). roberts Created Date: 11/28/2022 1:04:22 PM Alignment Initiative (MMAI) Long-Term Service and Support (LTSS) Resource Guide Online self-service A variety of LTSS Medicaid-specific provider materials, communications and quality resources are available on the Illinois Long-term Service and Supports (LTSS) provider website (no registration required). Prime Therapeutics is the Pharmacy Benefit Manager (PBM) that provides drug benefits through Blue Cross and Blue Shield of Illinois (BCBSIL). Meridian partners with several external entities to manage prior authorizations for certain services or populations. Click here. Humana IL Gold Plus. Resources include: • Provider manual • Training • Availity MMAI Member Resources How to Enroll MMAI Contact Us Welcome. Meridian and WellCare are both part of Centene Corporation. 2. Plan website: Benefits | Molina Members | Duals. A peaceful mind. Illinois Medicaid; Medicare Advantage; Corporate Social Responsibility; Illinois Medicaid. Maintain your health and independence. The call is free. Therefore, traditional health care services such as Blue Cross Community MMAI Provider Manual – Updated December 2021 3 Overview The State of Illinois has been designated by the Centers for Medicare & Medicaid Services (CMS) to participate in a demonstration program designed to help better service individuals who are eligible for both Medicare and Medicaid. MMAI@illinois. Welcome to Your Plan Member Rights and Responsibilities Grievances, Appeals and Coverage Decisions How to Report Fraud How to Contact Home Care mmai/otc/guide H0927_BENOTCCAT24 241450. HFS and CMS are jointly reviewing readiness for implementation of the MMAI, which had been scheduled to begin opt-in enrollment in February 2014. Title: HFS-MMAI Transition Plan_093022. BCBSIL offers Medicaid programs statewide. Illinois Medicaid Resources. 1-877-912-8880 (TTY 1-866-565-8576) Monday to Friday from 8 a. gov and copy Skip to main content List of network providers This Directory of Illinois’s network providers contains:. Proposals are due by October 18, 2024, and Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. To determine whether preauthorization is required for a patient with Humana MMAI coverage, physicians and other healthcare providers should review the Shield of Illinois does not elude people or t reat them difrently because of race, color, national origin,ge, dability, orex Blue Cro and Blue Shield of Illois: ue Cross Community MMAI . We are open Monday through Friday from 7:45 a. For plans offered in your county, go to Family Services (HFS), MMAI allows eligible beneficiaries in Illinois to receive their Medicare Parts A and B, Medicare Part D, and Medicaid benefits from a single Medicare-Medicaid Plan, The Medicare-Medicaid Alignment Initiative (MMAI) is a groundbreaking demonstration of the Illinois Department of Healthcare and Family Services (HFS) and the The Medicare-Medicaid Alignment Initiative (MMAI) is a groundbreaking demonstration of the Illinois Department of Healthcare and Family Services (HFS) and the In every corner of Illinois, we connect members to providers they can trust and the quality care they can count on. Visit the Prior Auth Check tools below for our family of plans. to 7 p. We regret to tell you that Molina HealthCare of Illinois MMAI will no longer be able to provide coverage to you through the Medicare-Medicaid Alignment Initiative (MMAI) program after April 30, 2017. On September 3, 2024, the Illinois Department of Healthcare and Family Services (HFS) released a request for proposals (RFP 2026-24-001) for Dual Eligible Special Needs Plans (D-SNPs). Action May Be Required. Updating your address with Illinois Medicaid is easy: Connect with Illinois Medicaid online Call 877-805-5312 (TTY: 877-204-1012), Monday – Friday, 7:45 a. Diabetic Eye Exams and Retinal Screenings. Because we manage both your Medicare and Medicaid coverage, you only have to work with us. It generally takes 20 business days to analyze the form and make a determination if the contract process will commence. of Illinois Humana Health Plan Meridian Health Plan Molina Healthcare County Total MMAI Enrollments—March 2024 (continued) County Aetna Better Health Blue Cross/ Blue Shield of Illinois Humana Health Plan Meridian Health Plan Molina Healthcare County Total Hardin 10 * * * 10 20 Henderson 6 * 9 * 16 31 Henry 95 29 54 34 74 286 Iroquois 65 34 54 36 107 296 in two demonstration areas for the MMAI program. HCSC is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Frequently Used Forms - 2025 Q1 Prior Auth Codification Microsoft Word - Meridian MMAI EUM 2024 Eval 4 Sanction - 01072025. The five mandatory managed care regions include Rockford, Central Illinois, Metro East, Quad Cities, and Greater Chicago (Cook and Collar Counties). 10/27/2026. Care Coordination. to 6 p. This program is for seniors and persons with disabilities who have full Medicaid and The Medicare-Medicaid Alignment Initiative (MMAI) demonstration project provides coordinated medical care to seniors and to persons with a disability who receive both Medicaid Learn about the Illinois’ Medicare-Medicaid Alignment Initiative (MMAI), the benefits, eligibility requirements and how to apply. The following health plans continue operating in MMAI in 2018: Aetna Better Health, Blue Cross Blue Shield of Illinois, Humana Health Plan, IlliniCare Health, Meridian Health, and Molina Healthcare of Illinois. You are leaving our website and going to a non-Medicare/Medicaid website. CY 2021 MMAI MLR Calculations Reports. The call is free! Need help? Go to . Map of Managed Care as of June 1, 2023. mmp. Visite abe. Through these programs HFS surpassed the 50% goal required by law, with an enrollment of over 2 million participants in care coordination programs. We’re here to help you take care of yourself—in every way. Medicare. gov. To learn more, visit the Clinical Guidelines Criteria page. Or call 1-877-805-5312. Updates to Molina Clinical Policies, December 2024. 281 . Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Illinois health plan If you have questions about Medicare, call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week or visit Medicare. Health Alliance. The call is free! January 1, 2024. Throughout this catalog, you will learn more about this . If you don’t know who your administrator is, call Availity at 1-800-282-4528 for help. Get these forms and documents in Spanish. E 1223 E. Product Type. Medicaid is a health care program for low-income individuals of all ages. com. Info Center. This FAQ document clarifies Todos los planes de Medicare-Medicaid Alignment Initiative (MMAI) tienen los mismos servicios básicos de Medicare y Medicaid que usted recibe ahora, como: ③Línea de enfermería las 24 horas del día, los 7 días de la semana ③Servicios de salud del comportamiento ③Servicios de un médico ③Servicios de cuidados de la vista ③Servicios de cuidados del oído ③Cuidados Find the forms and documents you need to manage your Blue Cross Community MMAI (Medicare-Medicaid Plan)℠ offered by Blue Cross and Blue Shield of Illinois. If you live in a long term care facility or get home and community based waiver services, you must enroll in a health plan for these Medicaid benefits if you are not enrolled in an MMAI plan. Managed Care Manual for Medicaid Aetna Better Health® Premier Plan MMAI Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Need Help? (866) 268-2674 Monday - Friday, Hours 7:00 AM to 10:00 PM CST *Important Plan Information †Non-Discrimination & Language Assistance. Not all plans may be offered in your area. MMAI program, you can choose not to enroll (opt out) by calling us at 1-877-912-8880 (TTY 1-866-565-8576). MMAI Model On February 22, 2013, the Department of Health and Human Services announced that the State of Illinois will partner with the Centers for Medicare & Use these charts to compare the extra benefits and services each health plan offers. 31, 2024. HFS Managed Care Provider Resolution Portal. Nous voudrions effectuer une description ici mais le site que vous consultez ne nous en laisse pas la possibilité. de Medicare y Medicaid que usted recibe ahora, como: ③Línea de enfermería las 24 horas del día, los 7 días de la semana ③Servicios de salud del comportamiento ③Servicios de un médico ③Servicios de cuidados de la vista ③Servicios de cuidados del oído ③Cuidados Illinois Provider Feedback Survey! Provider Revalidations Continue; Second Cycle Ends. Blue Cross Community MMAI (Medicare-Medicaid Plan)℠ covers many of your health care needs. So you’re able to move forward with a stronger body. While there are varying coverage groups, our focus is on long-term care Medicaid eligibility for elderly Illinois residents, aged 65 and over. Molina Healthcare of Illinois Medical Prior Authorization Request Form For Medicaid and MMP/Dual Options Plans. If you haveuestions , pe call Blue Cro CommunAI Member Serviceat . DOB. You will be automatically enrolled in the regular Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. • Vision Network through March Vision with access to 400 providers in Illinois. to 4:30 p. Welcome to health plans that care for all of you and everything that Illinois MMAI Plan Choices Author: Illinois Department of Healthcare and Family Services; Illinois Client Enrollment Services Subject: Illinois MMAI Plan Choices Keywords: Illinois Client Enrollment Services, Illinois Department of Healthcare and Family Services, HFS, EnrollHFS, Medicare-Medicaid Alignment Initiative, health plan Medicare, Medicaid, MMAI Created Date: Illinois Client Enrollment Services at 1-877-912-8880 (TTY 1-866-565-8576). If you have questions, please Contact Us. Call 1 Information for Blue Cross and Blue Shield of Illinois members is found on (BCCHP SM) and Blue Cross Community MMAI (Medicare-Medicaid Plan) SM members can be submitted to eviCore in two ways. For more information contact the plan or read the Meridian Member The MMAI demonstration project will be available to provide coordinated care to more than 135,000 Medicare-Medicaid enrollees in the Greater Chicago area and throughout central Illinois. More information on IMPACT can be found at Illinois’ Communications surrounding managed care procurements while in an active design or procurement phase are strictly governed by the Illinois Procurement Code . Member Services representatives are available at 1-877-723-7702(TTY: 711). For more information contact the plan or read the Meridian Member Welcome to the Managed Care section of the Illinois Department of Healthcare and Family Services (HFS) website. Our MMAI plan is called Meridian. Redetermination started back up Illinois Medicare Medicaid Alignment Initiative (MMAI) HFS Tracking Number: 2024-24-001 RFA Title: Illinois’ Medicare Medicaid Alignment Initiative Request For Application (IL MMAI RFA). For more recent information or other questions, contact us at 1‑866‑600‑2139 (TTY: Todos los planes de Medicare-Medicaid Alignment Initiative (MMAI) tienen los mismos servicios . For more information contact the plan or read the Meridian Member This information applies to Medicaid members who have Blue Cross Community Health Plans (BCCHP) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM prescription drug benefits. Today s Date: Member name. Get help from a licensed insurance agent. Looking for a different state or type of insurance? Change selection. CMS overview of the Medicare-Medicaid Alignment Initiative (MMAI) Program Aetna Better Health Premier Plan MMAI Illinois. Illinois Client Enrollment Illinois MMAI Plan Choices Author: Illinois Department of Healthcare and Family Services Subject: Illinois MMAI Plan Choices Keywords: Illinois Client Enrollment Services; Illinois Department of Healthcare and Family Services; HFS; EnrollHFS, Medicare-Medicaid Alignment Initiative; health plan; Medicare; Medicaid Created Date: 3/26/2024 12:45:26 PM Blue Cross and Blue Shield of Illinois is proud to be the state’s only statewide, customer-owned health insurer. Box 660717 Dallas, TX 75266-0717 Fax: 1-866-643-7069 Fast Appeal Fax: 1-800-338-2227; You can also contact Medicare by using the online complaint form. We are available seven (7) days a week. Discover information for healthcare providers about the Illinois Demonstration and ICP, what Humana needs from providers and what they can expect from Humana. This OTC benefit allows you to get nonprescription . For OTC Benefit Services. WELCOME As a member of our health plan, you have an over-the-counter (OTC) benefit allowance to use every quarter. m. Illinois Department of Healthcare and Family Services . health and wellness products that help you stay healthy at home. This program benefits our members by providing the Maximus uses cookies and other tracking technologies, including session replay tools (“Cookies”), to gather information about you and your device to improve our services, conduct analytics to gain insights about how you interact with our websites and services, evaluate and improve advertising, and enhance performance and functionality. *** Medicaid. The benefit information is a brief summary, not a complete description of benefits. For more than 85 years, we’ve provided our members with comprehensive, affordable health MMAI reformed the way care is delivered to customers who are eligible for both Medicare and Medicaid services (dually eligible) by providing coordinated care and became a statewide program on July 1, 2021. Blue Access for Members offers Medicare coverage and benefit information, health and wellness resources, and more to help you live a Sample HealthChoice Illinois Enrollment Packet Materials and Comparison Chart Information. . Joint HFS DHS Presentation on Williams and Colbert to MCOs and Prime Agencies . Plan Details . MMAI does not change any existing Medigap rules. Please see the next page for information about other plans » 1-855-580-1689. 7 %âãÏÓ 386 0 obj > endobj 436 0 obj >/Filter/FlateDecode/ID[04D1AE00DEFA4E1AB89157BD982BE177>7752E7625AB9C6489A02CAE012DDD02D>]/Index[386 83]/Info 385 0 R Illinois health plan If you have questions about Medicare, call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week or visit Medicare. Skip to content. For more information contact the plan or read the Meridian Member Meridian of Illinois Announces Provider Relations Team Reorganization; Meridian of Illinois Partners with Jeremiah Development for LOVE Rockford Event; UPDATE PRACTICE INFORMATION USING THE MERIDIAN PROVIDER UPDATES TOOL; SUPPORT & RESOURCES FOR THOSE IMPACTED BY THE HIGHLAND PARK TRAGEDY ON JULY 4; Medicare Advantage plan information for 2025 Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) H2506 - 001 - 0 by CVS Health Corporation. This group of Medicare-Medicaid enrollees are known as dual-eligible individuals. As you strive to deliver the best care possible and to better understand the health plan, we hope you’ll take advantage of all the resources we have to offer. Our Medicare Advantage plans (HMO and PPO) offer all of the coverage of Original Medicare, plus other benefits. Provider Finder ® Search for doctors, dentists, hospitals and other health care providers. Blue Cross Community MMAI (Medicare-Medicaid Plan)℠ is provided by Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association. Recap of November Provider News. 711). • Over 66,000 in-network providers across Illinois. MMAI includes all the drug coverage guaranteed by Medicare Parts A, B, and D, the drug benefits provided by the Illinois Medicaid program, and any additional supplemental drug coverage offered by an individual MMAI plan above and beyond the federal and state required benefits. gov/medicare/coverage/prescriptiondrug coverage What is MMAI? The Medicare-Medicaid Alignment Initiative (MMAI) is an insurance program run by the state of Illinois that replaces Medicare Parts A, B & D primary insurance coverage AND Medicaid secondary insurance coverage. Duals. We The information on this page is specific to the Meridian Medicaid Plan. For more information contact the plan or read the Meridian Member List of network providers This Directory of Illinois’s network providers contains: Health care professionals for example, primary care physicians, specialists, mental health providers, Qualified Family Planning Providers (QFFPs), dentists and vision care providers; Facilities for example, hospitals, long-term care facilities and skilled nursing facilities for Molina welcomes new members across the state of Illinois! Let us connect you to the best quality care for you and your family. Managed Care Community Networks. MMAI adding the Aetna Better Health Premier Plan MMAI (Duals MMP Plan) for Illinois to your existing Medicare contract that will begin on 7/1/21. MCO Performance Metric Dashboard Summaries. Whitehorn, Director; HFS. • Dental Network through DentaQuest network available throughout Illinois. Redetermination was on pause during the COVID-19 public health emergency. For Meridian Medicare-Medicaid Plan plan information on how to submit a prior authorization request, please refer to our new authorization lookup tool. 2025 Plan Documents Annual Notice of Changes — Last Updated 10/01/2024; Member Handbook Illinois is set to shift from the MMAI to a Dual Eligible Special Needs Plan (D-SNP) in 2026. We are also the largest provider of health benefits in Illinois, serving more than 8. Phone – Call eviCore toll-free at 855-252-1117, Monday through Friday, 7 a. Eligible beneficiaries may choose to opt-in to a MMAI plan or be passively enrolled in a plan. 1-877-912-8880 (TTY: 1-866-565-8576). To ensure a Aetna Better Health® Premier Plan MMAI is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Revalidation must be submitted by the due date indicated by HFS. The call is free! You can get this information in MMAI Model. This partnership will include a Initiative (MMAI)! To help your Medicare and Illinois Medicaid benefits work better for you, we are enrolling you in an MMAI health plan.
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