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General questions
Medicaid is a government program that provides health care for millions of Americans. In Illinois, it’s called HealthChoice Illinois. It covers low-income adults, children, pregnant women, elderly adults and people with disabilities. If you qualify, you’ll be covered for a wide variety of benefits and services, including:
Preventive care
Vision
Medications
Chronic disease management
Behavioral health services
Before you can get coverage, you need to make sure you qualify for HealthChoice Illinois. HealthChoice Illinois is Illinois’ Medicaid program. If you qualify for HealthChoice Illinois, the Illinois Department of Healthcare and Family Services (HFS) will send you an enrollment packet in the mail. As you complete your enrollment, you can choose Aetna Better Health of Illinois as your health plan.
Every 12 months, the Illinois Department of Healthcare and Family Services (HFS) will determine if you or your family members still qualify for HealthChoice Illinois. This review process is called redetermination.
We always try to give you the best health care experience possible. You’re encouraged to file a grievance if you’re unhappy with the service you got from us or one of our providers. You can file an appeal if we deny, delay or change a service. If you don’t agree with the decision of your appeal, you can:
Ask for a state fair hearing
Ask for an independent medical review (IMR)
Tell us. You have the right to report anyone you believe is committing fraud or abusing the HealthChoice Illinois system. You can use this form to report fraud or abuse.
Member Services
You will find your health plan summary and benefits information in your member handbook or on your secure Member Portal.
You may call the toll-free number at 1-866-329-4701 (TTY: 711), Monday through Friday, 8:30 AM to 5 PM CT. You can also contact us anytime by logging in to your secure Member Portal.
You can change your PCP through your secure Member Portal. You can also call the toll-free number on your ID card and follow the menu options.