Morris Daily Herald: Grundy Medicaid patients need to make plan changes soon

The following is from the Morris Daily Herald:


Area Medicaid patients should check their mail this month through February for information about the rollout of a revamped Medicaid program. It’s called, “HealthChoice Illinois.”

Responses to the packets being mailed out are required within 30 days of receipt if patients want to keep their current Medicaid plan and providers.

The letters are being sent to patients in Grundy and several neighboring counties. Will and Cook Counties, as well as other collar counties, have been in the new HealthChoice Illinois program for two years and will not need to make any changes in their plans. The state rolled out the new plan to other counties Jan. 1.

According to Pat Durkin, Vice President of Ambulatory Services at Morris Hospital, there will be no changes in Medicaid patients’ benefits or eligibility with HealthChoice Illinois.

Patients are being asked to choose a health plan, which includes hospitals, and a primary care provider, and they have only 30 days to submit that choice to the state. After that, the state will choose for them.

“We want to encourage everyone to open that packet and review it and make sure that they choose a physician . . . and one of the five health plans,” Durkin said. “If you don’t do anything, then the state will automatically assign a physician to you, as well as put you in a health plan.”

Durkin said the packet letters began going out recently and will continue through mid-February. Each patient will have 30 days from receipt of that letter to send in their choice of a plan and primary care provider.

“When you get something in the mail from the Illinois Department of Healthcare and Family Services,” Durkin said, “please open it up and look at it.”

Local Medicaid patients will essentially need to make two choices – one for a plan and one for a primary care physician.

They will be given a choice between five plans, which are Blue Cross Blue Shield of Illinois, Harmony Health Plan, IlliniCare Health Plan (which will also serve children under the care of DCFS), Meridian Health and Molina Healthcare.

There will be information in the mailed packets about how to find out which plans include Morris Hospital, Durkin said, and which physicians may be chosen.

Administrators at Morris Hospital, he said, are currently at work to get contracts with all five plans, but patients should be sure to check the plans to see which hospitals are on them.

Durkin said for their primary care providers, patients can choose from among the 45 Morris Hospital-employed physicians and other providers who are participating in the new Medicaid program, as well as several additional physicians who are affiliated with Morris Hospital but not directly employed by the hospital.

Other hospitals and physicians are also options for patients to choose.

Patients who do not make those two choices – of a plan and of a primary care provider – will be assigned plans and physicians that might not be ones they would have chosen themselves. Open enrollments periods where patients can change their plans will be offered once a year.

The rebooted Medicaid program is also rolling out changes designed to strengthen the program and “will bring quality healthcare for those with limited resources while ensuring sustainable costs for taxpayers,” according to a December press release from the Illinois Department of Healthcare and Family Services.

Durkin explained that by changing the plan to one managed by the health plans, rather than by the state, hopes are that there will be less waste and better care.

One of the goals of the program is to offer care coordinators to help patients navigate their care, with a focus on whole person health and wellness.

“I think the changes will be good for area residents,” Durkin said, “if the care coordinator program that each of these plans has is put into effect and works. But it will require patients to also cooperate and work with the care coordinators. It’s really a team effort.”


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