SIH Out of Network with Harmony Medicaid

April 3rd, 2018

Confused about selecting a health plan under Illinois’ new Managed Care, or Managed Medicaid, requirement? We understand. This is the first time our area has experienced the Medicaid program operating more like private insurance, and it takes some getting used to.

What’s happening now?

The Illinois program is called HealthChoice Illinois. It requires individuals currently covered by Medicaid to select a primary care physician (PCP) in a managed care health plan. It’s important to know if the physician and hospital services you desire are covered under the plan you ultimately choose.

As of April 1, 2018, SIH physicians and facilities accept the following health plans under this new Managed Medicaid initiative:

Managed Medicaid MCO and Customer Service Phone

  • IlliniCare Health – 866-329-4701
  • Meridian Health Plan – 866-606-3700
  • Molina Healthcare – 855-734-9617
  • Blue Cross Community Family Health Plan – 877-860-2837
  • Blue Cross Community ICP – 888-657-1211

Of note, SIH is not participating in the Harmony Medicaid Health Plan. This may have impacted you if you made your selection in recent weeks based on the health plans listed on the Illinois Healthcare and Family Services website. Unfortunately, the state’s website was not updated in a timely fashion. If you choose to continue with your Harmony plan going forward, you will experience significant gaps in coverage for physicians and hospitals across southern Illinois.

What now?

If you’ve already selected a health plan, you have some time to make changes. The state’s deadline for doing so is June 30, 2018. Under Illinois guidelines, we can’t advise you on which plan provides the best fit for you and your family. For questions regarding which plan is right for you, please call any of the customer service numbers listed above or the Illinois Department of Healthcare and Family Services at 877-912-8880 or visit www.EnrollHFS.Illinois.gov.