Medicare - Medicaid Alignment Initiative (MMAI)
Changes are coming soon if you have Medicare and full Medicaid (no spenddown). There are five plans to choose from for your coverage. Most people over age 21 who have Medicare Part A & B as their primary coverage and Medicaid as their secondary coverage will now have one plan. This plan becomes effective for some individuals as early as July 1,2021. Be sure to respond! It is not junk mail!
The letter guides you through your options.
- Select. There are five plans to choose from: Aetna Better Health, BlueCross BlueShield of Illinois, Humana Inc, Meridian Health Plan, and Molina Healthcare of Illinois.
- Opt Out. Keeping your current Medicare/Medicaid coverage.
- Do Nothing. If you do nothing, you will be automatically assigned to a plan.
There are a few things that may help you decide which plan works best:
- Contact your current providers and find out which plans they are in network with. SIH hospitals and physicians will be in network with four of the five plans:
- Blue Cross, Humana Inc
- Humana Inc
- Molina Healthcare of Illinois
- Aetna Better Health (effective August 15)
Here are a few Q & As to help navigate this change:
- What is MMAI?
- Who does this impact?
- How does this change things?
- How does this impact patients who seek services at and SIH provider or facility?
- When will this happen?
- Where do you call for help?
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. Coming soon, MMAI members will no longer carry two separate insurance cards. Instead, their coverage will be under one plan and one card.
This impacts most Illinois residents over age 21 who have Medicare Parts A & B as their primary coverage and Medicaid without spend-down as their secondary coverage. There are a few exceptions as to who is affected.
There will be some big changes. One of those changes is MMAI plans require patients to see in-network providers. This is why it is important to check with your current providers and learn which MMAI plans they plan to contract with. Another change is what may be covered. MMAI plans should have more benefits, meaning they cover more services than traditional Medicare/Medicaid. However, they may not cover the same prescriptions that Medicare/Medicaid covered. In order to understand the coverage differences, you may contact any MMAI plan for details.
Patients seeking services with an SIH provider or at an SIH hospital will need to know which MMAI plans we are in network with. SIH hospitals and physicians will be in network with four of the five MMAI plans: Blue Cross, Humana and Molina. Aetna Better Health will be in network starting in August.
Letters should be mailed around May 15. The mail is somewhat unpredictable right now, so keep an eye out for your letter, and remember it’s not junk mail. For individuals who actively enroll in a plan, their coverage effective date will be July 1, 2021. For individuals who do not take any action, their coverage effective date will be September 1, 2021.
- Illinois Client Enrollment Services at 877-912-8880 (if you do not receive a letter but think you qualify)
- Illinois Senior Helpline at 800-252-8966 and press option 2 for Medicare questions
- SIH Second Act at 877.480.4040 Medicare counselor