Medicaid Managed Care Plans
Illinois Medicaid Managed Care expanding into Perry County and is now called HealthChoice.
The Department of Health and Family Services (HFS) Medicaid has started mailing Medicaid patients notification letters related to new HealthChoice Illinois plan. All patients with an Illinois Medicaid medical card, will be required to pick one of the following managed care plans - Blue Cross, Molina, Meridian, Harmony or IlliniCare.
Pinckneyville Community Hospital and the Family Medical Center have signed contracts with the following HealthChoice Illinois plans:
Blue Cross Community Health Plan
However, as of January 26, Pinckneyville Community Hospital, the Family Medical Center, or any of the Family Medical Center providers are not being listed in these plans for being in-network. Therefore, patients attempting to enroll in a HealthChoice Illinois plan will not be able to select one of our providers.
We have been told that they are behind in processing contracts, and that it could be another 15-30 days before you can select one of our providers as your primary care provider.
We ask you to be diligent with HFS when choosing your new HealthChoice plan that works best for your needs. Please check back again between February 15 and February 28, to see if your Family Medical Center provider has been added to the list. We will continue to monitor this as well, and appreciate your patience.
If we are not yet in-network with the plans by the deadline for selecting a plan and primary care provider, the patient will need to select one of the plans Pinckneyville Community Hospital has signed with (BCBS, Molina, Meridian or Harmony) and then select a temporary primary care provider other than the provider they see at Family Medical Center. Once the Family Medical Center providers are enrolled, the patient will be able to change their primary care provider to Family Medical Center.
If the patient needs to see their Family Medical Center (FMC) provider before that switch can be made, the patient will need to alert FMC staff when scheduling an appointment that a call will need to be placed to grant temporary approval of the visit with a provider other than their selected primary care provider. If the network plan does not grant approval of that request, patients will need to see the temporary primary care provider.