The Medicare-Medicaid Alignment Initiative is one of Illinois' managed care programs. This program is for seniors and persons with disabilities who have full Medicaid and Medicare benefits.
Full Answer
Is Alignment Healthcare a Medicare plan?
The Illinois Medicare -Medicaid Alignment Initiative (MMAI) is a demonstration designed to improve health care for dually eligible beneficiaries in Illinois. Jointly administered by the Centers for Medicare & Medicaid Services (CMS) and the Illinois Department of Healthcare and Family Services (HFS), MMAI
What does Alignment Healthcare do?
Medicare Medicaid Alignment Initiative (MMAI) plan, and this is when participant confusion and system transaction issues are most likely to occur. We …
Does Medicare Advantage replace original Medicare?
What is the Medicare-Medicaid Alignment Initiative? The Medicare-Medicaid Alignment Initiative is one of Illinois' managed care programs. This program is for seniors and persons with disabilities who have full Medicaid and Medicare benefits. The Medicare-Medicaid Alignment Initiative started in Illinois in 2014. The program expanded to
What is the Medicare Medicaid alignment initiative?
The Medicare-Medicaid Alignment Initiative is one of Illinois' managed care programs. This program is for seniors and persons with disabilities who have full Medicaid and Medicare benefits. The Medicare-Medicaid Alignment Initiative started in Illinois in 2014. It operates in the Greater Chicago and Central Illinois Regions.
What is financial alignment initiative?
The Financial Alignment Initiative (FAI) was authorized under Section 3021 of the Patient Protection and Affordable Care Act (P.L. 111-148, as amended) to test ways to improve care for dually eligible beneficiaries and reduce program costs by aligning financing and coordinating care across Medicare and Medicaid.
Is Mmai mandatory in Illinois?
Is enrollment in MMAI mandatory? MMAI is a mandatory program, but individuals can opt-out of the program at any time and receive their Medicare and Medicaid benefits separately, as they do today.
What does Mmai mean in insurance?
The Medicare-Medicaid Alignment Initiative (MMAI) is a statewide program for adults who are enrolled in both Medicare and Medicaid. When you enroll, you will choose a primary care provider (PCP) and health plan to cover all your healthcare.
What is the goal of Medicare and Medicaid?
Advancing Care for People with Medicaid and Medicare Our goal is to make sure dually eligible individuals have full access to seamless, high quality health care and to make the system as cost-effective as possible.Mar 10, 2022
Is Mmai better than Medicare?
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.Jun 10, 2021
Can you have both Medicare and Medicaid in Illinois?
Illinois residents who are eligible for Medicare and Medicaid coverage and benefits can get it all through Humana Gold Plus® Integrated Medicare-Medicaid in Illinois. Through Humana Gold Plus Integrated, your Medicare and Medicaid coverage and benefits are combined into one plan—PLUS you get prescription drug coverage.Jan 1, 2022
What is Humana Gold Plus integrated?
The Humana Gold Plus Integrated plan combines your Medicare and Medicaid services, PLUS it includes coverage for prescription drugs. Some advantages include: You get the coverage of original Medicare PLUS extra benefits like rides to medical appointments, and added vision, hearing, and dental coverage.Jan 1, 2022
What does MMCP stand for?
MMCPAcronymDefinitionMMCPManaged Medical Care ProgramMMCPManaging Multiethnic Communities Program (Local Government and Public Service Reform Initiative)MMCPMaratha Mandal College of Pharmacy (Belgium, India)MMCPMaryland Motor Carrier Program (Maryland Department of Transportation)6 more rows
What is HealthChoice Illinois?
HealthChoice Illinois is the statewide Medicaid managed care program. Most Medicaid customers are required to choose a primary care provider (PCP) and health plan. We can help you understand your plan choices, find providers and enroll.
What are the disadvantages of Medicaid?
Disadvantages of MedicaidLower reimbursements and reduced revenue. Every medical practice needs to make a profit to stay in business, but medical practices that have a large Medicaid patient base tend to be less profitable. ... Administrative overhead. ... Extensive patient base. ... Medicaid can help get new practices established.
Do I need supplemental insurance if I have Medicare and Medicaid?
Do You Need Medicare Supplement Insurance if You Qualify for Medicare and Medicaid? The short answer is no. If you have dual eligibility for Medicare and full Medicaid coverage, most of your health costs are likely covered.
Is Medicare a disability or Medicaid?
Everyone eligible for Social Security Disability Insurance (SSDI) benefits is also eligible for Medicare after a 24-month qualifying period. The first 24 months of disability benefit entitlement is the waiting period for Medicare coverage.
What is the Medicare-Medicaid Alignment Initiative?
The Medicare-Medicaid Alignment Initiative is one of Illinois' managed care programs. This program is for seniors and persons with disabilities who have full Medicaid and Medicare benefits.
Why is the Medicare-Medicaid Alignment Initiative important for me?
The Medicare-Medicaid Alignment Initiative brings together all of your Medicare, Medicaid, and prescription drug benefits into one health plan. In the Medicare-Medicaid Alignment Initiative, you choose a health plan that is best for you.
Can I enroll in the Medicare-Medicaid Alignment Initiative?
Getting full Medicaid and Medicare benefits (Medicare Parts A and B and Medicaid without a spenddown),
How do I know which health plan is the right plan for me?
To choose the best health plan for you, you should think about your answers to these questions:
How do I enroll in the Medicare-Medicaid Alignment Initiative?
You can enroll in the Medicare-Medicaid Alignment Initiative at any time. To enroll in this program, call Illinois Client Enrollment Services at 1-877-912-8880 (TTY 1-866-565-8576). Call Monday to Friday, 8 a.m. to 7 p.m. The call is free!
What happens after I enroll in the Medicare-Medicaid Alignment Initiative?
Once you enroll in a Medicare-Medicaid Alignment Initiative health plan, you will get a health plan member handbook and a member ID card. Look for them in the mail. You will work with your health plan care coordinator to get the health care services you need. To learn more, call your health plan member services number.
What is financial alignment?
The Financial Alignment Initiative is designed to provide individuals dually enrolled for Medicare and Medicaid with a better care experience and to better align the financial incentives of the Medicare and Medicaid programs. Through the Initiative, ...
How many people are in Medicare and Medicaid?
Today there are over 12 million Americans enrolled in both the Medicare and Medicaid programs. The Financial Alignment Initiative seeks to increase access to high quality, seamless systems of care that better coordinate benefits and services for the dually eligible enrollee population.
What is dual eligible Medicare?
Dual-eligible beneficiaries are Medicare beneficiaries who are also enrolled in the Medicaid program in their state. In certain states, they may receive both types of benefits through private managed care plans. As of January 2019, about 386,000 such individuals were enrolled in both a private Medicare plan known as a dual-eligible special needs ...
What does GAO recommend CMS?
GAO recommends that CMS take steps to obtain quality information on the experiences of dual-eligible beneficiaries who have been default enrolled into D-SNPs. The Department of Health and Human Services concurred with the recommendation.
Medicaid Managed Care Program Map
Find out which health plans serve your area. View the managed care program and plan choices by county on the Medicaid Managed Care Program Map.
Health plan choices
The links below will help you find out more about the health plans that serve your area. Each health plan has a network of providers including primary care providers (PCPs), specialists, hospitals and long term care facilities that you must use. You can find out more information using the plan links below.
Personal Representative Designation Form
You can choose someone else (Authorized Rep) to speak for you and get information about your Medicaid benefits and managed care enrollment. Call us at 1-877-912-8880 (TTY: 1-866-565-8576). Or fax the Personal Representative Designation Form to us at 1-312-596-0249.
What is an MCO in Illinois?
A MCO is essentially a private healthcare company. The MCO has a network of care providers and program participants receive services via these providers. Within several counties of Illinois, there are a few managed care plans from which to choose. The Medicare-Medicaid Alignment Initiative is a mandatory Medicaid program for persons who require ...
How to apply for MMAI in Illinois?
To apply for the MMAI, one must apply for IL Medicaid. This can be done via one’s local Department of Human Services’ Family Community Resource Center (FCRC). One can find their local office here. Alternatively, persons can call the Bureau of Customer Inquiry and Assistance at 1-800-843-6154 to locate one’s local office. A needs assessment will be completed as part of the application process to determine if the nursing home level of care need is met.
What counties are eligible for Medicare in Illinois?
At the time of this writing, one must reside in one of the following 21 counties: Champaign, Christian, Cook, DeWitt, DuPage, Ford, Kane, Kankakee, Knox, Lake, Logan, Macon, McLean, Menard, Peoria, Piatt, Sangamon, Stark, Tazewell, Vermilion, or Will. Please note that this program will be available statewide beginning July 1, 2021. Additional eligibility criteria are as follows, alternatively one can take a quick, non-binding IL Medicaid eligibility test here.
What is the income limit for 2021?
In 2021, an applicant, regardless of marital status, can have a monthly income up to $1,073. When both spouses are applicants, the monthly income limit for the couple is $1,452.
How much can a spouse keep on Medicaid?
In this case, the applicant spouse can retain up to $2,000 in assets and the non-applicant spouse can keep up to $109,560. This larger allocation of assets to the non-applicant spouse is called a community spouse resource allowance. Some assets are not counted towards Medicaid’s asset limit.
Can you consult a medicaid planner?
However, there are some workarounds, and Medicaid planners are aware of them. For these reasons, it is highly suggested one consult a Medicaid planner for assistance in qualifying for Medicaid when over the income and / or asset limit (s). Find a Medicaid planner.
How long does it take to get medicaid?
The Medicaid application process can take up to 3 months, or even longer, from the beginning of the application process through the receipt of the determination letter indicating approval or denial. Generally, it takes one several weeks to complete the application and gather all of the supportive documentation. If the application is not properly completed, or required documentation is missing, the application process will be delayed even further. In most cases, it takes between 45 and 90 days for the Medicaid agency to review and approve or deny one’s application. Based on law, Medicaid offices have up to 45 days to complete this process (up to 90 days for disability applications). However, despite the law, applications are sometimes delayed even further.
Background
- Today there are over 12 million Americans enrolled in both the Medicare and Medicaid programs. The Financial Alignment Initiative seeks to increase access to high quality, seamless systems of care that better coordinate benefits and services for the dually eligible enrollee population.
Initiative Details
- In 2011 CMS announced two new models to support care coordination for the dually eligible individuals through the Financial Alignment Initiative. Through this initiative, CMS is working with States to test two models to integrate primary, acute, behavioral health and long-term services and supports for dually eligible individuals and better align the financing of the Medicare and Me…
Participating States
- When CMS has approved a state proposal for a demonstration under the Financial Alignment Initiative, CMS and a State develop a Memorandum of Understanding (MOU) to establish the parameters of the demonstration prior to implementation. States with an MOU are listed below: 1. California 2. Colorado(ended December 31, 2017) 3. Illinois 4. Massachusetts 5. Michigan 6. Mi…
Additional Information
- Evaluation Reports
1. California First Evaluation Report (PDF) 2. California Preliminary Second Evaluation Report (PDF) | Findings At-a-Glance (PDF) 3. Colorado Combined Years 1-3 Evaluation Report (PDF) | Findings At-a-Glance (PDF) 4. Illinois First Evaluation Report (PDF) 5. Illinois Second Evaluation … - Savings Reports
1. Colorado Preliminary Year 1 Savings Report (PDF) 2. Colorado Preliminary Year 2 Savings Report (PDF)(May 2019) 3. Colorado Concluding Demonstration Year 2 and Demonstration Year 3 Savings Report(PDF) 4. Washington Final Year 1 and Preliminary Year 2 Savings Report (PDF) 5. …