Family Health Plan Benefits Overview

IlliniCare Health offers health insurance plans with comprehensive healthcare services that suit the needs of families and individuals throughout Illinois.

View some of IlliniCare Health's benefits below. You can also view more information in our Member Handbook.        

As a Illinois health plan option, IlliniCare Health can help you find a provider, find local resources, plan an appointment and find transportation. Call Member Services at 866-329-4701 (TTY: 711).

Care coordination and disease coaching are part of your health benefits and are provided to you at no cost. IlliniCare Health pays for these services. We provide services for many conditions, such as asthma, diabetes, COPD, high-risk pregnancy and many more. Call Member Services at 866-329-4701 (TTY: 711).

IlliniCare Health is proud to be working with SafeLink Wireless to offer you this special, federal program. As a Member of our plan, you get all the same benefits of a SafeLink phone, plus unlimited inbound text messages and calls to IlliniCare Health member services. There is no added cost for these extras.

How to Enroll:

As a IlliniCare Health Member, you can choose who you see for your healthcare needs from our network of Providers. We have many for you to choose from. If you need help choosing a doctor, call Member Services at 866-329-4701 (TTY: 711).

IlliniCare Health members receive the following dental benefits:

  • Eligible adults (age 21 and over):
  • Limited and comprehensive exams
  • Restorations
  • Dentures
  • Extractions
  • Sedation

Children covered by the All Kids Program:

  • Exams (checkups)
  • Fluoride treatments
  • Cleanings
  • Oral surgery
  • Crowns (caps)
  • Extractions (pulling)
  • Fillings
  • Root canals
  • Sealants
  • X-rays

Eligible pregnant women PRIOR to the birth of their babies:

  • Periodic oral examination
  • Teeth cleaning
  • Periodontal work

All members are covered for emergency dental services.

To find a dental provider, call us at 866-329-4701 (toll-free) / 866-811-2452 (TDD/TTY) or click here.

Preventative care visits are covered by IlliniCare Health. This means visiting the doctor for a regular check-up, rather than waiting until you are sick.

IlliniCare Health covers an annual physical for adults.

Regular child check-ups are also covered for those under the age of 21. These doctor visits should occur at the below ages. Children also need a blood lead test at 12 and 24 months of age. We cover this. After that, if they are high risk, they need the blood lead test each year age 3 to 6.

  • Birth or neonatal exam
  • 2 to 4 days for newborns discharged less than 48 hours after delivery
  • By 1 month
  • 2 months
  • 4 months
  • 6 months
  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • Once per year from 2 years old through 20 years old

Search for a provider in our network.

Our Nurse Advice Line is ready to answer your health questions 24 hours a day – every day of the year. It is staffed with Registered Nurses. These nurses have spent lots of time caring for people. Now they are ready and eager to help you. Call 866-329-4701 and say "Nurse."

Through our MemberConnections program, we can help you get the support you need. A MemberConnections team member can talk to you over the phone. They can also visit your home. They can talk to you about things like how to choose a doctor, plan benefits and living healthy. They can also connect you to community social service programs. These programs will help you with food, housing and clothing.

Start Smart for Your Baby (Start Smart) is our special program for women who are pregnant and for those moms who just had a baby.  We want to help you take care of yourself and your baby every step of the way. If you are pregnant, please let us know by completing a Notification of Pregnancy form. After completing this form you will be enrolled in Start Smart. You will receive information in mail and over the phone. You can also get information in the Health & Wellness section.

Tips for Pregnancy
If you are pregnant or want to become pregnant, keep these things in mind:

  • Go before you show! Go to the doctor as soon as you think you are pregnant. It is important for you and your baby to see a doctor as early as possible. It will keep both of you healthy. It will also help your baby get off to a good start. It is even better to see a doctor before you are pregnant. This is so you can get your body ready for pregnancy.
  • Maintain healthy lifestyle habits. This includes exercising, eating balanced and healthy meals, and resting for 8-10 hours every night.
  • Do not use tobacco, alcohol or drugs now or while you’re pregnant.

Breastfeeding
Doctors and health organizations agree that breastfeeding is best.  You may already know that breast milk is packed with the perfect mix of nutrients your baby needs. Did you know that it is also more than just food?  Breast milk has special ingredients, like antibodies, that only you can provide.  Breast pumps are helpful if you are breastfeeding and have to be away from your baby. Call us after you deliver to see if breast pumps are offered.

Are You Pregnant? Tell Us Right Away!
Call us. Or, you can login to your IlliniCare Health account and fill out the Notification of Pregnancy form.

Interpreter services are provided free of charge to you during any service or grievance process. This includes American Sign Language and real-time oral interpretation.

If you need something translated into a language other than English, please call IlliniCare Health. We can also provide things in other formats such as Braille, CD or large print.

If you need an interpreter for your medical appointment, contact IlliniCare Health 48 hours before your appointment. We will arrange for one to be at your appointment.

Non-emergency transportation services are covered by IlliniCare Health for medically necessary services. IlliniCare Health will also provide an escort, if authorized in advance. To schedule transportation, please call 1-866-329-4701.

IlliniCare Health covers ambulance transportation to the nearest hospital for emergency situations. You do not need to contact IlliniCare Health before using an ambulance for emergencies.

IlliniCare Health offers members vision benefits. We also partner with Chicago Public Schools (CPS) to provide glasses for children in CPS. We offer exams to all of our members. Members have the choice between glasses or contact lenses. You are allowed:

  • Vision Exam: Preventative eye exam from our network of optometrists and ophthalmologists. You are allowed one (1) vision exam every year.
  • Frames: You are eligible for new glasses every two (2) years. You can choose from our standard selection of frames. You can also use an allowance of $100 towards the price of frames instead of choosing from our standard selection. If the value of the frames is more than $100, you must pay for the difference in price out of pocket.
  • Lenses: If certain prescription requirements are met, single vision and bifocal lenses are fully covered.
  • Contact Lenses: If you choose contacts instead of eye glasses, the fitting fee is fully covered. You can also use an $80 allowance towards the price of your contact lenses. If the value of your contact lenses is more than $80, you must pay for the difference in price out of pocket.

You must use an in-network vision provider. To find a vision provider, call us at 866-329-4701 (toll-free) / 866-811-2452 (TDD/TTY) or click here.

Through the CentAccount® program, IlliniCare Health members can earn rewards. These dollar rewards are put onto a personalized CentAccount card. Simply do things that help you stay healthy and you’ll earn rewards! This is not a credit card. It is a card pre-paid by IlliniCare Health!

Getting Started

You can start earning rewards as soon as you become an IlliniCare member! After you complete a healthy action your CentAccount card will be mailed to you. New rewards will be added to your card when you complete other healthy actions.

To check your account balance, call 1-866-809-1091. To see a full list of items you can buy with your CentAccount card, please click here.

Or you can call us at 1-866-329-4701. Once you are in the CentAccount program, you will receive more information on how to earn more rewards.

Earn rewards for specific healthy activities.

Health Risk Screening: Complete a health risk screening and get $10. A health risk screening is mailed within your new member kit. To complete this easy healthy action, you can 1.) Mail the form back with the pre-paid envelope or 2.) Complete it online. Please note: only one health risk screening, or $10 reward, can be earned per person.

PCP Visit: Go to your primary care provider (PCP) one time a year (annual visit) and get $20. You can get $20 every 12 months for visiting your PCP.

Pregnancy Visits: Get up to $45 when you complete prenatal visits. Prenatal visits are visits to the doctor while you are pregnant. Get $20 when you complete one postpartum visit. Postpartum visits are visits to the doctor after you have the baby.

Breast Cancer Screening: Get $25 / year.

Colorectal Cancer Screening: Get $15 / year.

Cervical Cancer Screening: Get $15 /year.

Comprehensive Diabetes Management: If you are diabetic, you can get up to $50 / year by completing the following:

  • Cholesterol Screening.
  • Nephropathy Screening. Nephropathy screening tests you for kidney disease.
  • A1C Screening. A1C screening is a blood test to check your blood sugar levels.
  • Eye Exam

Statin Therapy: If you are diabetic, you can get $10 for taking your diabetic medication (prescribed by your doctor).

ACE/ARB Therapy: If you are diabetic, you can get $10 for taking your diabetic medication (prescribed by your doctor).

Well Child Visits: Receive $10 ($60 max) for a well child visit within the first 15 months of life. Visits recommended at 3-5 days old, before 30 days old, and 2, 4, 6, 9, 12 and 15 months old.

Well child visit within the 3rd, 4th, 5th and 6th year of life are $10 each, up to $40 total.

Antidepressant Medicine Compliance: $10 per refill for 6 refills, up to $60 max per year. Requires a diagnosis of major depression. Get an additional $40 for completing all 6 refills in a row.

Follow-up After Hospitalizations: $25 when you follow-up with a Behavioral Health provider within 7 days of discharge from Behavioral Health facility.

Or you can call us at 1-866-329-4701. Once you are in the CentAccount program, you will receive more information on how to earn more rewards.

CentAccount Catalog - Items that can be purchased with your CentAccount card