IlliniCare Health offers health insurance plans with comprehensive healthcare services that suit the needs of families and individuals throughout Illinois.
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).
View some of IlliniCare Health's benefits below. You can also view more information in our Member Handbook.
IlliniCare Health members receive the following behavioral health benefits:
- Substance Abuse Services
- Inpatient Mental Health
- Mental Health Drugs
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 an 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 provider, 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
Children covered by the All Kids Program:
- Exams (checkups)
- Fluoride treatments
- Oral surgery
- Crowns (caps)
- Extractions (pulling)
- Root canals
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.
Click to find a dental provider, call us at 866-329-4701 (TTY: 711).
Preventive 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
IlliniCare Health wants to help you make informed choices and help you stay on top of your child’s health. You can find information on healthy steps to take for your child and how to get a medical card or primary care physician are included in this Health & Wellness For Your Child Packet (PDF). Once your child is signed up in the Medicaid program, he/she will be able to receive EPSDT services.
EPSDT stands for Early and Periodic Screening, Diagnostic and Treatment. It is one of the largest preventive health programs for Medicaid members under 21 years of age. The EPSDT program covers all preventive health wellness visits at no cost to you. The program also covers the cost of early detection and treatment of any problems found during a wellness visit.
Things to Remember
- All EPSDT Services are covered and there is no cost to you
- Maintaining and completing the recommended wellness checkups help you and the doctor make sure your child is growing healthy
- Uncovering any health problems while maintaining wellness checkups allows for treatment in a timely manner to obtain the best possible results
If you need help choosing a doctor or dentist for your child, making an appointment, as well as transportation or translation services, please contact Member Services at 866-329-4701 (TTY: 711). Interpreter services (including sign language) are also available at no cost.
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 (TTY: 711) and say "Nurse".
Through our MemberConnections Community Health Services program, we can help you get the support you need. A MemberConnections Community Health Services 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, health plan benefits, how to receive preventative care and screenings, 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.
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 at 866-329-4701 (TTY: 711). 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. Call 866-329-4701 (TTY: 711).
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 866-329-4701 (TTY: 711).
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 you a full network of vision providers. We offer exams to all of our members. This includes both routine exams and diabetic eye exams. You also have the choice between glasses or contact lenses. You are allowed:
- Vision Exam: preventive eye exam from our network of optometrists and ophthalmologists. You are allowed one vision exam every year.
- Frames: You are allowed one pair of glasses every two years. You can choose from our standard selection of frames. You can also choose to use $100 toward the retail value of frames instead of choosing from our standard line. If the value of the frames is above $100, you must pay for the difference in price out of pocket.
- Lenses: if you meet certain requirements, single vision and bifocal lenses are fully covered. Remember, you can only receive lenses once every two years.
- Contact Lenses: if you choose contacts instead of eye glasses, the fitting fee is fully covered. You can also use an $80 allowance toward the price of your contact lenses. If the value of your lenses is more than $80, you must pay for the difference in price out of pocket.
IlliniCare Health members must use an in-network vision provider. To find a vision provider, call Member Services at 866-329-4701 (TTY: 711).