Gold Plus Integrated

What is it? Do I qualify? Why join? Can I opt out?

Humana Gold Plus Integrated is a plan that allows you to get both Medicare and Medicaid benefits under one plan. Our goal is to help you achieve your best health.

What are Medicare and Medicaid?

Medicare

Medicare is the federal health insurance program for:

  • people 65 years of age or older
  • some people under age 65 with certain disabilities
  • people with end-stage renal disease (kidney failure).

Medicaid

Medicaid is a program run by the federal and state governments that helps people with limited income pay for medical costs and if qualified Long Term Services and Supports such as nursing homes and home and community based waiver services. It covers some extra services and drugs that Medicare doesn’t pay for. Each state decides what counts as income and who qualifies for Medicaid. States also decide what services are covered and how much they cost.

You can get Medicare and Medicaid services through Humana as long as:

  • Humana continues to offer the plan
  • Medicare and the State approve the plan

Even if our plan stops operating in the future, your eligibility for Medicare and Medicaid would not be affected.

How is this plan different than what I have now?

This plan combines your Medicare and Medicaid services and even includes coverage for prescription drugs. You get all of this at no extra costs through Humana's Gold Plus Integrated Plan.

Some of the advantages include:

  • You get all the coverage of original Medicare, plus extra benefits like rides to medical appointments, and added vision, hearing, and dental coverage.
  • You get a care team that you help put together. Your care team may include doctors, nurses, counselors, or other health professionals who are there to help you get the care you need.
  • You get a care manager. This is a person who works with you and your care providers to make sure you get the care you need. For example:
    1. Your care team will make sure your doctors know about all medicines you take so they can reduce any side effects.
    2. Your care team will make sure your test results are shared with all your doctors and other providers.

Is there any risk to joining the plan?

Joining is risk free. You can go back to your original Medicare/Medicaid plan, switch to another carrier, or even opt-out completely. You have the power to choose.

What makes you eligible to be a plan member?

You are eligible for our plan as long as:

  • You live in our service area
  • You are eligible for Medicare Part A and enrolled in Medicare Parts B & D, and
  • You are receiving full Medicaid, and you are at least 21 years of age or older at the time of enrollment. This includes those enrolled in Home and Community Based Services or Waiver and those residing in a Nursing Facilities (NF) or Long Term Care Facility (LTC).

How do I enroll?

Enrollment in Humana Gold Plus Integrated, is done through Illinois Client Enrollment Services. To see if you are eligible, call the Illinois Client Enrollment Services HelpLine, at 1-877-912-8880 Monday through Friday 8a.m. to 7p.m. (CST) and Saturdays 9a.m. to 3p.m. (CST) (TTY: 1-866-565-8576). The call is free.

To visit the enrollment broker website, click here (link opens in new window)