Enrollment
Humana Gold Plus® Integrated Medicare-Medicaid is for residents of Illinois who are eligible for Medicare and Medicaid. Enrolling in our plan is risk free.
Humana Gold Plus® Integrated Medicare-Medicaid is for residents of Illinois who are eligible for Medicare and Medicaid. Enrolling in our plan is risk free.
Illinois is checking to make sure you are still eligible for Medicaid coverage. To ensure a review of your Medicaid coverage, please update your information with the state
Everyone’s renewal date is different, so it is critical that you get ready to renew.
You will receive renewal information in the mail about 1 month before your renewal date. Please complete and return it right away.
For help with your renewal, call 800-843-6154.
You are eligible to enroll in Humana Gold Plus Integrated as long as you:
Individuals enrolled in home- and community-based services or waiver, and/or those residing in a nursing facility or long-term care facility, also may be eligible.
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.
To enroll in Humana Gold Plus Integrated:
You can request to end your membership in Humana Gold Plus Integrated at any time.
If you want to go back to getting your Medicare and Medicaid services separately:
If you want to switch to a different Medicare-Medicaid plan:
For more information about when you can end enrollment in Humana Gold Plus Integrated, call:
If you want to keep getting your Medicare and Medicaid benefits together from a single plan, you can join a different Medicare-Medicaid plan.
If you do not want to enroll in a different Medicare-Medicaid plan after you leave Humana Gold Plus Integrated, you will go back to getting your Medicare and Medicaid services separately.
You have 3 options for getting your Medicare services. By choosing 1 of these options, you will automatically end your membership in our plan.
A Medicare health plan, such as a Medicare Advantage plan or Programs of All-inclusive Care for the Elderly (PACE)
or
Original Medicare with a separate Medicare prescription drug plan
or
Original Medicare without a separate Medicare prescription drug plan
NOTE: If you switch to Original Medicare and do not enroll in a separate Medicare prescription drug plan, Medicare may enroll you in a drug plan, unless you tell Medicare you don't want to join.
You should only drop prescription drug coverage if you get drug coverage from an employer, union, or other source. If you have questions about whether you need drug coverage, call your Senior Health Insurance Program at 800-548-9034.
Call Medicare at 800-MEDICARE (633-4227) (TTY: 877-486-2048), 24 hours a day, 7 days a week, to enroll in the new Medicare-only health plan.
If you need help or more information:
You will automatically be disenrolled from Humana Gold Plus Integrated when your new plan's coverage begins.
If you leave Humana Gold Plus Integrated, you will either get your Medicaid services through fee-for-service or be required to enroll in the HealthChoice Illinois Managed Long-Term Services and Supports (MLTSS) program to get your Medicaid services.
If you are in a nursing facility or are enrolled in a home- and community-based service (HCBS) waiver, you will be required to enroll in the HealthChoice Illinois MLTSS program to get your Medicaid services.
To choose a HealthChoice Illinois MLTSS health plan:
If you are not in a nursing facility or enrolled in an HCBS waiver, you will be in Medicaid fee-for-service. This is how you received your Medicaid services before joining our plan. You can see any provider that accepts Medicaid and new patients.
Upon enrollment in a new plan, you will get a new member ID card, Member Handbook, and Provider and Pharmacy Directory from that plan.
If you leave Humana Gold Plus Integrated, it may take time before your membership ends and your new Medicare and Medicaid coverage begins. During this time, you will keep getting your healthcare and drugs through our plan.
Under certain circumstances, Humana Gold Plus Integrated can ask Illinois Client Enrollment Services to disenroll you from our health plan. This is called “disenrollment for cause.” We can ask that you be disenrolled for cause for the following reasons:
If you feel that you are being asked to leave our plan for a health-related reason, call:
We may, however, submit a written request, accompanied by supporting documentation, to the department and CMS to disenroll a member, for cause, if:
The member’s continued enrollment seriously impairs the contractor’s ability to furnish covered services to either this member or other members, provided the member’s behavior is determined to be unrelated to an adverse change in the member’s health status, or because of the member’s utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resulting from his or her special needs.
If we end your membership in our plan, we must tell you our reasons in writing for ending your membership. We must also explain how you can make a complaint about our decision to end your membership.
For more information about ending your enrollment:
Please note that our automated phone system may answer your call during weekends and holidays. You may leave your name and telephone number, and we’ll call you back by the end of the next business day.
Please note that Humana Gold Plus Integrated may terminate or not renew our contract or reduce our service areas. We will notify members of any changes to our contract or service area at least 30 days in advance of the change.