We know how important your family’s health is to you. It’s important to us, too. That’s why we make sure that you have access to the high-quality health care coverage you want, and the extras you need.

Illinois Medicaid plans have a lot in common: 

• All Medicaid plans have the same basic benefits.
• All Medicaid plans have the same drug coverage.

But that doesn’t mean that all Illinois Medicaid plans are created equal. Some, like Humana Healthy Horizons in Illinois, go above and beyond. We provide extra services and perks that make it easier and more rewarding to take care of your health. 

Humana Healthy Horizons in Illinois gives you the care and support you need. That way, you have more time to focus on what you love.

Am I eligible?

You may be able to join Humana Healthy Horizons through the state’s Medicaid contract if you are:

• A child or part of a family that qualified for Medicaid.
• A child who qualifies for the children’s health insurance program also called CHIP.
• An adult who qualifies for Medicaid under the Affordable Care Act, also called the ACA.  This may apply if your monthly income is below the Medicaid income limit.
• Under age 21 and qualify for Medicaid through:
  • Supplemental security income, also called SSI.
  • Division of Specialized Care for Children, also called DSCC.
  • Medicaid due to disability.
• Age 65 or older qualify for Medicaid, and do not have Medicare.
• Age 19 or older, qualify for Medicaid, and have a disability.

There are 2 ways to enroll in HealthChoice Illinois:

• Online: Go to https://enrollhfs.illinois.gov/en/combo-auth opens in new window .
• By phone: Call HealthChoice Illinois at 877-912-8880 (TTY: 866-565-8576). The call is free.

Mandatory enrollment

Once the state determines that you qualify for Medicaid, you must enroll in a Medicaid plan. This is called mandatory enrollment. You can choose the plan you want, or the state will automatically enroll you into a plan.

When you first enroll in a Medicaid Managed Care Plan, you have 90 days to try the plan. During this 90-day period, you can switch for any reason to a new plan. After this 90-day period ends, you cannot change health plans until the next open enrollment period, unless you have an event that allows a change. 

Open Enrollment

You can change your health plan once a year. This time is called Open Enrollment. You do not have to change your plan, but you can if you want to. Client Enrollment Services, or CES, will send you a letter 64 days before your anniversary date. During Open Enrollment, you have 60 days to change your plan. 

To change your plan, call 877-912-8880 (TTY: 866-565-8576). You can only change your plan one time during this 60-day period. After the 60 days are over, you must stay with your plan for 12 months. This is true even if you did not change your plan. If you have questions about joining or leaving Humana Healthy Horizons, call CES at 877-912-8880 (TTY: 866-565-8576).

Starting January 1, 2027, adults in the expansion population ages 19-64 must work or perform other qualifying activities for at least 80 hours a month to maintain their Medicaid coverage. This is called the Medicaid work requirements (also known as community engagement). You will be subject to this requirement unless you qualify for one of the following exceptions: 

• Under age 19
• Entitled to or enrolled in Medicare benefits
• Individuals meeting SNAP or TANF work requirements
• Former foster care children up to age 26
• American Indians
• Disabled individuals as defined by the Americans with Disabilities Act (ADA)
• Veterans with a total disability rating
• Inmates of public institutions

If you qualify for one of these exemptions please contact the state agency at 800-843-6154. For more information visit https://hfs.illinois.gov/medicalclients/medicaidguide/help.html opens in new window .

Disenrollment for cause

If you are a mandatory enrollee and you want to change plans after you are locked in, you must have a state-approved for cause reason. For a list of state-approved for cause reasons, please refer to your Member Handbook

Reinstatement

If you lose your Medicaid benefit, you cannot be enrolled in Humana Healthy Horizons in Illinois. If you get your Medicaid benefit back within 180 days (6 months) of losing your benefit, and you were enrolled in Humana Healthy Horizons in Illinois when you lost your benefit, you will be re-enrolled in our plan. We will let you know in-writing if you are re-enrolled in Humana Healthy Horizons in Illinois.