When new health and dental plans are added to your Medicaid benefits, Continuity of Care (COC) guidelines are in place to make sure you are covered during the transition to these new plans. COC makes sure that your dental and health services won’t be interrupted when we switch plans. You will be able to see your doctors and fill your prescriptions like normal.
Health and dental plans are required to ensure COC during the transition period for Medicaid recipients. requirements ensure that your services will continue seamlessly when you change:
- From one health plan to another
- From one provider to another
- From one service delivery system to another (i.e., fee-for-service to managed care)
What does continuity of care mean for you?
- Health care providers should not cancel appointments with current patients. Health plans must honor any ongoing treatment that was authorized prior to the recipient’s enrollment into the plan for up to 90 days after the roll-out date in each region.
- Providers will be paid. Providers should continue providing any services that were previously authorized, regardless of whether the provider is participating in the plan’s network. Plans must pay for previously authorized services for up to 90 days after the roll-out date in each region.
- Providers will be paid promptly. During the continuity of care period, plans are required to follow all timely claims payment contractual requirements.
- Prescriptions will be honored. Plans must allow recipients to continue to receive their prescriptions through their current provider, for up to 90 days after the roll-out date in each region, until their prescriptions can be transferred to a provider in the plan’s network.
Protect your coverage. Keep your information current
Don’t lose your Medicaid coverage. When your personal information changes, like your address or phone number, update it with a few simple steps.
Changes are coming to Medicaid in 2027 and we want to make sure you have the information you need.
The Federal government is making changes that may affect some Medicaid customers starting in January 2027. Many customers will not be affected. If these changes apply to you, Illinois Medicaid will contact you before you need to take any action.
Why updating your contact information is important
The most important step you can take right now is to make sure your contact information is up to date. This helps ensure you receive important notices about your coverage.
If you receive mail from the state of Illinois, open it right away. Your Medicaid coverage may depend on it.
Update your information today
Please make sure your address, phone number, and e-mail are current.
To update your information:
Keeping your contact information up to date does not mean your benefits are changing. It simply helps Illinois Medicaid reach you for important updates.
Have questions?
- Your Member Handbook is the best resource to find everything you want to know about your plan in one place.
- Call Member Services at 800-787-3311 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m., Central time