Re: More fun with ICP --NOT

[Guest guest]

:

Will share your story, minus your contact info with my contacts.

I appreciate getting as many stories as possible, so, everyone, please post

experiences with Managed/Integrated Care, good and bad...

Thanks.

Ellen

Ellen Garber Bronfeld

egskb@...

[Guest guest]

Just because someone is in-network with an insurance company, does not mean that

they will participate in every program administered by that insurance company.

If you were a doc in IL, would you want to deal with all this silliness and the

late payments that IL is famous for?

If you were Aetna, would you force all your in-network docs to be available to

this program, and risk them quitting your network?

-Gail

________________________________

From: Yoakam <lyoakam@...>

IPADDUnite

Sent: Tue, May 31, 2011 7:14:59 PM

Subject: More fun with ICP --NOT

This is just more and more frustrating. Today, I found out that some

secondary/backup physicians who Bill has seen that ARE listed with Aetna on

their website are listed because they take the Aetna INSURANCE. NOT this new

ICP stuff. So a physician's name listed on the companies websites is NOT a

guarantee they are in the program, as discussed in the letters I've been

receiving. So company websites are no good.

So I called the help number -- of course she won't talk to me without my faxing

the guardianship papers (SO GLAD I filed for those) and waiting for a call back

from the office sometime tomorrow or the next day before anyone will talk to me

about anything. Instead, she directed me to www.illinoiscebICP.com So the help

phone number is no good.

So I went to www.illinoiscebICP.com NOTHING. First they wanted all Bill's

numbers (SSN and medicaid) on a NONSECURED site (WHAT????) before I could even

search. So I crossed my fingers, listed the numbers, misspelled our family name

as the state has done for 6 years, and was then allowed to search. again

NOTHING in our zip code, NOTHING in our county. I tried multiple searches,

multiple combinations, added, deleted criteria. Always NOTHING!!!! So the ICP

web site is no good.

When I asked Bill's doctor what his advice was since I'm not finding any PCPs in

this town, or the next towns, I was advised " take him to the ER, they'll treat

him there " . So we have to use the ER for routine medical care?? This is

supposed to be cost-savings????????

And now I find I have no card for June -- his card expires today. Is the state

not sending out the old cards for June?

PLEASE HELP!!!!!!!

One very frustrated Mother / guardian / POA

The Arc of Illinois Medicaid Integrated Care Program

Advocacy Toolkit

Announcing The Arc of Illinois Medicaid Managed Care Advocacy Toolkit

The Illinois Department of Healthcare and Family Services (HFS) has now launched

ts Integrated Care Program, requiring enrollment of Medicaid recipients aged 19

nd over who receive SSI and reside in suburban Cook, DuPage, Kankakee, Kane,

ake and Will counties.

Persons who have Medicaid plus private insurance, or Medicaid plus Medicare,

re not eligible.

Individuals required to enroll must select either Aetna Better Health or

lliniCare as their managed care organization or HMO (Health Maintenance

rganization). In order to assist consumers and families to understand this

hange to Medicaid health insurance and make informed decisions, staff of our

amily to Family Health Information Center have prepared a Medicaid Managed Care

dvocacy Toolkit.

This easy-to-use toolkit covers basic information about each HMO and worksheets

o assist in the decision-making process. This toolkit will help enrollees

xplore providers and covered benefits and consider alternatives, including

equesting a Single Case Agreement. Information on appeal rights and possible

ources of advocacy assistance are also included.

The toolkit is available for free download from our website at

nnouncing The Arc of Illinois Medicaid Managed Care Advocacy Toolkit

The Illinois Department of Healthcare and Family Services (HFS) has now launched

ts Integrated Care Program, requiring enrollment of Medicaid recipients aged 19

nd over who receive SSI and reside in suburban Cook, DuPage, Kankakee, Kane,

ake and Will counties.

Persons who have Medicaid plus private insurance, or Medicaid plus Medicare,

re not eligible.

Individuals required to enroll must select either Aetna Better Health or

lliniCare as their managed care organization or HMO (Health Maintenance

rganization). In order to assist consumers and families to understand this

hange to Medicaid health insurance and make informed decisions, staff of our

amily to Family Health Information Center have prepared a Medicaid Managed Care

dvocacy Toolkit.

This easy-to-use toolkit covers basic information about each HMO and worksheets

o assist in the decision-making process. This toolkit will help enrollees

xplore providers and covered benefits and consider alternatives, including

equesting a Single Case Agreement. Information on appeal rights and possible

ources of advocacy assistance are also included.

The toolkit is available for free download from our website at

ttp://www.familyvoicesillinois.org/documents/documentdetails.asp?did=2851

If you have any questions or would like additional information, please call

ur Family to Family Health Information Center at 866-931-1110.

If you have any questions or would like additional information, please call

ur Family to Family Health Information Center at 866-931-1110.

-----------------------------------

[Guest guest]

It depends on the insurance carrier. Blue Cross/Blue Shield has told me if a

doctor is in their network, that doctor is part of all plans. It looks like

there are exceptions to this.

>

> Just because someone is in-network with an insurance company, does not mean

that

> they will participate in every program administered by that insurance company.

>

> If you were a doc in IL, would you want to deal with all this silliness and

the

> late payments that IL is famous for?

>

>

> If you were Aetna, would you force all your in-network docs to be available to

> this program, and risk them quitting your network?

>

>

> -Gail

>

>

>

>

> ________________________________

> From: Yoakam <lyoakam@...>

> IPADDUnite

> Sent: Tue, May 31, 2011 7:14:59 PM

> Subject: More fun with ICP --NOT

>

>

>

> This is just more and more frustrating. Today, I found out that some

> secondary/backup physicians who Bill has seen that ARE listed with Aetna on

> their website are listed because they take the Aetna INSURANCE. NOT this new

> ICP stuff. So a physician's name listed on the companies websites is NOT a

> guarantee they are in the program, as discussed in the letters I've been

> receiving. So company websites are no good.

>

> So I called the help number -- of course she won't talk to me without my

faxing

> the guardianship papers (SO GLAD I filed for those) and waiting for a call

back

> from the office sometime tomorrow or the next day before anyone will talk to

me

> about anything. Instead, she directed me to www.illinoiscebICP.com So the

help

> phone number is no good.

>

> So I went to www.illinoiscebICP.com NOTHING. First they wanted all Bill's

> numbers (SSN and medicaid) on a NONSECURED site (WHAT????) before I could even

> search. So I crossed my fingers, listed the numbers, misspelled our family

name

> as the state has done for 6 years, and was then allowed to search. again

> NOTHING in our zip code, NOTHING in our county. I tried multiple searches,

> multiple combinations, added, deleted criteria. Always NOTHING!!!! So the

ICP

> web site is no good.

>

> When I asked Bill's doctor what his advice was since I'm not finding any PCPs

in

> this town, or the next towns, I was advised " take him to the ER, they'll treat

> him there " . So we have to use the ER for routine medical care?? This is

> supposed to be cost-savings????????

>

> And now I find I have no card for June -- his card expires today. Is the

state

> not sending out the old cards for June?

>

> PLEASE HELP!!!!!!!

>

>

>

> One very frustrated Mother / guardian / POA

>

> The Arc of Illinois Medicaid Integrated Care Program

> Advocacy Toolkit

>

> Announcing The Arc of Illinois Medicaid Managed Care Advocacy Toolkit

> The Illinois Department of Healthcare and Family Services (HFS) has now

launched

>

> ts Integrated Care Program, requiring enrollment of Medicaid recipients aged

19

> nd over who receive SSI and reside in suburban Cook, DuPage, Kankakee, Kane,

> ake and Will counties.

> Persons who have Medicaid plus private insurance, or Medicaid plus Medicare,

> re not eligible.

> Individuals required to enroll must select either Aetna Better Health or

> lliniCare as their managed care organization or HMO (Health Maintenance

> rganization). In order to assist consumers and families to understand this

> hange to Medicaid health insurance and make informed decisions, staff of our

> amily to Family Health Information Center have prepared a Medicaid Managed

Care

> dvocacy Toolkit.

> This easy-to-use toolkit covers basic information about each HMO and

worksheets

> o assist in the decision-making process. This toolkit will help enrollees

> xplore providers and covered benefits and consider alternatives, including

> equesting a Single Case Agreement. Information on appeal rights and possible

> ources of advocacy assistance are also included.

> The toolkit is available for free download from our website at

> nnouncing The Arc of Illinois Medicaid Managed Care Advocacy Toolkit

> The Illinois Department of Healthcare and Family Services (HFS) has now

launched

>

> ts Integrated Care Program, requiring enrollment of Medicaid recipients aged

19

> nd over who receive SSI and reside in suburban Cook, DuPage, Kankakee, Kane,

> ake and Will counties.

> Persons who have Medicaid plus private insurance, or Medicaid plus Medicare,

> re not eligible.

> Individuals required to enroll must select either Aetna Better Health or

> lliniCare as their managed care organization or HMO (Health Maintenance

> rganization). In order to assist consumers and families to understand this

> hange to Medicaid health insurance and make informed decisions, staff of our

> amily to Family Health Information Center have prepared a Medicaid Managed

Care

> dvocacy Toolkit.

> This easy-to-use toolkit covers basic information about each HMO and

worksheets

> o assist in the decision-making process. This toolkit will help enrollees

> xplore providers and covered benefits and consider alternatives, including

> equesting a Single Case Agreement. Information on appeal rights and possible

> ources of advocacy assistance are also included.

> The toolkit is available for free download from our website at

> ttp://www.familyvoicesillinois.org/documents/documentdetails.asp?did=2851

> If you have any questions or would like additional information, please call

> ur Family to Family Health Information Center at 866-931-1110.

>

> If you have any questions or would like additional information, please call

> ur Family to Family Health Information Center at 866-931-1110.

>

> -----------------------------------

>