HealthChoice Illinois (HCI), the state's mandatory statewide Medicaid managed care program, is administered by HFS. Per CMS's most recent managed care enrollment data, report year 2024, Illinois's managed care programs covered approximately 2.6 million members. A second, smaller integrated-care track covers full dual eligibles through a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP) model, a federally required CMS structure.
HCI is mandatory in all 102 counties, delivered by five MCOs: Aetna Better Health of Illinois, Blue Cross Community Health Plans, Meridian Health Plan of Illinois (a Centene company), Molina Healthcare of Illinois, and CountyCare Health Plan (a Cook County-only safety-net plan affiliated with the county health system). YouthCare, operated by Meridian/Centene, is a separate statewide specialty plan for DCFS youth and former youth in care. HCI covers a comprehensive benefit package for most enrollees; the MLTSS (dual-eligible LTSS) population receives a narrower carve of benefits from their HCI plan since Medicare remains primary for most of their care. HFS has announced its intent to award new HCI contracts to the five incumbent MCOs plus Humana as a new entrant, effective January 1, 2027; the current MCO lineup remains in effect until then.
For Medicaid-only LTSS beneficiaries, long-term services and supports are integrated directly into their regular HealthChoice Illinois MCO plan. For dual-eligible members, LTSS is instead delivered through a distinct MLTSS plan choice, separate from their Medicare coverage; most duals who want fully integrated Medicare-Medicaid coverage instead enroll in a FIDE SNP covering LTSS, Medicare, and Medicaid benefits through one plan, offered statewide by four carriers: Aetna Medicare FIDE, Humana Dual Fully Integrated, Molina Medicare Complete Care Plus, and Wellcare Meridian Dual Align. Effective January 1, 2027, CountyCare and Blue Cross Blue Shield will no longer be MLTSS plan options; members in those two plans must select a new MLTSS plan by December 31, 2026.
Partially integrated into managed care
Behavioral health is carved into HCI: it's part of each MCO's comprehensive benefit package for full-benefit (non-MLTSS) enrollees, not managed by a separate statewide behavioral health organization. Certain state-funded substance use disorder services that fall outside the Medicaid benefit continue to be administered separately by DHS's Substance Use Prevention and Recovery (SUPR) division, distinct from HFS's Medicaid MCO contracts.
Carved in
Dental is not carved out to a single statewide vendor. Fee-for-service dental claims are administered through DentaQuest, HFS's FFS dental benefit administrator. The large majority of members are in HCI managed care, where dental is a covered in-plan benefit delivered through each MCO's own subcontracted dental network rather than through DentaQuest.
Pharmacy is carved in to managed care (each MCO processes and pays its own members' pharmacy claims), but all plans, including fee-for-service, are required to follow one Uniform Preferred Drug List (UPDL), which Illinois adopted effective January 2020 to standardize coverage across MCOs. MCOs may layer their own additional prior authorization and utilization management on top of the shared PDL.
Non-emergency medical transportation is not administered by a single statewide broker. For fee-for-service members, Transdev administers prior authorization only under the NETSPAP program; enrolled transportation providers bill HFS directly. Each HCI MCO separately contracts its own transportation broker for its own enrollees (ModivCare, MTM, or First Transit, depending on the plan).
Providers enroll and revalidate through IMPACT, HFS's provider enrollment system. Eligibility verification and claims-related lookups run through MEDI (Medical Electronic Data Interchange), distinct from each MCO's own portal.
Last updated: Sep 22, 2026
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