Frequently Asked Questions
- What is a medical home and why is it good to have one?
- What is a PCP (Primary Care Provider)?
- What is Healthy Kids?
- Who must enroll?
- Can I keep the doctor I have?
- Can a specialist be my doctor?
- Will I lose any services?
- Who do I call if I have a problem with my doctor and/or health plan?
- What if I want to stay in my current health plan?
- What happens if I don't enroll?
- How will I get medical services?
- Can I change health plans?
- Can I change my doctor?
- When can I start making appointments with my doctor?
- What if I have more questions?
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What is a medical home and why is it good to have one?
Your medical home is the doctor’s office or clinic where you go to see your Primary Care Provider (PCP). Having a medical home means:
- All your medical records are kept there in one place
- Your primary care provider gets to know you well
- You get better health care because your personal doctor knows all of your health care needs
- You and your family get the top quality health care you need to stay healthy
- Even if you are healthy and never get sick, it is good to have a medical home
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What is a PCP (Primary Care Provider)?
Your Primary Care Provider (PCP) is your family doctor, nurse or other health care provider at your medical home who takes care of you and your family. Your doctor will:
- Take care of you when you are sick or need medical attention.
- Give your children regular check-ups and immunizations (shots) to stay well.
- Help you manage diseases and other conditions like diabetes, high blood pressure, and asthma.
- Send you to specialists or other health care providers when you need to go. This is called a referral.
- Answer questions you have about your health care.
- Give you the information you need to stay healthy.
- Work with you to get the health care you need.
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What is Healthy Kids?
Healthy Kids is Illinois’ EPSDT (Early and Periodic, Screening, Diagnosis and Treatment) Program. It is a free health care program for babies, kids, teens, and young adults through age 20 who use the HFS Medical Card. Learn more about the Healthy Kids program.
If your doctor finds a problem during a Healthy Kids exam, he or she can send you to a specialist.
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Who must enroll?
Most people with an HFS or All Kids Medical Card must join. To find out more, read the page about who must enroll or call the ICEB Helpline at 1-877-912-8880 (TTY: 1-866-565-8576). The call is free.
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Can I keep the doctor I have?
Yes. If your current doctor is in Illinois Health Connect, Harmony Health Plan, Family Health Network or Meridian Health Plan, you may pick them for your PCP.
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Can a specialist be my doctor and/or health plan?
Yes. In some cases, a specialist may be a PCP. You can discuss this with the Customer Service Representative at the ICEB Helpline by calling 1-877-912-8880 (TTY: 1-866-565-8576). The call is free.
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Will I lose any services?
No. You will not lose any of the services you currently receive with your HFS or All Kids medical card. Some health plans may offer additional benefits and reduced co-pays.
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Who do I call if I have a problem with my doctor or health plan?
If you have a problem with your healthplan or doctor contact your health plan. If the situation cannot be resolved, call the ICEB Helpline at 1-877-912-8880 (TTY: 1-866-565-8576). The call is free.
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What if I want to stay in my current health plan?
If you are currently enrolled in Illinois Health Connect-(available in all counties), Family Health Network-(available in Cook County only) or Harmony Health Plan-(available in Cook, Jackson, Kane, Madison, Perry, Randolph, St. Clair, Washington and Williamson County), Meridian Health Plan-(available in Adams, Brown, Henry, Mercer, Perry, Pike and Rock Island County) and you do not want to make a change, you do not need to do anything. You will stay enrolled with your current health plan and doctor. You don’t have to change.
If you are not in any of these plans, you must enroll in one. If you are not sure if you are enrolled in any of the health plans, call the ICEB Helpline at 1-877-912-8880 (TTY: 1-866-565-8576). The call is free.
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What happens if I don't enroll?
If you do not enroll, a health plan and PCP will be selected for you.
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How will I get medical services?
When you or a family member needs medical help, you will first call your doctor for an appointment. If needed, your doctor will refer you to a specialist for additional services.
If you have an emergency, you should go to the closest Emergency Room or call 911 (if available in your area). You may go to any Emergency Room. You do not need to ask your doctor.
An emergency is a health problem that is life threatening or one that will seriously hurt your health if not treated right away. Only go to the Emergency Room if your problem is serious. If it is not serious, make an appointment to see your doctor.
Here are some emergencies:
- Chest Pains
- High Fever
- Bleeding that Won't Stop
- Passing Out
- Seizures
- A Broken Bone
- Trouble Breathing
- Serious Burns
- Serious Stomach Pains
- Damage to the Eyes
- Any Medical Problem You Think is Serious
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Can I change health plans?
Yes, you can change health plans, for any reason, once a month. If you want to change your health plan, call the ICEB Helpline at 1-877-912-8880 (TTY: 1-866-565-8576). The call is free.
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Can I change my doctor?
Yes, you can change doctors, for any reason, once a month. If you want to change doctors, call your health plan.
- Family Health Network - 1-888-346-4968
- Harmony Health Plan – 1-800-684-3925, ext. 2101
- Illinois Health Connect – 1-877-912-1999
- Meridian Health Plan - 1-866-606-3700
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When can I start making appointments with my doctor?
After you enroll, you will receive confirmation from your health plan. At that time you can begin making appointments to see your doctor.
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What if I have more questions?
If you have questions or need more information, you can call the ICEB Helpline at 1-877-912-8880 (TTY: 1-866-565-8576). The call is free.
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