Questions about Medicaid in Illinois
May 11, 2016 12:44 AM   Subscribe

I'd love to hear what it's like to be moved from private health insurance to medicaid in Illinois.

I have two serious health maladies that need periodic attention by physicians. Is it realistic that I could be successfully treated by an Illinois doctor who accepts Illinois Medicaid?

I currently take four medications, all of which will potentially cause my death if I suddenly cease taking them. I currently have a generous benefactor who pays an extreme monthly amount for my private health insurance. Needless to say, this could end at any time, in which case I'd be forced to enroll in IL Medicaid.

I get the impression that Medicaid in IL is a scam - an excuse. Sure you have full health coverage! However it's not the state's fault if they pay so little that you can't find a doctor with a consistent appt. schedule.

Also, as I said, I currently have private insurance. Do any of you know if I can "try out" Medicaid in IL to see if it's acceptable treatment? And if it's not, then I can stick to my current private insurance plan? What if I lose the private insurance plan? I most likely will, and I don't like not knowing what to expect. I'm very frightened.

Many thanks in advance.

posted by InsertNiftyNameHere to Health & Fitness (3 answers total)
The #1 question is whether your current doctor will keep you on. We had All Kids + the adult extension for awhile and had a good experience. However, we didn't have any unusual condition to deal with besides diabetes.

And yes, you can sign up now although your current insurance will apply first.
posted by michaelh at 2:41 AM on May 11, 2016

Thanks for the reply, michaelh. The answer to that is a firm no. In fact, I don't know of a single doctor (and I have been to see many) who accepts patients on IL medicaid.

Doctors who accept medicaid patients in IL seem to be mythical creatures that can be found online, but never IRL.

I'm bummed there aren't more responses. I swear I've seen Mefites mention using medicaid in IL.
posted by InsertNiftyNameHere at 6:56 PM on May 11, 2016

I wouldn't call Illinois Medicaid a "scam". But it's pretty fractured. To my understanding, there's no longer plain-old one-size-fits all "Medicaid" as it's all been farmed out to private insurance providers and you have to enroll with one of the private plans available in your area, and then work with doctors who are on that plan, and the doctors who take one IL medicaid plan may not take another. It's not bad for routine things, and for specialists probably OK Chicago. But even in the mid-sized cities/towns the specialist network can get thin.

I would suggest you do your due diligence and look at the plans available in your county of residence and then look at the specific plans and see what doctors are available in their network, what medications are on their formulary, etc. You're probably not going to be able to determine the more qualitative aspects of care such as "do these doctors have regular appointments."

This experience is based on helping my brother, who is disabled, navigate the system. He has not had problems with routine medical, diabetes management, or mental health stuff. His primary care physician is terrific, IMHO. But he ran into a major problem when he broke his leg and discovered that the big integrated main provider of orthopedic services in the county doesn't take his particular medicaid plan. The closest providers were in other towns at least 30 minutes away and he doesn't drive... If he'd been on one of the other two medicaid plans available in his county, he'd have been fine.
posted by drlith at 6:24 AM on May 12, 2016

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