What you need to know about Medicaid
Changes to Medicaid are coming in 2027. We can help you understand what to expect.
What you need to know about Medicaid
Changes to Medicaid are coming in 2027. We can help you understand what to expect.
Take steps now to help protect your coverage
Beginning in 2027, some Medicaid members may be asked to complete additional eligibility reviews, provide updated information or meet new requirements to keep their coverage. If any action is needed, your state Medicaid agency will contact you directly with instructions.
Expected changes include:
- New work and community engagement requirements for some adults ages 19-64, with exemptions for certain individuals, including those with disabilities or medical frailty. Understanding whether you qualify for an exemption can help you protect your coverage.
- More frequent eligibility reviews, with some Medicaid members required to verify eligibility every six months instead of annually.
- Additional documentation or verification requirements from state Medicaid agencies.
Some patients may lose Medicaid coverage if they miss renewal deadlines or do not respond to requests from their state.
What you can do now
These changes are expected to begin in 2027, so now is the time to stay informed, keep your information up to date, and know where to turn for help.
- Keep your contact information current Make sure Medicaid has your current mailing address, phone number, and email address.
- Watch for important notices Pay attention to mail, email, text messages, and other communications from Medicaid.
- Respond quickly If your state Medicaid agency asks for information or documentation, respond as soon as possible to avoid delays or interruptions in coverage.
- Ask for help if needed If you have questions about your Medicaid coverage or need help understanding next steps, resources are available to assist you.
What if I no longer qualify for Medicaid?
If you’re no longer eligible to receive Medicaid coverage, you can select a health plan through the Affordable Care Act’s Health Insurance Marketplace®. Learn more about the Marketplace at healthcare.gov.
These are the health insurance plans offered through the health care marketplace that include Advocate Health Care:
- Molina Healthcare
- Oscar Health
- BlueCare Direct℠, offered by Blue Cross Blue Shield of Illinois
- UnitedHealthcare
When you choose a plan that’s part of our network, you can continue getting care with Advocate – including seeing the doctors you know and trust. Take time to compare your options and make sure to choose a plan that includes Advocate Health Care doctors and hospitals.
Our financial advocates can help
If you have questions about Medicaid changes, call 800-888-3081.
If you have questions about Marketplace enrollment, our certified application counselors can help. Call 877-732-6334.
How do I apply for Medicaid?
You have flexible options when applying for Medicaid. Choose the method that works best for you.
Online
Visit Application for Benefits Eligibility (ABE).
If applying for the first time, select “Apply for Benefits.”
If reapplying or updating contact information, select “Manage My Case” and log in.
By phone
Call toll-free 800-843-6154 (TTY: 800-447-6404).
In person
Visit your local DHS Family Community Resource Center (FCRC). To find the FCRC for your county or ZIP code, use the DHS office locator or call 800-843-6154 (TTY: 800-447-6404). The call is free.
Need more help?
Contact your state Medicaid agency to update your information or learn more about your coverage requirements. Learn more at Medicaid.gov.
Frequently asked questions about Medicaid renewals
Advocate Health Care is included in these Medicaid health insurance plans:
- Aetna Better Health
- Blue Cross Blue Shield
- CountyCare
- YouthCare Health Choice Illinois*
- Meridian
- Molina Healthcare
* Not all plans are available in every county within the area. Please check your individual plan to confirm benefits and in-network providers.
- If you move or change your address
- If you are pregnant or your household size has changed
- If you have a new job or change in income
You can report changes to your caseworker through ABE.illinois.gov.
If there have been no changes to your personal information, you don’t need to do anything.
When you enroll in a health plan, you can change your health plan once for any reason within 90 days of initial enrollment. After that, you can change your health plan:
- At your Medicaid renewal date
- If you’re required to change health plans
- If you have a special or “with cause” reason, such as:
- You moved out of your health plan’s service area.
- You have a family member in a different health plan.
- You cannot get all the related services you need from providers in your health plan, and there is a risk to getting the services separately.
- A different health plan may be better for your complex medical conditions.
- Your Long-Term Services and Supports (LTSS) provider is not in your health plan.
- Your health plan does not cover a service you need for moral or religious reasons.
You can change your health plan at any time for these reasons:
- You need services to address a mental health disorder, substance use disorder, intellectual/developmental disability (I/DD) or traumatic brain injury (TBI).
- You are a federally recognized tribal member or qualify for services through Indian Health Service (IHS).
To change your primary care provider within your current health plan’s provider network, please contact your health plan.