Blue Cross Community OptionsSM
This section of our website includes information on the Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Community ICPSM, or Integrated Care Plan.
The Centers for Medicare & Medicaid Services (CMS) and the State of Illinois have contracted with Blue Cross and Blue Shield of Illinois (BCBSIL) along with 5 other Managed Care Organizations to implement MMAI.
MMAI is a 3-year demonstration plan developed to better serve individuals eligible for both Medicare and Medicaid.
This combines Medicare and Medicaid funding under a blended payment agreement to provide integrated, comprehensive care to benefit dual-eligible enrollees.
BCBSIL is one of 6 health plans in the Greater Chicago area to participate in the demonstration.
BCBSIL will provide services to MMAI members in 6 counties: Lake, DuPage, Kane, Cook, Will and Kankakee.
The Illinois 2011 Medicaid Reform Law requires the Medicaid plan to enroll at least 50% of Medicaid members into coordinated care/managed care by Jan. 1, 2015.
ICP is for seniors and adults, 19 and older, with disabilities and Medicaid only (no Medicare).
BCBSIL will provide services to ICP members who live in Cook County.
Together, MMAI and ICP are designed to improve accessibility and availability of care with a focus on maintaining our members’ independence. Learn more
Individuals may enroll for MMAI and ICP when specific criteria are met. Medicaid Waivers also may apply to MMAI and ICP members who meet all other criteria. According to State regulations, MMAI enrollment is voluntary; ICP enrollment is required for Medicaid members. Learn more
A person centered practice involves primary health care that is relationship-based with a focus on the individual. Coordination by a health care team is critical to help ensure that each member receives all services as needed, according to their health benefit plan. Learn more
To help ensure the health, safety and well-being of vulnerable individuals, it is important to report critical incidents of abuse, neglect and financial exploitation to the appropriate authorities. Learn more
Under the Affordable Care Act (ACA), there will be greater access to Home and Community Based Services (HCBS) through Long Term Services and Supports (LTSS) providers who provide medical and non-medical services to seniors and people with disabilities in need of sustained assistance. Learn more
It is a CMS and State of Illinois requirement for BCBSIL to make available training on certain topics related to MMAI and ICP. Several training modules and other learning opportunities are available and completion of training is mandatory for specified provider types. Learn more