IlliniCare Health - MMAI is a 2019 MMP Medicare Advantage plan, from IlliniCare Health, that's available in Kane County, Illinois. This is a Medicare-Medicaid plan, with prescription drug coverage, for people with both Medicare and Medicaid benefits (dual-eligible). It gives you all of the same health insurance benefits as Original Medicare. However, the Medicare out-of-pocket costs are covered by Medicaid.
A Medicare Advantage Medicare-Medicaid Plan (MMP), aka, Medi-Medi plan, is a private health plan designed to provide integrated and coordinated Medicare and Medicaid benefits for dual-eligible Medicare beneficiaries. Nearly all MMPs are Health Maintenance Organization (HMO) plans. However, these plans can also be setup as an HMO-POS (point of sale) plan with costs assigned to supplemental benefits.
Unlike a Special Needs Plan (D-SNP), MMPs only serve full benefit dual-eligible beneficiaries. Plus, some additional limitations may apply, such as state-specific requirements.
Contact the Illinois Medicaid office for more details or to see if you qualify.
These are the areas of the plan that are important to compare and review:
- Premium: This is the amount you will pay monthly, above and beyond your Medicare Part B.
- Maximum-Out-Of-Pocket (MOOP): This is the most you will pay for co-pays and co-insurance before the plan pays 100%.
- CMS Ratings: Important measurements across 9 different areas that will help you understand how well this plan will care for you.
- Prescription Coverage: Medications are expensive, so you'll want to know how this plan covers your prescriptions.
- Co-pays & Co-insurance: If you see the doctor regularly, including specialists, you need to know what you'll pay for each visit.
How Much Does IlliniCare Health - MMAI Cost?
With the IlliniCare Health - MMAI Medicare-Medicaid Plan there are no additional premiums (beyond your Medicare Part B premium paid through Social Security) and there are no deductibles. That includes your prescription drugs, as well. Plus, Medicare co-payments and/or co-insurances are paid for you through Medicaid.
What is the Maximum Out-of-Pocket (MOOP) Limit?
Because MMPs must provide all Medicare Parts A and B services at $0 cost sharing to enrollees, Medicare's maximum out-of-pocket figure does not apply to these plans.
IlliniCare Health - MMAI is a new plan for 2019. As such it has not been rated by CMS.
NOTE: Many new plans enter the market with low premiums and low co-pays. Remember, it's important to evaluate plans every year. This is particularly true with new plans.
Does IlliniCare Health - MMAI include Medicare Part D?
This plan includes prescription drug coverage (Medicare Part D). If you have regular prescriptions, it's critical that you evaluate your costs using the plan's formulary.
In addition to the monthly premium and Part D deductible, the drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the drug coverage schedule for this plan:
|1 (Generic Drugs)||$0.00 copay|
|2 (Brand Drugs)||$0.00 copay|
|3 (Non-Medicare Rx/OTC Drugs)||$0.00 copay|
How Much are the Copays & Co-Insurance?
In this Summary of Benefits section we outline high-level information about the plan's co-payment and co-insurance costs for inpatient, outpatient, preventive care, transportation and other healthcare services.
IlliniCare Health - MMAI vs. Medigap
To compare IlliniCare Health - MMAI with a Medigap plan (Medicare supplemental insurance), you need to evaluate your healthcare and financial needs. Look at the total potential cost with each plan type, not just the monthly premium, and choose how you want to use medical care (locally or nationally).
To help you make a better decision, we created our How-to Choose the Best Medicare Plan guide (opens in a new tab). It will help you understand how to compare IlliniCare Health - MMAI with Medicare Supplement plans in Illinois. Medicare Plan F in Illinois is the most popular.
Contact IlliniCare Health
For more information about this plan, call their prospective members line, or visit their website:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov or the Wikipedia page.
Medicare Part C Plan Availability
IlliniCare Health - MMAI is available to beneficiaries living in Burlington, Carpentersville, Dundee, Elburn, Elgin, Geneva, Gilberts, Hampshire, Kaneville, Lafox, Maple Park, Plato Center, Saint Charles, South Elgin, Wasco, Aurora, Batavia, Big Rock, Mooseheart, North Aurora, Sugar Grove, and all other areas of Kane County, Illinois; Medicare plans are the same throughout the County.
The Medicare Advantage plan data on MedicareWire comes directly from CMS.gov and is subject to change. CMS has neither reviewed nor endorsed the information on this site.
The health insurance benefit information provided on this page is a brief summary only, not a complete description. Limitations, co-payments, and restrictions may apply. For more information contact the plan directly at (877)941-0482 or (711)- for TTY users.
The MedicareWire website is available for educational purposes. Our goal is to present information accurately and without bias, based on our interpretation of factual information. However, this site is not intended as a substitute for legal, health, or financial advice from a licensed professional. On this page we help consumers research and compare:
IlliniCare Health - MMAI for Kane County, Illinois is a 2019 Medicare Advantage Plan (MMP H0281-001), with a $0.00/mo premium and N/A max out-of-pocket limit. Compare star ratings, benefits, premiums, co-pays, deductibles and prescription coverage with other Part C plans.
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This Medicare Advantage plan information is maintained by David Bynon and was last updated on .