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Phone: (312) 864-8200
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The State of Illinois and Cook County Health & Hospitals System will be operating a new Medicaid program for uninsured adults in Cook County called CountyCare. This is a Medicaid program through the Affordable Care Act (Healthcare Reform). CountyCare will provide coverage for tens of thousands of currently uninsured patients, as Cook County Health and Hospitals System transforms into a patient-centered continuum of care.

The FAQs below supply some basic information about CountyCare.  Please note that you will be able to obtain additional information by calling (312) 864-8200.

What is CountyCare?

Milestone 11

The State of Illinois and Cook County Health & Hospitals System will be operating a new Medicaid program for uninsured adults in Cook County called CountyCare. This is a Medicaid program through the Affordable Care Act (Healthcare Reform).

CountyCare is an Illinois Medicaid benefits program for adults. To be eligible, an individual must live in Cook County, be 19-64 years of age, be a legal immigrant for 5 years or more or a US citizen and have income within the program limits ($16,105 for an individual and $21,707 for a couple). Individuals must also have a Social Security Number or have applied for one. Individuals who are already eligible for Medicaid – children, parents, pregnant women, the aged, blind and disabled – cannot enroll in CountyCare. With CountyCare enrollment individuals will receive medical care from providers in the Cook County Health & Hospital System (CCHHS) and select community providers.

Who is eligible for CountyCare?

To qualify for a CountyCare Medical Card, individuals must:

  • Live in Cook County
  • Be 19-64 years old
  • Have income at or below 133% of the Federal Poverty Level ($16,105 individual, $21,707 couple – annually)
  • Not be eligible for “state Plan” Medicaid (parent, pregnant, blind or receiving disability income)
  • Not be eligible for Medicare
  • Be a legal immigrant for five years or more or a US citizen
  • Have a Social Security number or have applied for one

How can I apply?

CountyCare is enrolling potential members at this time.  Individuals can call (312) 864-8200 to apply by phone between the hours of 8:00AM to 8:00PM,Monday through Friday and 9:00AM to 2:00PM, Saturday. Individuals who apply by phone will provide all application information by phone to application assistance staff who will mail the applicant a signature page and a checklist indicating which verification documents should be returned to application assistors with a signed signature page. CountyCare will submit applications to the state to process.

Individuals may now apply in-person at Stroger Hospital, Provident Hospital and Oak Forest Health Center.
For additional information about applying on-site, please call 312-864-8200.

What documents are required to apply for CountyCare?

Individuals must supply certain documents to verify their identity, address, citizenship or immigration status and all sources of income they receive.

What services are covered?

CountyCare Services
Advanced Practice Nurse services Laboratory and x-ray services
Targeted Case Management Medical supplies, equipment, prostheses and
orthoses, and respiratory equipment and
Emergency Services (includes poststabilization services) Mental Health Services (including rehabilitation and clinic option)
EPSDT (for 19-21 year olds) Nursing Facility Services (30 days) (covers post-hospitalization nursing home stays)
Family planning services and supplies Podiatric Services (for diabetics)
FQHCs, RHCs and other Encounter rate clinic visits Prescription Drugs
Home health agency visits Physical, Occupational, Hearing and Speech Therapy Services
Hospice (and palliative) Physician services
Hospital emergency room visits Sub-acute alcoholism and substance use disorder services
Hospital inpatient services Transportation – to secure Covered Services
Hospital ambulatory services

When does coverage start?

CountyCare expects to have its first members in January 2013.

How do I find out if I am accepted?

Applicants will receive a notice by mail as to whether their application was approved or denied. Approved applicants will receive a medical card in the mail that they should carry with them at all times. They will also receive a packet of information explaining how the CountyCare program works.

Are all Medicaid doctors accepting CountyCare patients?

No, only doctors that are part of the CountyCare network may accept CountyCare patients. When an individual enrolls in CountyCare, they will be asked to select a patient centered medical home site from a list of participating providers. Choices will include Cook County Health & Hospital System sites as well as some other community providers, such as community health centers.

The CountyCare transformation is changing the way that patients enter CCHHS, as they will be assigned intelligently (based on risk, complexity and need) to patient-centered medical homes instead of relying on the emergency department for basic services while waiting for new appointment availability. It is changing the way that care is delivered at the clinic site, as medical home teams built around primary care providers will coordinate all services needed by their own panel of patients, supported by care management and information technology. It is changing the way that services are delivered within the broader system, as emergency, specialty outpatient, diagnostic and inpatient services are reconfigured to assure that the care of patients is coordinated by their medical home and that they are returned there. It is changing the way in which CCHHS works with other providers caring for similar populations, as new partnerships are being developed to assure adequate primary care capacity, geographic accessibility to specialty and inpatient services and connections to services that CCHHS does not provide itself.