To change your Medicaid plan in Illinois, call Illinois Client Enrollment Services at 1-877-912-8880 or use the state’s enrollment portal at EnrollHFS.Illinois.gov. You can switch during your annual open enrollment window (tied to your personal anniversary date, not a fixed calendar month), within the first 90 days of a new enrollment, or any time you have a qualifying reason such as moving out of your plan’s service area.1HealthChoice Illinois. Contact Us
When You’re Allowed to Switch
Your Annual Anniversary Window
HealthChoice Illinois doesn’t use a shared open enrollment month the way the ACA Marketplace does. Your window is tied to your own enrollment anniversary. The Department of Healthcare and Family Services mails you a notice about two months before that date reminding you to review your options.2HealthChoice Illinois. Managed Care A plan change made during this window takes effect on your anniversary date.3Illinois Department of Healthcare and Family Services. Sample Open Enrollment Notice for HealthChoice Illinois
The First 90 Days After You Enroll
If you’ve just been enrolled in a HealthChoice Illinois plan, federal law gives you 90 days to switch to a different plan without needing a reason. The clock starts on your enrollment date or the date the state sends you notice of your enrollment, whichever is later.4eCFR. 42 CFR 438.56 – Disenrollment Requirements and Limitations This is the window to test whether a plan’s provider network actually works for you before you’re locked in for the rest of the year.
For-Cause Changes Any Time
You don’t have to wait if you have a qualifying reason. Federal regulations allow disenrollment at any point for causes that include:
- Moving to a county your plan doesn’t cover.
- Lack of access to covered services within a reasonable distance or timeframe.
- Poor quality of care.
- For enrollees receiving long-term services and supports, your residential or employment supports provider leaving the plan’s network.
- Your plan declining to cover a service on moral or religious grounds.
Any of these lets you request a change regardless of where you are in your enrollment year.4eCFR. 42 CFR 438.56 – Disenrollment Requirements and Limitations
What to Check Before You Switch
The plans available depend on where you live. Compare the options for your county at EnrollHFS.Illinois.gov, which lets you view plans side by side.2HealthChoice Illinois. Managed Care Every plan covers the same core Medicaid benefits, but they differ in which doctors and hospitals are in-network, how prescription drugs are handled, and what extras they offer.
Look up your current primary care doctor and any specialists in each plan’s provider directory before you commit. If a doctor you want to keep isn’t in the new plan’s network, switching means finding a replacement or paying out of pocket after the transition period ends.
Check prescription coverage too. Plans use different formularies, so a medication filled for free under one plan might require prior authorization or a higher cost-share under another. Verifying coverage ahead of time prevents a surprise at the pharmacy counter.
Before you call or log in, have your Medicaid Recipient Identification Number (RIN), your current plan name, your full name, date of birth, and current address ready.
How to Make the Change
Online
The fastest route is the HealthChoice Illinois enrollment portal at EnrollHFS.Illinois.gov. Log in or create an account, go to the enrollment section, pick your new plan, and confirm.
By Phone
Call Illinois Client Enrollment Services at 1-877-912-8880 (TTY: 1-866-565-8576), Monday through Friday, 8:00 a.m. to 6:00 p.m. An enrollment counselor will compare plans with you and process the change.1HealthChoice Illinois. Contact Us
Either way, you should receive a confirmation notice and a welcome packet from your new plan.
When the Change Takes Effect
Timing depends on why you switched. Changes made during your anniversary open enrollment take effect on your anniversary date. Changes made during the 90-day new enrollee window or for cause generally become effective the first day of the following month.
Keeping Your Current Doctors During the Transition
Illinois builds in a 90-day continuity-of-care period. When you join a new HealthChoice Illinois plan, you can keep seeing your current providers for up to 90 days even if they aren’t in the new plan’s network. The new plan pays those out-of-network providers at the state’s Medicaid fee-for-service rate during that time.5Illinois Department of Healthcare and Family Services. HealthChoice Illinois Frequently Asked Questions
This covers all provider types, including behavioral health and long-term services and supports. If you’re in the middle of an ongoing course of treatment with a specialist, the new plan may extend access beyond 90 days on a case-by-case basis until a qualified in-network provider is available. Treat it as a bridge: use those 90 days to establish care with in-network providers so coverage doesn’t lapse when the transition ends.
If You Don’t Choose a Plan
New Medicaid enrollees who don’t actively pick a plan during their initial 60-day voluntary enrollment period are auto-assigned by the Illinois Client Enrollment Broker. The algorithm uses factors like your location and health needs to match you to a plan and primary care provider.6Illinois Department of Healthcare and Family Services. Client Enrollment Auto-Assignment for ACEs and CCEs If the assigned plan isn’t a good fit, you still have your 90-day window to switch.
During open enrollment, ignoring the HFS letter typically means staying in your current plan. The plans available in your county can change from year to year, so it’s worth reviewing the notice even if you expect to stay put.