Our colleague Erin Weir, Manager of Health Care Access at AgeOptions, has just shared
some important information with us about Medicaid Managed Care “passive enrollment”
for adults with disabilities who live in Chicago and have insurance coverage from both
Medicare and Medicaid. (See notice pasted below).
1.What is “passive enrollment”?
Passive enrollment means that HFS first reviews their records for people on Medicaid
who have been sent a letter informing them of the requirement to sign up for a managed
When they find people who have not followed up with the instructions in the letter by the
due date, they then proceed to “auto-enroll” these people in a managed care plan.
They then send out a notice telling people which managed care plan they have been
2.Who are Dual Eligibles?
Dual Eligibles are adults who have health insurance coverage from both Medicare and
3.What is the MMAI?
MMAI stands for Medicare Medicaid Alignment Initiative.
This is a program from the federal government’s Center for Medicare and Medicaid
The Illinois Department of Healthcare and Family Services (HFS) started our state’s
MMAI program in January 2014. More information is available at http://www2.illinois.gov/hfs/PublicInvolvement/cc/mmai/Pages/default.aspx
4.Who is required to enroll in the MMAI?
Adults with disabilities who receive Medicare and Medicaid health insurance plus Social
Security benefits are required to enroll in the MMAI if they live in one of the participating
For a list of counties, programs, and managed care companies, see: http://www2.illinois.gov/hfs/PublicInvolvement/cc/Pages/CareCoordinationExpansion.aspx
5.Who is not required to be enrolled in the MMAI?
Adults with developmental disabilities who also participate in the DHS/DDD Adults with
Developmental Disabilities Waiver (Home-Based, Residential and/or Day Training
options) are not required to enroll.
Here is a fact sheet on the Adults with DD Waiver:
Adults with any disability and/or chronic illness who also have private health insurance
in addition to Medicare and Medicaid.
How can I get more information about the MMAI and adults with developmental disabilities/
See The Arc of Illinois Family to Family Health Information Center’s fact sheet:
Focus on Dual Eligibles with Developmental Disabilities, August 2014
Information for individuals who receive health benefits from both Medicare and