40 percent of southern IL Medicaid recipients could be without coverage in many area hospitals

SOUTHERN ILLINOIS (KFVS) - Southern Illinois Medicaid recipients might want to consider making sure they are covered by their healthcare provider. According to data from Shawnee Health Services, approximately 40 percent of people on Medicaid in the region could be without coverage after recent changes to Illinois' health insurance policy plans.

According to Sarah Miller, a clinical case manager for Shawnee Health Services, prior to January 1, 2018, the state provided two health insurance plans. One of those plans was Harmony Health, which most southern Illinois hospitals accepted before the state added more health insurance plans. There are now five in total.

Miller says a majority of hospitals in this area chose not to renew their contracts with Harmony Health after more options became available for Medicaid patients. These contracts ended on April 1.

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Miller says this became a huge problem because of the state auto-enrolled Medicaid recipients into Harmony Health at the beginning of the year if they didn't choose a different plan.

"They were looking at the contracts that existed which made it look like harmony was the one primarily being contracted in this area because they were the only ones contracted in this area at that time," she said.

Once the switch was made, it left around 25,000 people covered by Harmony Health. Now, most area hospitals aren't accepting Harmony. Miller says these hospitals will stabilize you in an emergency, but for any specialty or continuing services, they will have to turn to a health care provider who accepts Harmony.

If you are enrolled in Harmony Health and aren't covered by your health care provider, you have until June 30th to call the Illinois Enrollment Broker Line or visit their website to change plans. It is highly recommended that you talk to your healthcare provider first, as you are only allowed to switch your plan one time.

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