Health Alliance MAPD for State of Illinois Retirees

Total Retiree Advantage Illinois
We have a rich history of supporting State of Illinois retirees. We are proud to offer our Health Alliance MAPD HMO plan to State, CIP, and TRIP retirees for the 2017 plan year. See our coverage map.

Are you a current State of Illinois employee? Check out your plans

Not a State of Illinois retiree? Check out our other plans


Health Alliance MAPD HMO Plan Details

Medical Benefits

  StateCIP/TRIP
Yearly Out-of-Pocket Max $3,000 $3,000
Deductible $0 $0
PCP $20 $20
Specialist $30 $20
Emergency Room
(Worldwide Coverage)
$75 $75
Urgent Care
(Worldwide Coverage)
$30 $20
Inpatient Hospital $350 $250
Outpatient Surgery $250 $150
Ambulance $0 $0
Laboratory Services $0 $0
Diagnostic Radiology $0 $0
Preventive Services
including Wellness Visit, Pap Smear, Cervical Cancer Screening, and Colorectal Screening*
$0 $0

*See the Benefit Highlights below for a full list of covered preventive services.

Pharmacy Benefits

  StateCIP/TRIP
Deductible $100 $0
Do I Have Coverage Through the Gap? Yes Yes
Initial and Coverage Gap Period
Tier 1 and Tier 2:
Generic, 30-day Supply
$0 at Walgreens
$8 at all other contracted pharmacies
$0 at Walgreens
$10 at all other contracted pharmacies
Tier 3:
Preferred Brand
$26 $20
Tier 4:
Non-Preferred Drug
$50 $40
Tier 5:
Speciality Tier
$50 $40
Retail 90 Benefit Get 90-day supply for 2 X 30-day copayment at Walgreens
2.5 X 30-day copayment at all other contracted pharmacies
Get 90-day supply for 2 X 30-day copayment at Walgreens
2.5 X 30-day copayment at all other contracted pharmacies
Mail-Order Get 90-day supply for 2.5 copayments through mail order Get 90-day supply for 2 copayments through mail order
Catastrophic Coverage
Generics $3.30 or 5%
(whichever is higher; amount capped at $50 for a 30-day supply)
$3.30 or 5%
(whichever is higher; amount capped at $40 for a 30-day supply)
All other drugs $8.25 or 5%
(whichever is higher; amount capped at $50 for a 30-day supply)
$8.25 or 5%
(whichever is higher; amount capped at $40 for a 30-day supply)

NOTE: Annual plan deductible must be met before plan benefits apply.

Plan Extras


Using Your Coverage


Pharmacies and Covered Drugs

Comprehensive Formularies

A complete list of all drugs covered by our plan:

Some covered drugs have rules or limits to when they're covered. See our Pharmacy Coverage Requirements for details.

High Risk Medications

Find high-risk medications for elderly people and alternative treatment options on this list:


Contact Us

The State of Illinois is now using MyBenefits Marketplace as an online enrollment tool. It's designed specifically to streamline your benefit options into a one-stop shop for your insurance needs, which includes learning more about your current benefits, making enrollment decisions, changing your current coverage, and finding contact information for all your plan administrators.

You can also call the MyBenefits Marketplace at 1-844-251-1777 (TTY 1-844-251-1778), Monday through Friday, 8 a.m. to 6 p.m. CST.

Already a Member

1-877-795-6131 (TTY 711)
Daily 8 a.m. to 8 p.m. local time

Voicemail used on holidays and weekends, February 15 to September 30

Email Us

Anytime Nurse Line

1-855-802-4612

Mailing Address

Health Alliance
301 S. Vine St.
Urbana, IL 61801

 
File an Appeal or Grievance

Learn how on our Appeals and Grievances page

Visit Us

Health Alliance Medicare
206 W. Anthony Dr.
Champaign, IL 61822