Health Alliance MAPD for State of Illinois Retirees
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 2019 plan year. See our coverage map.
Are you a current State of Illinois employee? Check out your plans
Plan Details
Medical Benefits
| State | CIP/TRIP | |
|---|---|---|
| Out-of-Pocket Maximum | $3,000 | $3,000 |
| Deductible | $0 | $0 |
| PCP | $20 | $20 |
| Specialist | $30 | $20 |
| Emergency Room Worldwide coverage |
$120 | $120 |
| Urgent Care Worldwide coverage |
$30 | $20 |
| Inpatient Hospital Care | $350 | $250 |
| Outpatient Surgery | $250 | $150 |
| Ambulance | $0 | $0 |
| Laboratory Services | $0 | $0 |
| Diagnostic Radiology | $0 | $0 |
| Preventive Services including wellness visits, Pap smears, cervical cancer screenings, and colorectal screenings |
$0 | $0 |
| State Benefit Highlight | CIP/TRIP Benefit Highlight |
Pharmacy Benefits
| State | CIP/TRIP | |
|---|---|---|
| Rx 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 preferred pharmacies $8 at other network pharmacies |
$0 at preferred pharmacies $10 at other network pharmacies |
| Tier 3 Preferred Brand, 30-day supply |
$26 | $20 |
| Tier 4 Non-Preferred Drug, 30-day supply |
$50 | $40 |
| Tier 5 Speciality Tier, 30-day supply |
$50 | $40 |
| Retail 60 and 90 Benefit | 2 copays at preferred pharmacies for 60 and 90 days; 2 copays for 60 days and 2.5 copays for 90 days at other contracted pharmacies | 2 copays at preferred pharmacies for 60 and 90 days; 2 copays for 60 days and 3 copays for 90 days at other contracted pharmacies |
| Catastrophic Coverage | ||
| Generics | $3.35 or 5% Whichever is higher. Amount is capped at $50 for a 30-day supply. |
$3.35 or 5% Whichever is higher. Amount is capped at $40 for a 30-day supply. |
| All Other Drugs | $8.35 or 5% Whichever is higher. Amount is capped at $50 for a 30-day supply. |
$8.35 or 5% Whichever is higher. Amount is capped at $40 for a 30-day supply. |
Plan Extras
Using Your Coverage
- Use your ID card whenever you see a doctor or pick up prescriptions from the pharmacy to help you and you providers use your coverage.
- Your Health Alliance gives you instant access to your coverage anytime, anywhere.
- See the Benefit Highlights for deductibles, copayments, and coinsurance info for various services:
- College Insurance Program (CIP) and Teacher Retirement Insurance Program (TRIP) Benefit Highlight
- State of Illinois (State) Benefit Highlight
- The Evidence of Coverage (EOC) is your main guiding document, like a policy, for how your health care is covered on this plan:
- The Annual Notice of Change (ANOC) describes the differences from last year's plan:
- Illinois HMO Star Ratings Flier
Pharmacies and Covered Drugs
Directories
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.
By Phone
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
Anytime Nurse Line
1-855-802-4612
Mailing Address
Health Alliance
3310 Fields South Drive
Champaign, IL 61822
File an Appeal or Grievance
Learn how on our Appeals and Grievances page
Visit Us
Health Alliance Medicare
Health Alliance Connections
3301 Fields South Drive
#105
Champaign IL 61822
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Page_Title (TextArea) 2018 MAPD for State of Illinois Retirees | Health Alliance Reviewed_Date (Textbox)