On July 1, 2013, state-run operation of the Illinois Pre-Existing Condition Insurance Plan (IPXP) is transitioning to the federally run Pre-Existing Condition Insurance Plan (PCIP). The PCIP coverage then runs through December 2013. Illinois, like many other states, made this decision to ensure that members will still have access to coverage until more options are available on January 1, 2014.
Reminders about Wellness Coverage Chlamydia screening is covered for all members without cost-sharing. Cholesterol and lipid screening (80061, 82465, 83718 and 83721) is covered without cost-sharing for: Men 35 years and older - Once every 5 years Men 20-35 years- Once every 5 years with diagnosis code V17.3–V17.4X, V81.0-V81.2 Women 45 years and older - Once every 5 years Women 20-45 years Once every 5 years with diagnosis code V17.3–V17.4X, V81.0-V81.2 Services performed outside these parameters, as well as other coded services, are covered according to the limits of the member’s medical benefits. The wellness brochure, which lists services and procedure codes covered under the wellness benefit, is posted on the Forms and Resources page of Your Health Alliance. You can also contact your provider relations specialist for a copy.
Effective May 1, 2013, we will partner with naviHealth (formerly SeniorMetrix) for post-acute care services for our Medicare Advantage ONLY. We're excited at the new opportunities this partnership will bring to our members. naviHealth offers a comprehensive suite of functional assessment and clinical decision-support solutions to support evidence-based care.