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BCBS IllinoisMedicare Advantage · Coverage · General · IL · Geriatrics, Palliative CareHigh impact

Managed Long-Term Services and Supports Transition for Blue Cross and Blue Shield of Illinois

Act
by Dec 31, 2026
Effective date
Jan 1, 2027
Identified
Oct 14, 2026

Summary

Effective January 1, 2027, Blue Cross and Blue Shield of Illinois (BCBSIL) will cease providing Managed Long-Term Services and Supports (MLTSS) coverage. All current MLTSS members will be transitioned to Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs) operated by awarded MLTSS Prepaid Inpatient Health Plan sponsors, with member reassignments coordinated by the Illinois Department of Healthcare and Family Services. Home and Community-Based Services waiver coverage for non-MLTSS members through Blue Cross Community Health Plans remains unchanged.

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What to do

by Dec 31, 2026 · 1 steps
01Billing and clinical teams should (1) review current patient rosters to identify all MLTSS members covered by BCBSIL; (2) monitor official communications from BCBSIL, Illinois Department of Healthcare and Family Services (HFS), and receiving MLTSS PIHP sponsors regarding member assignments and continuity-of-care requirements; (3) document member transitions and ensure billing systems are updated with correct new plan information before January 1, 2027; (4) prepare to direct affected MLTSS members to appropriate resources from their newly assigned health plans; (5) coordinate with BCBSIL and receiving plans on continuity-of-care procedures to prevent claim denials and service disruptions.
If missed: Failure to update member plan information in billing systems may result in claim denials and delayed reimbursement for services rendered to transitioned members.

Original notice

Managed Long-Term Services and Supports Transition for Blue Cross and Blue Shield of Illinois
bcbsil.com · Always check the source before changing claims.
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BCBS Illinois policiesIL policy changesGeriatricsPalliative Care

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