Illinois Medicaid Eligibility Verification (MEDI) for Behavioral Health
Illinois Medicaid members can be in one of several HealthChoice Illinois plans, two of which are limited to specific populations. Knowing which one before the first session decides whether your clinician is in network and which authorization rules apply, and members do switch plans mid-year.
Short answer
Verify Illinois Medicaid eligibility in MEDI, the free Medical Electronic Data Interchange system for Medicaid-enrolled providers, through its Eligibility Inquiry function, which opens the Recipient Eligibility Verification system. Then confirm the member's HealthChoice Illinois plan: Aetna Better Health of Illinois, Blue Cross Community Health Plans, Meridian, or Molina statewide; CountyCare in Cook County only; or YouthCare for former youth in care.
Where to check
MEDI is available free to Medicaid-enrolled providers through the Illinois Department of Healthcare and Family Services. Select Eligibility Inquiry to reach the Recipient Eligibility Verification system.
The HealthChoice Illinois plans
| Plan | Where it operates |
|---|---|
| Aetna Better Health of Illinois | Statewide |
| Blue Cross Community Health Plans | Statewide |
| Meridian | Statewide |
| Molina Healthcare | Statewide |
| CountyCare | Cook County only |
| YouthCare | Former youth in care and children of youth in care |
Source: HFS HealthChoice Illinois plan list. Plan lineups change; confirm current plans with HFS.
What the check has to answer
- Which plan. Each has its own network and authorization rules, which Illinois practices commonly treat as uniform.
- Mid-year switches. Members change plans during the year, so the plan at booking may not be the plan at the visit.
- Your enrollment. Rendering clinicians must be enrolled through IMPACT, and enrollment and revalidation gaps surface as denials.
What eligibility will not tell you
Whether your clinician is in network with the member's plan, whether the license level fits community mental health or SUD service rules, and whether the service needs prior authorization.
Verify at booking, then before each visit
Eligibility can change between booking and the visit, so check both times. Stable's AI receptionist verifies insurance during the booking call or text and books the patient with a clinician credentialed with their plan.
Related: the Illinois Medicaid billing guide, insurance verification for behavioral health and eligibility denials.
Frequently asked questions
How do I verify Illinois Medicaid eligibility?
In MEDI, the free Medical Electronic Data Interchange system for Medicaid-enrolled providers. Choose Eligibility Inquiry to open the Recipient Eligibility Verification system.
What are the HealthChoice Illinois plans?
Aetna Better Health of Illinois, Blue Cross Community Health Plans, Meridian, and Molina statewide; CountyCare in Cook County only; and YouthCare for former youth in care and their children. Confirm the current lineup with HFS.
Is CountyCare available outside Cook County?
No. CountyCare is available only in Cook County.
How often should I verify Illinois Medicaid eligibility?
At booking and before each visit, because members switch HealthChoice Illinois plans mid-year.
The right plan, checked before the first session.
See Stable verify an Illinois Medicaid member's plan during booking and match them to an in-network clinician.
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