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MFTD Waiver Families

Support for families of children in the Medically Fragile, Technology Dependent Waiver

A Note About Managed Care

September 25, 2014

Many families may have received notices about children in Illinois being required to join managed care this fall. All children in the MFTD Waiver are exempt from managed care. You do not need to sign up for a plan. If you accidentally signed up for one, call your DSCC case manager to resolve the situation.  

If your child has special needs but is not eligible for the waiver, you may still be able to avoid managed care. Any child who receives any services from DSCC is exempt. These include all children who receive Care Coordination services, all children in the Core program, and all children in the Home Care (MFTD) Waiver. If your child has a condition that makes him/her eligible for DSCC but you have not registered with them, go to How to Apply and fill out an application. Families of all incomes are eligible for Care Coordination and the MFTD Waiver, but the Core program is limited to lower income families.

There are two other groups of individuals who are exempt from managed care:

  1. Children who receive full or partial SSI based on their own disability.
  2. Children who have comprehensive private insurance (third party liability) in addition to Medicaid.

Apparently, HFS is having difficulty exempting these children, but it is possible with persistent effort.

Finally, if you must choose a managed care plan and your child with special needs lives in the Chicago area, you might want to consider joining a Complex Care ACO. Both Lurie and LaRabida will pioneer these new types of programs. They will primarily provide care coordination for children. Children in these programs are exempt from the 4 prescription a month Medicaid limit. Children will also be able to use facilities other than Lurie and LaRabida.

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