Questions

Health plans can be confusing. We are here to help. If you have questions, call 833-ASK-NLHP (833-275-6547) from 8am to 5pm, or if you’re hearing impaired, Illinois Relay 711. Ask a question here.

Who runs NextLevel Health?Show

An Executive Team and Board of Directors manage us. They have years of experience and understand health care. Click here to learn more about them.

What communities does NextLevel Health serve?Show

We help people with Medicaid, and persons participating in the Managed Long Term Services and Supports (MLTSS) program (Medicare and Medicaid), who live in Cook County.

What is a Provider?Show

A Provider is a doctor or health care professional we work with.

What is a PCP?Show

PCP stands for “Primary Care Provider”. This person is your main doctor or clinic.

What is a Care Manager?Show

A Care Manager is someone who can:

  • meet you in person
  • make doctor appointments
  • arrange transportation to and from appointments
  • provide other health care resources

What is the Affordable Care Act (ACA)?Show

The Affordable Care Act is also known as “Obamacare”. Millions of people can now get Medicaid benefits and access to health care. Learn more about the Affordable Care Act here. Learn more about Medicaid benefits and access to health care here.

How much will a NextLevel Health plan cost?Show

All of covered services are FREE. Our Members pay nothing because Medicaid and/or Medicare covers the costs. NextLevel Health has no copays.

Click here for a complete list of Member benefits.

Click here for a complete list of MLTSS Member benefits.

What is NextLevel Health?Show

We are a Medicaid managed care health plan for people with Medicaid, and persons participating in the (Medicare and Medicaid) Managed Long-Term Services and Supports (MLTSS) program, who live in Cook County. We are hired by the Illinois Department of Healthcare and Family Services. Visit About Us.

Is there a copay?Show

No. NextLevel Health does not have any copays.

How do I become a NextLevel Health Member?Show

You can become an NLH Member if you live in Cook County and have Medicaid or if you participate in the Managed Long Term Services and Supports (MLTSS) program (Medicare/Medicaid). During your open enrollment period, you can choose NextLevel Health. If you do not know when your open enrollment period is, or if you have questions about enrolling, contact Client Enrollment Services.

Online:
Go to enrollhfs.illinois.gov. to sign up. Choose a health plan and a Primary Care Provider (PCP), and review your choices.

You’ll also need:

  • Your date of birth
  • Your Medicaid Recipient Identification Number (RIN)
  • Last four digits of your Social Security Number.

By Mail:
Fill out the enrollment form you received from the Department of Healthcare and Family Services and send it back to them in the envelope they provided.

Top three reasons to choose NextLevel Health:

Experienced. We have years of experience. We understand you, your neighborhood, and the services and benefits that will work best for you.

Community-­based. Our Care Management Teams can be found in your neighborhood. When you need us, we’re there.

Dedicated. We want you to have the right health care right where you live. Our medical providers are nearby, which makes it even easier for you. Click here for more information.

Do I have to pick a Primary Care Provider (PCP)?Show

Yes. You must choose a PCP who is in our network. He or she leads your Care Management Team. Click here to choose a PCP or here to see our Provider Directory. Call 833-ASK-NLHP (833-275-6547) for help. If you’re hearing impaired, call Illinois Relay 711.

How can I change my PCP?Show

Call 833-ASK-NLHP (833-275-6547). For hearing impaired call Illinois Relay 711. We will help you choose a new PCP. If you have one in mind, make sure he or she is in our Provider Directory. Click here to get started.
You’ll need:

  • Your date of birth
  • Medicaid Recipient Identification Number (RIN)
  • Last four digits of your Social Security Number

I have a question about my benefits. Who can I call?Show

Call 833-ASK-NLHP (833-275-6547). For hearing impaired call Illinois Relay 711.

I need to see a mental health or behavioral health professional. Do I need a referral?Show

No. Check our Provider Directory here. Call 833-ASK-NLHP (833-275-6547) or Illinois Relay 711 if you’re hearing impaired. We can help you make your first appointment.

What if I have a complaint?Show

A grievance is a complaint about any matter other than a denied, reduced or terminated service or item.

NextLevel Health takes Member grievances very seriously. We want to know what is wrong so we can make our services better. If you have a grievance about a provider or about the quality of care or services you have received, you should let us know right away. NextLevel Health has special procedures in place to help members who file grievances. We will do our best to answer your questions or help to resolve your concern. Filing a grievance will not affect your health care services or your benefits coverage.

You can file your grievance on the phone by calling Member Services. You can also file your grievance in writing and then mail or fax to:

NextLevel Health
Attn: Grievance and Appeals Dept.
303 W. Madison Street, Suite 800
Chicago, IL 60606
Fax: (312)767-2544
Email: [email protected]

In the grievance letter, give us as much information as you can. For example, include the date and place the incident happened, the names of the people involved and details about what happened. Be sure to include your name and your member ID number. You can ask us to help you file your grievance by calling Member Services.

If you do not speak English, we can provide an interpreter at no cost to you. Please include this request when you file your grievance.

At any time during the grievance process, you can have someone you know represent you or act on your behalf. This person will be “your representative.” If you decide to have someone represent you or act for you, inform NextLevel Health in writing the name of your representative and his or her contact information. We will try to resolve your grievance right away. If we cannot, we may contact you for more information.

You can also see your Member Handbook.