Questions


Become a Member

Here are some commonly asked questions about becoming a Member. If you have other questions, call us

Do I Qualify?

If you live in Cook County and have Medicaid or if you participate in the Managed Long-Term Services and Supports (MLTSS) program (Medicare and Medicaid), you qualify!

What is NextLevel Health?

NextLevel Health is a managed care health plan for Cook County residents with Medicaid and for Cook County residents in the Managed Long-Term Services and Supports (MLTSS) program (Medicare and Medicaid). We are hired by the Illinois Department of Healthcare and Family Services.

How much does this plan cost?

All 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.

How do I become a NextLevel Health Member?

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 and 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.

Contact Client Enrollment Services:

Online:
Go to enrollhfs.illinois.gov to sign up. Choose a health plan, a PCP and review your choices.
You’ll also need:

  • Your date of birth
  • 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 providing health care services. We understand you, your neighborhood and the services and benefits that are right for you.

Community-­based. We work to provide you with the right health care right where you live. Our medical providers have their services in your community, which makes it even easier.

Dedicated. We are in your neighborhood. Our Care Management Team can be where you are. We understand how hard it can be to manage your health alone, so we’ll come to your home, your doctor’s office, your clinic, or the emergency room. When you need us, we’ll be there.

Click here to learn more about our health plans and our Care Management Team.

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?

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?

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?

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

What is a PCP?

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

What is a Care Manager?

A Care Manager is someone who can:

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

What is the Affordable Care Act (ACA)?

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?

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?

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?

No. NextLevel Health does not have any copays.

How do I become a NextLevel Health Member?

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 hhealthcareright 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)?

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

How can I change my PCP?

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?

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?

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?

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.

How to become a NextLevel Health partner provider?

We value our providers and work closely with you to deliver high­-quality care for our Members. Call 833-ASK-NLHP (833-275-6547) from 8:30am to 5pm to learn more.

Can I have NextLevel Health information at my office?

Yes. The information must follow marketing guidelines set by the Department of Healthcare and Family Services (HFS). It helps Medicaid enrollees to understand their health plan options.

Can I talk with a Health Care Manager?

Yes. Call 833-ASK-NLHP (833-275-6547) from 8am to 5pm.The Care Manager can help you set up and coordinate services for Members.

Can I make suggestions about the program?

Yes. We always encourage feedback. Part of our commitment is the Professional Advisory Committee (PAC). This is a group of providers, including specialists in physical and mental health, substance abuse and nursing, and others that oversees the development of our clinical guidelines and protocols. PAC also suggests quality initiatives for progress and improvement. If you are interested in joining the PAC, call 833-ASK-NLHP (833-275-6547) from 8:30 am to 5pm.

How do I become a Medicaid provider?

First, you must be a Medicaid ­certified provider. To be certified, you need to complete forms with the Department of Healthcare and Family Services (HFS). Click here for more information.

How do I become a registered Illinois Health Connect provider?

First, you need to register with IMPACT. Once you’ve completed your application at IMPACT and received verification of acceptance, please feel free to contact NextLevel Health Provider Services department at [email protected] for contracting materials.

Can I help Members enroll in NextLevel Health?

You can provide education to Members about their health plan choices. That includes approved materials by the Department of Healthcare and Family Services (HFS). These materials need to include information about the health plans that you are contracted with. You can also give phone access so potential Members can contact Client Enrollment Services. However, you are not allowed to help potential Members enroll online. They must make that choice. Click here to access the HFS website.