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Get the Most from Your Coverage

Your primary care provider (PCP) is your personal doctor who will give you most of your care. They may also send you to other providers if you need special care. With YouthCare, you can pick your PCP. You can have one PCP for your whole family. Or you can choose other PCPs for each family member. You may choose a specialist as a PCP if you have chronic health conditions, disabilities, or special healthcare needs and the specialist agrees to take on that role.

YouthCare has several programs to improve the health of our members. We do this through education and personal help from YouthCare staff. This is referred to as care coordination. The goal of this service is to add to the quality of your care and give you the support you need. If you qualify for care coordination and choose to stay in care coordination, a Health Care Coordinator will be assigned to you to assist you in managing your care.

It is very important that you keep all appointments you make for doctor visits, lab tests, or X-rays. Please call your PCP at least one day ahead of time if you cannot keep an appointment or if you need assistance with transportation. If you need help in making an appointment, please contact Member Services at 844-289-2264 (TTY: 711). Hours are 8:00 a.m.-6:00 p.m., Monday through Friday.

Effective January 1, 2020, YouthCare will use a Preferred Drug List (PDL), designed in partnership with the Illinois Department of Healthcare and Family Services (HFS). A PDL is a list of the drugs that we prefer you use.

If you need a medication that does not appear on the PDL, your provider may ask for a review. Please call Member Services at 844-289-2264 (TTY: 711).

You must pick up your drugs at one of our 1,500 pharmacies. Prescriptions from out-of-state pharmacies may not be covered. To find an in-network pharmacy, call Member Services at 844-289-2264 (TTY: 711).

YouthCare provides another option for you to receive your medication. This is our maintenance medication program. You can get a 90-day supply (three-month supply) of the drugs you take every day at most in-network pharmacies, or delivered directly to you. Please call Member Services at 844-289-2264 (TTY: 711) to find out more, or to sign up for drug delivery.

Your Member Handbook is a great source for information about your coverage and benefits. It also lists important phone numbers.

 


You can also contact Member Services for additional help at 844-289-2264 (TTY: 711). Translation services are available if you need them.

Contact Member Services for:

  • A paper copy of your Member Handbook
  • Help finding a doctor and making an appointment
  • Help speaking with a health care coordinator
  • Help with an appeal for a service that’s been denied
  • Help with a ride to your appointment

 


Creating an online member account is free and easy. With it, you can:

  • Find or change your PCP
  • Request a new Member ID Card or print a temporary ID Card
  • View and update your personal information

You can also send a message directly to your health plan from your member account.