Illinois Home Care Provider Resources
This page provides an overview of Illinois programs, waivers, payers, and EVV requirements relevant to home care (non-medical) providers operating in the state of Illinois.
Electronic Visit Verification
Illinois requires EVV for most Medicaid-funded personal care and home health aide services. Clean, timely visit data is critical—any issues in EVV can result in denied or delayed payments.
HHAeXchange
Open Model
EVV is required for Illinois Department on Aging (IDoA) and Division of Rehabilitation Services (DRS) providers beginning March 2, 2026.
Waivers & Programs
IIllinois Division of Developmental Disabilities (DDD)
- Children and Young Adults with Developmental Disabilities Support Waiver
- Adults with Developmental Disabilities Waiver
Division of Specialized Care for Children (DSCC)
- Medically Fragile and Technology Dependent Programs:
Supports children and individuals with complex medical needs requiring in-home services.
Illinois Division of Rehabilitation Services (DRS)
Home Services Program (HSP)
- Persons with Disabilities Waiver
- Persons with Brain Injury (BI) Waiver
- Persons with HIV or AIDS Waiver
Illinois Department on Aging (IDoA)
- Persons Who Are Elderly Waiver:
Commonly referred to as the Community Care Program (CCP), supporting older adults who wish to remain safely at home.
Payers
State Agencies
- Division of Rehabilitation Services (DRS)
- Illinois Department on Aging (IDoA)
HealthChoice Illinois Managed Care Organizations (MCOs)
- Aetna Better Health
- Blue Cross Blue Shield Community Health Plans
- CountyCare Health Plan
- Meridian Health Plan
- Molina Healthcare
Fully Integrated Dual Eligible (FIDE SNP) Plans
- Aetna Medicare FIDE
- Humana Dual – Fully Integrated
- Molina Medicare Complete Care Plus
- Wellcare Meridian Dual Align
Waivers & Programs
Payers
Frequently Asked Questions
A common timeframe is 60–120 days, though the exact timeframe varies by state and can be longer if applications are incomplete or require corrections.
Yes. After IMPACT approval, you must credential with each individual MCO to receive referrals, authorizations, and payment.
Illinois offers multiple waivers that support non-medical home care, including the Children and Young Adults with Developmental Disabilities - Support Waiver, Children and Young Adults with Developmental Disabilities - Residential WaiverChildren and Young Adults with Developmental Disabilities - Residential Waiver, Children and Young Adults with Developmental Disabilities - Residential Waiver, and People who are Medically Fragile, Technology Dependent. Eligibility and rates vary based on the client’s program and MCO.
Yes. Agencies must obtain a Medicaid Provider ID through IMPACT, with appropriate service codes tied to waiver eligibility. This ID is required before you can submit claims or contract with MCOs.
Credentialing typically takes 3 to 5 months, depending on the speed of IMPACT approval and how quickly MCOs respond to your contracting submissions.
You must first register with Illinois Medicaid via the IMPACT system. Once approved, you’ll need to complete credentialing with each MCO individually before you can begin billing. Paradigm supports both state and MCO enrollment steps.
How Paradigm can Help
Paradigm offers a combination of tech and highly skilled people to bridge the gaps in:
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
& Eligibility
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
Credentialling
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
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