URBANA -- Four years after she was diagnosed with stage-three breast cancer, Leslie Hammersmith has to worry about something else:

Will she be able to keep her trusted doctors at Carle and insurance coverage through Health Alliance Medical Plans? Both, she says, have been there for her every step of the way.

"They give you access to the best doctors and facilities in our area," Hammersmith, 40, of Sadorus, says of Health Alliance. "And you don't want to risk that for any reason, but especially when you have cancer."

A University of Illinois e-learning analyst, Hammersmith is among the 137,000 people -- state employees, their dependents and retirees -- waiting on decisions from the state that will affect where they go for future medical care and how much it will cost.

That's been unclear since the state Department of Healthcare and Family Services chose new insurance options a month ago that don't include Health Alliance, Humana and PersonalCare HMOs. Nearly 100,000 state members are in the Health Alliance HMO, and about 37,000 others are covered through PersonalCare and Humana HMOs.

Enrollment in new health plans started May 1 but will be extended past the end of the month because Health Alliance and Humana filed protests, and those protests are still pending.

Matt Brown, the state's chief procurement officer, is set to begin his review of the protests May 11, and what happens after that whether the protests are upheld or not is undetermined, Health Alliance spokeswoman Jane Hayes said.

"The procurement and protest rules are being developed as we go through this," she said.

The state has projected its new insurance plan choices will save $102 million the first year and about $1 billion over the 10-year life of the insurance contracts.

But information obtained by Health Alliance from the Department of Healthcare and Family Services states projected costs, savings and the probable migration of state employees from existing HMO plans to other state-offered health plans weren't part of the evaluation process and weren't considered in insurance plan choices.

Health Alliance had asked the state, in connection with its protest, to supply detailed calculations to support its projected savings and for the projected migration by county of state members to other insurance plans, plus other information, and the state responded by stating it didn't consider those factors.

Hayes says her company continues to hear every day from state employees anxious about keeping their Health Alliance coverage.

And they're making that known at public hearings. At one hearing last week, a Health Alliance member with stage four lung cancer waited four hours to give his testimony, Hayes said.

"And he was not well," she said. "He drove three hours from Carbondale to the hearing, and then had to go back and go to St. Louis for a treatment the next day."

Hammersmith, who has been a Health Alliance member since 1999, said she's never had to worry about coverage for her cancer treatments and ongoing care for chronic swelling.

She's met many breast cancer patients who haven't been as fortunate, she said. And she doesn't even want to think about changing doctors.

"I think, for my cancer, I'm in the best place you could possibly go for medical treatment," she added.

Fellow Health Alliance member JoAnne Geigner of Urbana, a UI visiting information/research specialist in computer science, said she is becoming increasingly worried as uncertainty about her family's future health coverage continues.

"It's my family's health and my family's budget, and that are the two things that are most important to us," she said.

Of particular concern to Geigner is the fact that her husband is being treated for an ongoing medical condition and they want to keep their doctors at Carle.

If the state decision goes against Health Alliance, other options to stay at Carle might be unaffordable for her family, Geigner said. And if they have to change doctors, she said, where will they find available doctors in the local community?

"I don't want to go out and find a new doctor, but if we get the hint that this isn't going to be resolved in favor of Health Alliance, I'm going to be in line with 20,000 other people," she said.

Kirstin Dougan of Urbana is also feeling the strain as she waits to find out if she can keep Health Alliance and her Carle doctors.

A music and performing arts librarian at the UI, Dougan said she has some ongoing health issues and it might be difficult to find openings with new doctors.

To have her family's costs bumped up through other insurance plans and not have an HMO option at Carle doesn't seem reasonable, Dougan said.

"Carle is the big provider down here," she added.

Fellow UI employee Cynthia Voelkl, 48, of Champaign, said she and her family have been with Health Alliance since 1994, and keeping their Carle doctors is important because her husband is undergoing care for prostate cancer.

With the insurance uncertainty stretching into a second month, she said, "I'm incredibly worried about it."

Her husband's cancer, diagnosed in 2004, returned in 2008 and has metastasized.

Doctors are keeping it under control, Voelkl said, and she and her husband feel fortunate that he's had good care. But that care could quickly become unaffordable under a new insurance plan that would require 10 percent or 20 percent payments for treatments costing thousands of dollars,

Plus, having to give up his Carle doctors for more affordable coverage would be hard because his doctors have "been absolutely wonderful," she said.

"They give you good news and laugh with you, and they give you bad news and they look at you and they cry," she said.

If the state's new insurance options made sense and were affordable, said Voelkl, who is assistant director of Japan House, she might be able to accept the changes.

But where all this leaves her right now is uncertain and waiting, "which is not a good feeling," she said.