Illinois Medicaid Eligibility Information
There are many paths to Medicaid eligibility. Medicaid eligibility can depend on factors such asyour household size, household income, household assets, you age, and whether you have a disability. If you’reunder 65 and don’t have a disability, you’re eligibility will likely be based on your income only .If you’re over65 or have a disability, you’re likely eligible for Medicare. If eligible for Medicare,there are alternate pathways to Medicaid eligibility which typically include asset tests. Additionally,the way that your income is calculated for these programs is more complicated, meaning that yourincome could be above the income limits and you’d still be eligible.For a more personalized estimate, you canuse our Medicaid eligibility calculator.Please note that there may be otherhealth insurance assistance programs offered by your state not listed here,and there may be other eligibilityrequirements for these programs that are not listed here. Additionally, the way that household incomeand household size are calculated can differ from a household’stotal pre-tax income and the number of people on the tax return.
This website is not affiliated with any government organization or Medicaid,CHIP, or health insurance program.
Income Requirements For Illinois Medicaid
Income requirements vary depending on household size and outgoing bills. Larger families have a lower threshold to meet than single-family households. An individual can make up to 183 percent of the poverty level, equating to a monthly income total of $1,366. A couple can make $1,845 combined for both to qualify.
Health Insurance And Other Benefit Resources
The DuPage County Health Department can help you apply for the following benefits:
Complete health insurance for your child and family is available. Eligibility requirements apply.
To apply, you will need to bring the following documents to your appointment:
- Social Security card or number
- A valid photo ID, birth certificate or US Passport
- If you are not a US Citizen, bring your LPR documents
- Proof of Illinois residency
- Proof of income for 90 days for all types of earned and unearned income
Complete health and dental insurance for adults ages 19 to 64 is available. Eligibility requirements apply.
To apply, you will need to bring the following documents to your appointment:
- Social Security card or number
- A valid photo ID, birth certificate or US Passport
- If you are not a US Citizen, bring your LPR documents
- Proof of Illinois residency
- Proof of income for 90 days for all types of earned and unearned income
For more information or to apply on your own, please visit the ABE website.
Read Also: Florida Medicaid Change Of Address
Who Is Eligible For Medicaid In Illinois
Federal law specifies mandatory and optional coverage groups for Medicaid. States must cover the mandatory groups to receive federal Medicaid funding, and they qualify for additional funding if they cover optional groups.
The federal government specifies minimum thresholds for eligibility for the various groups, and states can set their requirements at or above the minimum threshold. Illinois has established requirements that are near national averages.
Do You Need More Help
If you arent sure if your Medicaid coverage has been approved yet or if it is still active, you can check Manage My Case or call the states Automated Voice Recognition System at 1-855-828-4995 with your Recipient Identification Number .
If you have an urgent medical need and need Medicaid quickly, call the DHS Helpline at 1-800-843-6150.
Recommended Reading: Can I Get Medicare And Medicaid
Medicaid Applications In Illinois
If you are a resident of Illinois and you do not have adequate medical coverage then you should consider applying for medicaid through the Illinois Department of healthcare and family services. Your medicaid application is one of the best ways to secure medical coverage if you have a low or fixed income, and cannot provide medical for yourself or for your family any other way. Medicaid is provided to low income individuals and families as a joint effort between the state government and the federal government. The program was designed many year ago, and its core function has remained the same: providing health care coverage to people who cannot other wise afford it.
You should first submit your application for medicaid in Illinois online at the Illinois Department of healthcare and family services website. The application is free, and is conveniently done online. once you have submitted your application, it will be routed to a case worker who will then process your application and let you know the status of your outcome. Illinois medicaid applications can be fairly time consuming which is why it is important to submit the application online. This allows you to save your application and come back to work on it another day.
Medicare is NOT Medicaid
First understand that Medicare is not Medicaid. Medicare pays for doctors and hospitalization and a very limited nursing home stay . Medicare does NOT pay for nursing home costs.
Medicaid is Complicated
Illinoiss Requirements For Medicaid Qualification
The state of Illinois sets particular requirements for enrollees to qualify for the Medicaid program. First, certain income standards must get met if residents in the area hope to qualify. What was once given to children and pregnant women is now available for women and men as well, as long as they meet the criteria. Those who fall far above the poverty level cannot receive this state insurance. If you would like to find out if you should apply, use the Check If I Should Apply button on the Application for Benefits Eligibility website. It asks questions regarding your family size, age, gender, taxes, health coverage through work, medical needs, and more.
Also Check: North Carolina Managed Medicaid Plans
Medicaid Eligibility By State
Each state in the US has different eligibility requirements. Senior Planning offers an interactive map showing Eligibility for Medicaid long-term care. Just pick the state you want to see the requirements for.
Medicaid is available for low-income people and families. For people who dont qualify for Medicaid, open enrollment starts in November 2022. Visit Get Covered Illinois to learn more about healthcare coverage options. If you have not registered yet, you may qualify for Marketplace through the Special Enrollment Period. You have 60 days after a qualifying event to enroll.
What Are The Medicaid Plans In Illinois
Illinois has contracts with a variety of health plans overall.
VMC is provided by Family Health Network, Harmony Health Plan, a local for-profit plan, and Harmony Health Plan, a nationwide for-profit plan . ICP is offered through several health plans servicing various counties throughout the state.
Cook County IlliniCare Health Plan, Blue Cross Blue Shield of Illinois, Cigna HealthSpring of Illinois, Community Care Alliance of Illinois , Humana Health Plan, Meridian, and Aetna Better Health are some of the regional, for-profit affiliates of Centene Corporation .
Aetna Better Health and IlliniCare are available in DuPage, Kane, Kankakee, Lake, and Will Counties. Aetna, Community Care Alliance of Illinois , Knox, Peoria, Stark, and Tazewell Counties:
My Health Care Coordination , Meridian, and Molina. Boone, McHenry, and Winnebago Counties: Aetna.
Rock Island and Mercer Counties: IlliniCare and Precedence. Madison, Clinton and St. Clair Counties: Meridian and Molina.
- Voluntary Managed Care program covers primary, acute, and specialty care, and behavioral health services on a voluntary basis to low-income children and families, pregnant women, and American Indians who live in certain counties.
- A medical home will coordinate acute, primary, and specialty care under Illinois Health Connect .
- In some counties in the state, older persons and adults with disabilities who are qualified for Medicaid but not Medicare are required to participate in the Integrated Care Program .
Read Also: Dc Medicaid Customer Service Number
What Should I Do If I Am Already Enrolled In A Medicaid Plan And I Received A Letter From The State Asking If I Want To Change My Plan
The Illinois Department of Healthcare and Family Services will send letters once a year, giving those insured by Medicaid the option to change plans. This is called your annual open enrollment period.
If you are enrolled in a plan that is meeting your needs, you do not have to do anything. You will remain in that Medicaid plan for another year.
If you want to change plans, you should call the States Client Enrollment Services at or visit their enrollment website.
How To Apply For Medicaid
Enter your zip code to get started.
Illinois Medicaid, which is an initiative by the state of Illinois and the federal government, caters for a range of medical related fees incurred by its beneficiaries. Illinois Medicaid mainly targets families and individuals with low income, providing them with a range of affordable services. These services are divided into primary services and other additional medical services, which are highlighted below:
The program provides support for regular medical checkup of children, making sure that they are able to stay healthy by preventive measures. If your child needs to go to a dentist or a doctor, you wonât have to worry about paying extra-ordinary costs. Once your child is enrolled in the program, all such expenses will be covered by the program.
Primary Services
- Laboratory tests
- Family planning
In order to qualify for Illinois Medicaid, one needs to meet a set of eligibility requirements. The Illinois Medicaid only covers US citizens, or legally approved permanent residents. This means that those individuals residing in the country through visas are not covered. Some of these requirements include, being a resident of the state of Illinois, a Us citizen and other specific requirements.
From the above it can be concluded that Illinois Medicaid has proven to be an important healthcare tool for the residents of the state.
Recommended Reading: What Dme Is Covered By Medicaid
You May Like: Check To See If You Have Medicaid
Humana Gold Plus Integrated Eligibility
You are eligible to enroll in Humana Gold Plus Integrated as long as you:
- Live in our service area, and
- Have Medicare Part A and Medicare Part B, and
- Are eligible for Medicare, and
- Are a U.S. citizen or are lawfully present in the U.S., and
- Are at least 21 years of age or older at the time of enrollment, and
- Are enrolled in the Medicaid Aid to the Aged, Blind, and Disabled category of assistance, and
- Meet all other Demonstration criteria and are in one of the following Medicaid 1915 waivers:
- Persons who are elderly
- Persons with brain injuries
- Persons residing in supportive living facilities
Individuals enrolled in home- and community-based services or waiver, and/or those residing in a nursing facility or long-term care facility, also may be eligible.
Joining is risk free. You can go back to your original Medicare-Medicaid plan, switch to another carrier, or even opt out completely. You have the power to choose.
To Disenroll From Humana Gold Plus Integrated And Still Get Medicare And Medicaid Benefits Without Enrolling In A New Medicare
If you do not want to enroll in a different Medicare-Medicaid plan after you leave Humana Gold Plus Integrated, you will go back to getting your Medicare and Medicaid services separately.
You have 3 options for getting your Medicare services. By choosing 1 of these options, you will automatically end your membership in our plan.
Recommended Reading: Affordable Braces For Adults With Medicaid
Read Also: Louisiana Medicaid Dental Coverage For Adults
Handy Tips For Filling Out Illinois Medicaid Application Form Online
Printing and scanning is no longer the best way to manage documents. Go digital and save time with signNow, the best solution for electronic signatures. Use its powerful functionality with a simple-to-use intuitive interface to fill out Illinois medicaid application pdf online, design them, and quickly share them without jumping tabs. Follow our step-by-step guide on how to do signNowwork without the signNow.
The Way To Generate An Electronic Signature For A Pdf On Android Os
In order to add an electronic signature to an illinois medicaid application pdf, follow the step-by-step instructions below:
If you want to share the medicaid application with other people, it is possible to send it by e-mail. With signNow, you are able to design as many files per day as you require at a reasonable price. Begin automating your signature workflows today.
Read Also: Dentist In Owensboro Ky That Accept Medicaid
How You Will Get Medicare Services
Original Medicarewitha separate Medicare prescription drug plan
Original Medicarewithouta separate Medicare prescription drug plan
NOTE: If you switch to Original Medicare and do not enroll in a separate Medicare prescription drug plan, Medicare may enroll you in a drug plan, unless you tell Medicare you dont want to join.
You should only drop prescription drug coverage if you get drug coverage from an employer, union, or other source. If you have questions about whether you need drug coverage, call your Senior Health Insurance Program at 800-548-9034.
Call Medicare at 800-MEDICARE , 24 hours a day, 7 days a week, to enroll in the new Medicare-only health plan.
If you need help or more information:
- Call the Senior Health Insurance Program at 800-548-9034.
You will automatically be disenrolled from Humana Gold Plus Integrated when your new plans coverage begins.
Illinois Medicaid Long Term Care Programs
Nursing Home / Institutional Medicaid
Illinois Medicaid will cover the cost of long term care in a nursing home for eligible Illinois residents through its Nursing Home / Institutional Medicaid. This includes payment for room and board, as well as all necessary medical and non-medical goods and services. These can include skilled nursing care, physicians visits, prescription medication, medication management, mental health counseling, social activities and assistance with Activities of Daily Living .
Some of the things that Illinois Medicaid wont cover in a nursing home are a private room, specialized food, comfort items not considered routine , personal reading items, plants, flowers, and any care services not considered medically necessary.
Any Illinois Medicaid beneficiary who receives Nursing Home Medicaid coverage must give most of their income to the state to help pay for the cost of the nursing home. They are only allowed to keep a personal needs allowance of $30 / month. This can be spent on any personal item clothes, snacks, books, haircuts, cell phones, etc. It can not be spent on any item that Medicaid covers, including hygiene basics like toothbrush, soap, deodorant, razors and incontinence supplies, unless the Medicaid beneficiary wants a specific brand that is not covered by Illinois Medicaid. In this case, they could spend their personal needs allowance on the item.
Home and Community Based Service Waivers
Don’t Miss: Dermatologist In Lake Charles That Accept Medicaid
Until Your Membership Ends You Will Keep Getting Your Medical Services And Drugs Through Our Plan
If you leave Humana Gold Plus Integrated, it may take time before your membership ends and your new Medicare and Medicaid coverage begins. During this time, you will keep getting your healthcare and drugs through our plan.
- You should use our network pharmacies to get your prescriptions filled. Usually, your prescription drugs are covered only if they are filled at a network pharmacy including through our mail-order pharmacy services.
- If you are hospitalized on the day that your membership ends, your hospital stay will usually be covered by our plan until you are discharged. This will happen even if your new health coverage begins before you are discharged.
You May Like: Does Medicaid Pay For Assisted Living In Wisconsin
Who Is Eligible For Illinois Medicaid
You must be a resident of Illinois, a national or citizen of the United States, a permanent resident, or a legal alien in need of health care or insurance help, and have a low income to qualify for Illinois Medicaid.
You must also be one of the following papers at the time of application submission:
- Be in charge of a youngster who is younger than 18 years old or
- Have a disability yourself or a family member who is disabled.
- Be 65 years of age or older.
You May Like: How Old To Be On Medicaid
Illinois Home Care Ombudsman Program
The Illinois Home Care Ombudsman Program works as an advocate on your behalf. Program employees can:
- Answer questions if you have a problem or complaint
- Help you understand what to do
- Help you file a complaint or an appeal with our plan
The Illinois Home Care Ombudsman Program is not affiliated with Humana Gold Plus Integrated or with any other insurance company or health plan.
800-252-8966 , Monday Friday, from 8:30 a.m. 5 p.m., Central time
Medicaid Funding For Enhanced Mental Health Care
In September 2016, Illinois officials requested permission from the federal government to use existing Medicaid funds to test different approaches to treating Medicaid enrollees who need mental health and/or substance abuse treatment. The state had planned to implement the changes in July 2017, but CMS didnt approve the waiver proposal until May 2018.
The idea is to focus more on preventive care, supportive housing services, and community-based care, rather than institutional care. The state notes that while 25% of Illinois Medicaid enrollees have mental health and/or substance abuse diagnoses, their treatment accounts for 56% of the Medicaid programs total cost.
Under the terms of the approved waiver, Illinois is running ten pilot projects that provide coverage for services that werent previously covered by Medicaid, including short-term inpatient substance abuse treatment, services to help people manage withdrawals during substance abuse recovery, home health visits for new babies and for children born to opioid-addicted mothers, and job coaching and transportation services designed to help people obtain and keep employment.
Recommended Reading: How Can You Protect Your Assets From Medicaid
