{"id":627022,"date":"2024-02-28T14:18:52","date_gmt":"2024-02-28T19:18:52","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=627022"},"modified":"2025-12-12T18:28:15","modified_gmt":"2025-12-12T23:28:15","slug":"illinois-medicaid-guide","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/illinois-medicaid-guide\/","title":{"rendered":"Guide to Medicaid in Illinois"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Illinois is one of the many states that opted to expand Medicaid coverage under the 2013 Affordable Care Act (ACA). It now <\/span><a href=\"https:\/\/hfs.illinois.gov\/medicalclients\/faqsendofcontinuouscoverage.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">covers more than 3.9 million Illinoisans<\/span><\/a><span style=\"font-weight: 400;\"> as of November 2023. The Illinois Medicaid program is an essential health insurance plan for Illinois residents and a leader in the nation for its expansive service coverage, especially its coverage for families. For example, Illinois was <\/span><a href=\"https:\/\/www.illinois.gov\/news\/press-release.23111.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">the first state<\/span><\/a><span style=\"font-weight: 400;\"> to extend postpartum Medicaid coverage to 12 months after the baby is born\u2014a significant change from the previous 60-day limit. To help keep Illinoisans abreast of key <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/news\/guide-to-medicaid-changes\/\"><span style=\"font-weight: 400;\">Medicaid changes<\/span><\/a><span style=\"font-weight: 400;\"> like this, we\u2019ve created this guide to Medicaid in Illinois with the help of experts and official government resources. You\u2019ll find all the information you need to access Illinois Medicaid for yourself and your loved ones.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Read on to learn about the program\u2019s eligibility requirements, covered services, and how to apply for Medicaid in Illinois.\u00a0<\/span><\/p>\n<h2 id=\"eligibility-for-illinois-medicaid\"><span style=\"font-weight: 400;\">Eligibility for Illinois Medicaid<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Under the state\u2019s expanded Medicaid coverage, more Illinois residents are eligible for Medicaid than ever before. To qualify, you must meet certain income, age, disability, and\/or citizenship status requirements. If you have health insurance through your employer, you are not eligible for Medicaid in Illinois.\u00a0<\/span><\/p>\n<h3 id=\"income-requirements\"><span style=\"font-weight: 400;\">Income requirements<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">In states like Illinois that have opted for the ACA\u2019s Medicaid expansion, Medicaid eligibility is based on the applicant&#8217;s modified adjusted gross income (MAGI), which has a built-in 5% income disregard. To be eligible for Illinois Medicaid based on your income, your MAGI must not exceed the percentage of the federal poverty level (FPL) established for your coverage group. The <\/span><a href=\"https:\/\/www.medicaid.gov\/state-overviews\/stateprofile.html?state=illinois\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">FPL limits<\/span><\/a><span style=\"font-weight: 400;\"> for Illinois Medicaid\u2019s various coverage groups are as follows:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">313% for ages 0 to 18<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">313% for children under the separate CHIP program<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">208% for pregnant women<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">133% for parents or related caregivers of eligible children<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">133% for adults eligible under the ACA expansion<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">For reference, the 2026 FPL for a single individual is $16,430 per year. Therefore, an applicant who makes twice that amount ($32,860) has an income that is 200% of the FPL likely would not qualify for Medicaid based on his or her income alone. However, the same applicant may still be eligible for Medicaid or one of Illinois\u2019 Medicaid-related programs if he or she meets certain disability or healthcare needs requirements.<\/span><\/p>\n<h3 id=\"age-requirements\"><span style=\"font-weight: 400;\">Age requirements<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">In Illinois, residents aged 65 or older can qualify for both Medicaid and Medicare coverage through the state\u2019s <\/span><a href=\"https:\/\/enrollhfs.illinois.gov\/en\/mmai\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Medicare\u2013Medicaid Alignment Initiative<\/span><\/a><span style=\"font-weight: 400;\">. To qualify for Medicaid as a senior, at the time of writing, a single person must have an income below $1,064 a month and countable assets below $2,000. (Note that income and asset requirements are subject to change year to year based on inflation and other factors).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Adults aged 19 to 64 may be eligible for Medicaid in Illinois as long as they meet the state\u2019s income or disability requirements and are not receiving Medicare coverage.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Children aged 18 and younger may qualify for either Illinois Medicaid or the State Children\u2019s Health Insurance Program (SCHIP), depending on their family\u2019s income level. The SCHIP program is designed for children whose families earn too much to qualify for Medicaid but not enough to afford private health insurance.\u00a0<\/span><\/p>\n<h3 id=\"disability-requirements\"><span style=\"font-weight: 400;\">Disability requirements<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">In some states, people who qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) automatically qualify for SSA-linked Medicaid. Unfortunately, this is not the case in Illinois.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In Illinois, people on SSI must apply for Medicaid separately. Depending on their income and work status, individuals with disability designations may be eligible for one of the following Illinois Medicaid coverage programs: Aid to Aged, Blind, and Disabled (AABD), FamilyCare, ACA Adult, or Health Benefits for Workers with Disabilities (HBWD).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">People with disabilities whose income exceeds the Medicaid income limits for Illinois may be eligible for the state\u2019s <\/span><a href=\"https:\/\/hfs.illinois.gov\/info\/brochures-and-forms\/brochures\/hfs591sp.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Spenddown program<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<h3 id=\"citizenship-requirements\"><span style=\"font-weight: 400;\">Citizenship requirements<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">To be eligible for Illinois Medicaid, you must reside in the state of Illinois and have been a U.S. national, citizen, or permanent resident (Green Card holder) for at least five years. Children and pregnant women of any immigration status can qualify if they meet income requirements.<\/span><\/p>\n<h3 id=\"healthcare-needs-requirements\"><span style=\"font-weight: 400;\">Healthcare needs requirements<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Illinois Medicaid provides full or partial coverage to people with certain healthcare needs who are not defined as disabled by the SSA. These programs include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Illinois Breast and Cervical Cancer Program (IBCCP) <\/b>c<span style=\"font-weight: 400;\">overs uninsured women at any income level who need treatment for breast or cervical cancer.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>State Hemophilia Program assists<\/b><span style=\"font-weight: 400;\"> eligible patients in obtaining antihemophilic factors, annual comprehensive visits, and other outpatient medical expenses related to the disease.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>State Renal Dialysis Program <\/b>c<span style=\"font-weight: 400;\">overs the cost of renal dialysis services for eligible persons with chronic renal failure who are ineligible for coverage under Medicaid or Medicare.<\/span><\/li>\n<\/ul>\n<h2 id=\"illinois-medicaid-benefits\"><span style=\"font-weight: 400;\">Illinois Medicaid benefits<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Under Illinois Medicaid, enrollees receive a full range of health benefits comparable to the coverage of a typical private health insurance provider.<\/span><\/p>\n<h3 id=\"covered-medical-services\"><span style=\"font-weight: 400;\">Covered medical services<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The medical services Illinois Medicaid covers vary depending on the coverage program. In general, Medicaid enrollees in Illinois can expect coverage for the following health services:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Doctor and dental care visits<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ambulance rides<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Emergency room services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hospital stays<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Surgery<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Well-child care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Immunizations for children<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mental health and substance abuse services<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Prescription drugs<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Medical equipment\/supplies<\/span><\/li>\n<\/ul>\n<h3 id=\"prescription-drug-coverage\"><span style=\"font-weight: 400;\">Prescription drug coverage<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Some of Illinois\u2019 Medicaid coverage programs (including All Kids and Moms &amp; Babies) cover the full cost of prescription drugs. Other programs (like FamilyCare) require enrollees to pay a small copayment, usually ranging from $2 to $3.90 per prescription. Notably, All Kids, FamilyCare, and Moms &amp; Babies must approve some medicines before a pharmacy may fill the prescription.<\/span><\/p>\n<h3 id=\"dental-coverage\"><span style=\"font-weight: 400;\">Dental coverage<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Similar to the state\u2019s prescription drug coverage, some Medicaid programs in Illinois include comprehensive service coverage for dental, which fully covers the cost of dental visits. There may be a small copay for dental visits under other coverage programs (for example, FamilyCare).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For children, dental coverage includes the cost of diagnostic services (e.g., oral exams, X-rays), preventive services (e.g., cleanings, topical fluoride, sealants), restorative services (e.g., fillings, crowns), endodontic services (e.g., root canals), periodontal services, prosthodontic services (e.g., dentures, bridges), oral and maxillofacial services (e.g., surgical extractions), orthodontic services, general anesthesia, and sedation.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Adult Medicaid enrollees receive coverage for most of the same dental services but with certain <\/span><a href=\"https:\/\/hfs.illinois.gov\/content\/dam\/soi\/en\/web\/hfs\/sitecollectiondocuments\/covereddentalservices.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">exceptions<\/span><\/a><span style=\"font-weight: 400;\">. For example, adults are limited to one oral exam and cleaning every 12 months, whereas children may receive these services every six months.\u00a0<\/span><\/p>\n<h3 id=\"vision-coverage\"><span style=\"font-weight: 400;\">Vision coverage<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">All Kids, FamilyCare, and Moms &amp; Babies provide coverage for optometrist services and the cost of prescription eyeglasses. Similar to dental coverage, the extent of vision coverage varies by program, with children receiving the most coverage.\u00a0<\/span><\/p>\n<h3 id=\"long-term-care-services\"><span style=\"font-weight: 400;\">Long-term care services<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Illinois Medicaid is crucial in providing long-term care services for seniors and individuals with physical disabilities. The state offers various programs, each tailored to meet the specific needs of its residents requiring Nursing Facility Level of Care.\u00a0<\/span><\/p>\n<h4 id=\"nursing-home-and-institutional-medicaid\">Nursing Home and Institutional Medicaid<\/h4>\n<p><span style=\"font-weight: 400;\">Illinois Nursing Home Medicaid is designed to cover the cost of long-term care in nursing homes for financially limited seniors. This includes coverage for the following:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">room and board\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">personal care assistance<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">skilled nursing care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">physician&#8217;s visits\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">prescription medication\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">medication management\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">mental health counseling\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">social activities<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">However, it&#8217;s important to note that certain items and services are not covered, such as private rooms, specialized food, and comfort items beyond routine necessities.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Illinois Nursing Home Medicaid operates as an entitlement, ensuring that all qualified applicants are entitled by law to receive benefits without a wait. Despite this entitlement, not all nursing homes accept Medicaid, and availability from your chosen facilities is not guaranteed.<\/span><\/p>\n<h4 id=\"home-and-community-based-services-hcbs-waivers\">Home and Community Based Services (HCBS) Waivers<\/h4>\n<p><span style=\"font-weight: 400;\">Home and Community Based Services (HCBS) Waivers offer an alternative to nursing home care, supporting financially limited seniors in remaining in their communities. These waivers act like vouchers, covering long-term care goods and services for individuals who meet the Nursing Facility Level of Care criteria.<\/span><\/p>\n<h4 id=\"supportive-living-program-slp\">Supportive Living Program (SLP)<\/h4>\n<p><span style=\"font-weight: 400;\">The Supportive Living Program (SLP) targets disabled or seniors who require a Nursing Facility Level of Care but choose to live in state-approved residential settings such as board and care homes, assisted living facilities, or memory care units. SLP benefits encompass nursing care, Personal Emergency Response Systems, housekeeping assistance, medication management, and personal care assistance.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Unlike Nursing Home Medicaid, SLP operates with a limited number of enrollment spots and places additional applicants on a waitlist once full.<\/span><\/p>\n<h4 id=\"waiver-for-the-elderly\">Waiver for the Elderly<\/h4>\n<p><span style=\"font-weight: 400;\">The Waiver for the Elderly, also known as the Persons who are Elderly Waiver, supports seniors who require a Nursing Facility Level of Care but opt to live at home or with a loved one. Benefits include adult day care, Personal Emergency Response Systems, housekeeping and shopping assistance, and personal care assistance.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Similar to SLP, the Waiver for the Elderly has a large but limited number of enrollment spots, and eligible applicants beyond the capacity are placed on a waitlist.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Understanding the unique differences of Illinois Medicaid&#8217;s long-term care programs is essential for individuals and their families as they navigate the options that fit their unique needs. From nursing home coverage to community-based waivers, Illinois Medicaid strives to provide comprehensive support for those needing long-term care services.<\/span><\/p>\n<h2 id=\"illinois-medicaid-programs\"><span style=\"font-weight: 400;\">Illinois Medicaid programs<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Jointly funded by the federal government, Medicaid operates with benefits and administration exclusively managed at the state level within federal guidelines. Each state has the authority to shape coverage programs and set eligibility requirements.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While there are minimum eligibility thresholds and a federal mandate for covered services, states can surpass these requirements, providing greater generosity in their Medicaid offerings. This flexibility allows states to tailor their programs to meet the unique needs of their residents better, ensuring a comprehensive approach to healthcare without compromising federal guidelines.<\/span><\/p>\n<h3 id=\"overview-of-illinois-medicaid-programs\"><span style=\"font-weight: 400;\">Overview of Illinois Medicaid programs<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">In Illinois, there are several Medicaid coverage programs for low-income families, children, pregnant women, seniors, and individuals with disabilities. In addition to income, eligibility for these programs is based on the applicant\u2019s age, health needs, parental\/caregiver role, disability, and employment status. The most notable Illinois Medicaid coverage programs include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">FamilyCare<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">All Kids<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Moms &amp; Babies<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Aid to Aged Blind and Disabled (AABD)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health Benefits for Workers with Disabilities (HBWD)<\/span><\/li>\n<\/ul>\n<h3 id=\"familycare-health-coverage-for-low-income-parents\"><span style=\"font-weight: 400;\">FamilyCare: Health coverage for low-income parents<\/span><\/h3>\n<p><a href=\"https:\/\/hfs.illinois.gov\/medicalprograms\/allkids\/familycare.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">FamilyCare<\/span><\/a><span style=\"font-weight: 400;\"> is an Illinois Medicaid program that offers healthcare coverage to low-income parents living with children aged 18 years old or younger. It also covers relatives who have taken on guardianship of children in place of their parents.<\/span><\/p>\n<h3 id=\"all-kids-health-coverage-for-children\"><span style=\"font-weight: 400;\">All Kids: Health coverage for children<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">All Kids provides comprehensive health benefits to eligible children aged 18 years old and younger. To qualify, children must live in families with countable family income at or below 147% of the <\/span><a href=\"https:\/\/www.healthcare.gov\/glossary\/federal-poverty-level-fpl\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">federal poverty level (FPL)<\/span><\/a><span style=\"font-weight: 400;\"> for their household size.\u00a0<\/span><\/p>\n<h3 id=\"health-benefits-for-workers-with-disabilities\"><span style=\"font-weight: 400;\">Health Benefits for Workers with Disabilities<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/hfs.illinois.gov\/medicalprograms\/hbwd.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Health Benefits for Workers with Disabilities (HBWD)<\/span><\/a><span style=\"font-weight: 400;\"> program is for individuals with disabilities who work and earn up to 350% of the FPL. Unlike FamilyCare and All Kids, HBWD requires enrollees to buy into Medicaid by paying a small monthly premium.\u00a0<\/span><\/p>\n<h3 id=\"medical-assistance-programs-for-seniors\"><span style=\"font-weight: 400;\">Medical assistance programs for seniors<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/www.dhs.state.il.us\/page.aspx?item=45317\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Aid to Aged, Blind, and Disabled (AABD) Medicaid program<\/span><\/a><span style=\"font-weight: 400;\"> covers seniors, the blind, and persons with disabilities who earn up to 100% of the FPL and have less than $2,000 of non-exempt resources.<\/span><\/p>\n<h3 id=\"services-for-children-and-pregnant-women\"><span style=\"font-weight: 400;\">Services for children and pregnant women<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The Illinois Medicaid coverage program for pregnant women is called <\/span><a href=\"https:\/\/hfs.illinois.gov\/medicalprograms\/allkids\/momsandbabies.html#momsbabies\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Moms &amp; Babies<\/span><\/a><span style=\"font-weight: 400;\">. It provides a full slate of health benefits to eligible pregnant women and babies up to one year of age. You must have countable family income at or below 213% of the FPL for your household size to qualify.<\/span><\/p>\n<h2 id=\"how-to-apply-for-illinois-medicaid\"><span style=\"font-weight: 400;\">How to apply for Illinois Medicaid<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">You can apply for Illinois Medicaid online, with a paper application, over the phone, or in person at a local Department of Human Services (DHS) office. The application is the same for every coverage program; just be sure to check the correct box to indicate the specific program(s) you want to apply for.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In addition to medical assistance, the Medicaid Illinois application allows applicants to apply for cash assistance and the supplemental nutrition assistance program (SNAP). However, if you\u2019re not interested in applying for those benefits, you can simply leave their respective sections of the application blank.\u00a0\u00a0<\/span><\/p>\n<h3 id=\"required-documents-for-the-application\"><span style=\"font-weight: 400;\">Required documents for the application<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There are no required documents to submit the initial Medicaid application, but once DHS has received and processed your application, you\u2019ll need to provide additional supporting documents, such as tax returns, pay stubs, or another document accepted as proof of income.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">On the initial application, you will also need to provide the Social Security number (SSN) of each person for whom you request benefits, but you won\u2019t need to present a physical SSN card.\u00a0<\/span><\/p>\n<h3 id=\"online-application-process\"><span style=\"font-weight: 400;\">Online application process<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">For most individuals, the easiest way to apply for Illinois Medicaid is to submit an <\/span><a href=\"https:\/\/abe.illinois.gov\/abe\/access\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">online application<\/span><\/a><span style=\"font-weight: 400;\">. Before accessing the application, you\u2019ll need to set up an account using the <\/span><a href=\"https:\/\/abe.illinois.gov\/abe\/access\/jsp\/access\/security\/ASCreateAccount.jsp\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Application for Benefits Eligibility (ABE) online form<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<h3 id=\"in-person-application-process\"><span style=\"font-weight: 400;\">In-person application process<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">You can apply for Medicaid in person at certain Illinois Department of Human Services locations called Family Community Resource Centers (FCRCs). To find your nearest FCRC, use the online <\/span><a href=\"https:\/\/www.dhs.state.il.us\/page.aspx?module=12\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">DHS Office Locator<\/span><\/a><span style=\"font-weight: 400;\">. Additionally, some hospitals, health centers, and other community-based organizations may be able to assist you in applying for Medicaid as well as for other benefits.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To schedule an appointment for in-person help, call Get Covered Illinois at 1-866-311-1119.\u00a0<\/span><\/p>\n<h3 id=\"paper-application-process\"><span style=\"font-weight: 400;\">Paper application process<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Follow <\/span><a href=\"https:\/\/hfs.illinois.gov\/content\/dam\/soi\/en\/web\/hfs\/sitecollectiondocuments\/il444-2378b.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">this link<\/span><\/a><span style=\"font-weight: 400;\"> to download the paper application for Illinois Medicaid (also called medical assistance).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">After completing the application, drop off, mail, or fax it to your local Family Community Resource Center (FCRC). You can find the address or fax number of your nearest FCRC using the online <\/span><a href=\"https:\/\/www.dhs.state.il.us\/page.aspx?module=12\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">DHS office locator<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h2 id=\"cost-of-illinois-medicaid\"><span style=\"font-weight: 400;\">Cost of Illinois Medicaid<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The cost of Illinois Medicaid varies with the coverage program. There is no monthly premium for FamilyCare, All Kids, or Mom &amp; Babies. However, other coverage programs (e.g., HBWD) may require enrollees to pay a small monthly premium based on their income range.\u00a0<\/span><\/p>\n<h2 id=\"additional-illinois-medicaid-resources\"><span style=\"font-weight: 400;\">Additional Illinois Medicaid resources<\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/abe.illinois.gov\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">https:\/\/abe.illinois.gov\/<\/span><\/a>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Use this site to apply for and manage your Medicaid benefits<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/getcovered.illinois.gov\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">https:\/\/getcovered.illinois.gov\/<\/span><\/a>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">If you don\u2019t qualify for Medicaid, shop the ACA Marketplace and enroll in a health insurance plan.\u00a0<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.illinois.gov\/hfs\/MedicalProviders\/cc\/mmai\/Pages\/default.aspx\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">https:\/\/www.illinois.gov\/hfs\/MedicalProviders\/cc\/mmai\/Pages\/default.aspx<\/span><\/a>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Learn about the Medicaid renewal process and other services the Illinois Department of Healthcare and Family Services (HFS) offers.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2 id=\"illinois-medicaid-faq\"><span style=\"font-weight: 400;\">Illinois Medicaid FAQ<\/span><\/h2>\n<h3 id=\"how-to-find-a-doctor-who-accepts-medicaid\"><span style=\"font-weight: 400;\">How to find a doctor who accepts Medicaid<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">To find a healthcare provider in Illinois who accepts Medicaid, visit the online <\/span><a href=\"https:\/\/ext2.hfs.illinois.gov\/hfsindprovdirectory\/Main\/CompleteProviderList\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">DHS Medicaid Provider Directory<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h3 id=\"how-to-renew-medicaid-coverage\"><span style=\"font-weight: 400;\">How to renew Medicaid coverage<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">You can complete your renewal for Medicaid when it is due at <\/span><a href=\"https:\/\/abe.illinois.gov\/abe\/access\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">abe.illinois.gov<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When it\u2019s time for renewal, the Department of Healthcare and Family Services will mail you a letter with instructions. It is imperative you don\u2019t delay your renewal. If you fail to respond in time, your coverage may automatically end, and you could lose all the benefits you receive through Medicaid.<\/span><\/p>\n<h3 id=\"how-to-appeal-a-denied-claim\"><span style=\"font-weight: 400;\">How to appeal a denied claim<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The simplest way to appeal a denied claim is through your online <\/span><a href=\"https:\/\/abe.illinois.gov\/abe\/access\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Manage My Case<\/span><\/a><span style=\"font-weight: 400;\"> account. The \u2018appeals\u2019 button is at the top of every screen: click it, select the reason for your appeal from the list, and follow the on-screen directions to file your appeal.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can also file an appeal by phone, fax, mail, email, or in person. You can find links to the forms you need to file your appeal on the <\/span><a href=\"https:\/\/www.dhs.state.il.us\/page.aspx?item=80561\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">DHS website<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h3 id=\"how-to-report-medicaid-fraud\"><span style=\"font-weight: 400;\">How to report Medicaid fraud<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">To report Medicaid fraud by a recipient, fill out an online <\/span><a href=\"https:\/\/ilhfspartner3.dynamics365portals.us\/recipientfraudadd\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">OIG Recipient Fraud Complaint<\/span><\/a><span style=\"font-weight: 400;\"> or call 1-844-ILFRAUD.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To report Medicaid fraud by a provider, fill out an online <\/span><a href=\"https:\/\/ilhfspartner3.dynamics365portals.us\/providerfraudadd\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">OIG Provider Fraud Complaint<\/span><\/a><span style=\"font-weight: 400;\"> or call 1-844-ILFRAUD.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Illinois is one of the many states that opted to expand Medicaid coverage under the 2013 Affordable Care Act (ACA). It now covers more than 3.9 million Illinoisans as of November 2023. The Illinois Medicaid program is an essential health insurance plan for Illinois residents and a leader in the nation for its expansive service [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":627023,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2],"tags":[16],"coauthors":[8861],"class_list":["post-627022","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-company","tag-medicaid","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Guide to Medicaid in Illinois<\/title>\n<meta name=\"description\" content=\"Everything you need to know to receive free or low-cost health services from Illinois Medicaid, including how to apply, eligibility, restrictions, coverage, and more.\" 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