MEDICAID

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Medicaid is a program that provides health coverage to some low-income Illinois residents. Medicaid (also called medical assistance) covers families with children and pregnant women, medically needy individuals, the elderly, people with disabilities, and persons with breast or cervical cancer, if state and federal guidelines are met. Legal residents who are not U.S. citizens may be eligible for Medicaid. Non-citizens who do not have immigration documents cannot enroll in Medicaid. Questions concerning immigration status and eligibility should be directed to the Illinois Department of Public Aid.

· For certain categories of people, eligibility for Medicaid is based on the amount of your household income.

In Illinois you may be eligible for Medicaid if you are a child, pregnant, or a parent of a child and your family income meets the Medicaid income standards.

Income eligibility levels for these categories are described below. Your assets and some expenses also may be taken into account, so you should contact the Medicaid Program for more information.

Low income persons eligible for Medicaid in Illinois*

Category                 Income eligibility (as percent of federal poverty level)

Infant                           200%
Child 1-19                     133%
Working Parent              185%
Non-Working Parent        185%
Pregnant woman             200%
Medically needy
     Individual                   40%
     Couple                       39%

* Eligibility information was compiled from State Health Facts Online, the Kaiser Family Foundation, and may have changed since this guide was published. Contact your state Medicaid program for the most up-to-date information and for other eligibility requirements that may apply.

To get an idea of how your income compares to the federal poverty level, use the federal poverty guideline issued by the U.S. Department of Health and Human Services for the year 2009:

Size of Family Unit                    Poverty Guideline (annual income)
   1                                             $10,830
   2                                             $14,570
   3                                             $18,310

For larger families add $3,740 for each additional person.

So, for example, using this guideline, 200% of the federal poverty level for a family of 3 would be an annual income of $36,620, or a monthly income of $3,052.

Contact your state Medicaid program for the most up-to-date information and for other eligibility requirements that may apply.

· Families who get cash benefits from TANF (also known as Temporary Assistance for Needy Families) can get Medicaid. In addition, your children may qualify for Medicaid if your family’s income meets certain income standards.

· Very poor elderly or disabled people who get Supplemental Security Income (SSI) benefits can also qualify for Medicaid. You do not need to submit a separate application for Medicaid.

Disabled individuals should know that if your income earned from a job increases so that you no longer qualify for SSI, you may be able to continue your Medicaid coverage if you are elderly or you are still considered disabled and you continue to have medical need.

· People who have high medical expenses may also qualify for Medicaid. You may qualify as medically needy if you have high medical expenses that, when subtracted from your income, would make you eligible for Medicaid coverage. For example, people who have to pay a lot for prescription drugs, nursing home care, or other long term care services sometimes qualify as medically needy if their health insurance is limited or does not cover these services.

· Retired or disabled people who have low incomes and are enrolled in Medicare may also qualify for help from Medicaid. Even though your income may be too high to qualify for Medicaid insurance coverage, there may be other ways Medicaid can help you.

If your household income is below the poverty level, Medicaid will pay your Medicare monthly premium and your Medicare deductibles and coinsurance.

If your household income is above 100% but below 135% of the poverty level, Medicaid will pay for your monthly Medicare premiums only.

· Working, disabled persons with higher income levels may be eligible for Medicaid benefits under the Health Benefits for Workers with Disabilities Program (HBWD). To qualify for HBWD, you must be employed, disabled and between the ages of 16 and 64, with a countable income up to 200% poverty level and less than $10,000 in assets. HBWD enrollees must pay a monthly premium that ranges from $0 to $100 based on income level.

· There may be other ways that Medicaid can help. To find out if you or other members of your family qualify for Medicaid, contact the Illinois Department of Healthcare and Family Services at (217) 782-1200 or visit online at http://www.hfs.illinois.gov/.


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