Illinois Medicaid Program

Calendar Icon Updated February 26, 2019
Medicaid

Medicaid coverage gets funded by the government, but residents of each state must first qualify if they wish to take advantage of the offered funds. Low-income households within Illinois should apply if they need assistance with medical coverage and cannot afford to pay regular rates. The state has its own set of rules regarding Medicaid eligibility with certain requirements to meet. It’s best to look into these prerequisites before applying.

Illinois’s 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.

How to Apply for Medicaid in Illinois

Applying for Medicaid in Illinois can be accomplished in several ways. Those who prefer to handle the task in person can visit their local Department of Human Services office and fill out a paper application. You may also fill out an online application if that suits you better. Go to the Application for Benefits Eligibility website to fill out the necessary forms. You can also continue to monitor and manage your case through this site if you do get approved.

Illinois Medicaid Application

You must first create an account when attempting to apply for benefits online. Use your first and last name and set up a User ID and password as well. You must also choose and answer two security questions so future attempts recognize you as the one accessing the information. Once you set up your account, you will get to start on your application. You must provide contact details, such as name, telephone number, and address, as well as income information. It is also important to disclose a number of large outgoing bills, such as rent and utilities, so they can be deducted from your gross income. Bank account information is also important to note so your caseworker sees the full picture of your finances to determine if you qualify for the assistance.

What Does Medicaid Cover in Illinois?

The Illinois Medicaid program covers most medical services. Well-checks or yearly visits are the primary services offered. You may also receive free or low-pay emergency room visits, urgent care visits, emergency dental services, and more. If you’re an older adult, the program may even cover a portion of your long-term healthcare expenses, including in-home care or a short stay at a nursing facility.

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.

How Much Does Medicaid Cost in Illinois?

The state of Illinois, partnered with the federal government, spends more than $19 billion on Medicaid costs for recipients. Illinois paid roughly 40 percent of the total while the government footed the remainder of the bill. The amount accounted for more than 27 percent of Illinois’ total budget in the year 2015, with costs expected to rise in the future as more and more people become dependent on the health care coverage.

Cost and Coverage of Medicaid in Illinois

The point of Medicaid is for low-income individuals and families to receive access to health care they otherwise would not be able to obtain. Many people do not pay anything towards their coverage, and instead, receive their services for free. The state takes on the expenses. Those that do have to pay often only spend a cash amount of $3.90 per visit for emergency rooms, clinics, and even prescriptions.

Prescription Drugs with Medicaid in Illinois?

While not all prescriptions get covered by Illinois Medicaid, many do. Antibiotics are the most commonly received option. Children, in particular, can receive their prescriptions free of charge so they can take the medicine they need to get better. Adults may have to pay a co-pay amount of $3.90 per prescription for brand names, or $2 for the generic versions.

Which Medicaid Plan is Best in Illinois?

IlliniCare Health has been rated one of the top Illinois Medicaid plans in the state. They offer an Integrated Care Plan for seniors and the disabled and Family Health Plan for children and expecting mothers, along with new members who are now eligible thanks to the Affordable Care Act.

Eligibility Team

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