WAG 06-18-01
A person may receive both Illinois Cares Rx and medical benefits. If a person is eligible for Illinois Cares Rx and medical benefits, payment for prescription drugs is made under the medical program. If a person is eligible for Illinois Cares Rx and medical benefits with an unmet spenddown obligation, payment for prescription drugs is made under Illinois Cares Rx.
To be eligible for Illinois Cares Rx Basic, a person must:
- have countable income no more than 200% of the Federal Poverty Level (FPL);
- live in Illinois;
- not have Medicare; and
- be 16 years of age or older but under age 65 and totally disabled, or 65 years of age or older and not meet the requirements for Illinois Cares Rx Plus (see below).
To be eligible for Illinois Cares Rx Plus, a person must:
- have countable income no more than 200% of the Federal Poverty Level (FPL);
- live in Illinois;
- be a U.S. citizen or qualified noncitizen (see requirements at PM 03-01-02); and
- have Medicare or be 65 years of age or older without Medicare.
NOTE: Medicare recipients are not eligible for Illinois Cares Rx Basic. To qualify for Illinois Cares Rx Plus, besides meeting all the above requirements, they must also be enrolled in a coordinating Medicare Part D prescription drug plan (see WAG 06-18-01). All persons with Medicare are required to apply for "Extra Help" from Social Security. If they currently have Extra Help, they do not need to reapply unless they receive a notice from Social Security telling them they need to reapply. The Extra Help application can be found on the Social Security Administration website or can be obtained by calling the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778). The Extra Help application can also be obtained by calling the Illinois Department on Aging Senior HelpLine at 1-800-252-8966 (TTY 1-888-206-1327).
