Medical programs revised textare called Family Health Plans (FHP), Affordable Care Act (ACA) Adults, AABD Medical, Health Benefits for Persons with Breast or Cervical Cancer (BCC), Former Foster Care, Veterans Care (VC), Medical Benefits for Asylum Applicants and Torture Victims (AATV), and Medicare Savings Programs (MSP) . There are several FHP programs; i.e., Family Assist, All Kids/FamilyCare Assist, Moms & Babies, All Kids Share, All Kids Premium and Family Health Spenddown.

revised textPersons who qualify for TANF or AABD cash automatically qualify for medical benefits.

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Persons on most HFS medical programs cases get an HFS medical card. deleted textThe HFS medical card lists each eligible person. When someone needs medical service, they show the medical card to the doctor, hospital, drug store, clinic, etc. A medical provider who is approved to participate in the medical program has agreed to accept payment from HFS and send the bill to HFS.

Medical Programs

Family Health Plans

  • revised textFamily Assist: medical benefits for families whose income is below the TANF Cash Payment Level. Once the family's income rises above the Family Assist income standard, the family unit may be eligible for up to a year of extended medical coverage.
  • revised textAll Kids Assist: medical benefits for children under age 19 whose income is above the Family Assist income standard, but equal to or less than 147% of the FPL. Children are guaranteed financial eligibility for 12 continuous months of medical coverage, dating from the last eligibility determination.
  • revised textFamilyCare Assist: medical benefits for the parent or caretaker relative (and their spouse) of dependent children under age 18, with countable income greater than the Family Assist Standard, but equal to or less than 138% of the FPL.
  • revised textAll Kids Share: medical benefits for children under age 19 with income greater than the All Kids Assist standard, but equal to or less than 157% of the FPL. Children are guaranteed financial eligibility for 12 months from the first month of approval or last renewal.
  • revised textAll Kids Premium Level 1: medical benefits for persons under 19 with income greater than the All Kids Share standard, but equal to or less than 209% of the FPL. Children are guaranteed financial eligibility for 12 months from the first month of approval or last renewal.
  • revised textAll Kids Premium Level 2: medical benefits for persons under 19 with income greater than the Premium Level 1 standard, but equal to or less than 318% of the FPL. Children are guaranteed financial eligibility for 12 months from the first month of approval or last renewal. Only uninsured children can receive All Kids Premium Level 2.
  • revised textMoms & Babies: medical benefits for pregnant women and infants under 12 months of age who are born to eligible women whose income is above the Family Assist standard, but equal to or less than 213% of the FPL. This program covers both inpatient and outpatient health care for women while they are pregnant and for 60 days after the baby is born regardless of changes in income.
  • revised textFamily Health Spenddown: medical benefits for children with income above the All Kids Assist standard and pregnant women with income above the Moms & Babies standard. A benefit unit must incur medical expenses that equal or exceed  the monthly spenddown amount before medical coverage is provided for a month. The spenddown amount is the difference between a benefit unit's countable income and the Family Health Spenddown standard.
  • revised textMedicaid Presumptive Eligibility (MPE): offers immediate, temporary coverage for outpatient health care for pregnant women. If eligible, MPE covers the customer for pregnancy care starting on the date of application until the Moms & Babies application is approved. 

ACA Adults

new textA person age 19-64 who does not qualify for FHPs or Former Foster Care, and who has countable income equal to or less than 138% of the FPL. A person who is blind or has a disability and does not have Medicare may qualify for the ACA Adult program whether living in the community or in a long term care facility.

AABD Medical

revised textA person who is aged (at least 65 years old) or blind or has a disability may qualify for AABD Medical whether living in the community or in a long term care facility. A person with countable income and assets that are equal to or less than the AABD Medical income standard and AABD Medical asset disregard may qualify for AABD Medical benefits without a spenddown obligation.

DCFS Related

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Medical benefits are also provided to the following groups:

  • Foster care/adoption care children from other states who live in Illinois under the All Kids Assist program. The category designator for these cases is 94. FCRCs do not handle these cases. The Bureau of Local Office Transaction and Support Service, Springfield, approves and maintains them.
  • Foster care/subsidized adoption care cases administered by DCFS. The category designator for these cases is 98.
  • The child(ren) of a child receiving an adoption assistance subsidy through DCFS is eligible for Medicaid as a newborn up to age one based on the mother's receipt of Medicaid under category 98. The category designator for these representative payee (RPY) cases is 94. After one year, they have to be a regular 94 or 96 case.
  • The child(ren) of a child in a subsidized guardianship program through DCFS is eligible for Medicaid as a newborn up to age one based on the mother's receipt of Medicaid under category 98. The category designator for these representative (RPY) cases is 94. After that, they have to be a regular 94 or 96 case.

Former Foster Care

new textMedical coverage is provided to persons age 19 through 25 under the Former Foster Care program. Eligible individuals must have received foster care services through the Illinois Department of Children and Family Services (DCFS) and lost related Medicaid coverage when they aged out of the foster care program at age 18 or older. There is no income or resource test for these individuals.

Health Benefits for Workers with Disabilities (HBWD)

A person who meets the SSA definition of disabled, and is employed, receives benefits through the Health Benefits for Workers with Disabilities (HBWD) program administered by the central HBWD Unit. The category designator is 93 with local office number 250.

Health Benefits for Persons with Breast or Cervical Cancer (BCC)

A person who needs treatment for breast or cervical cancer or a precancerous condition receives benefits through the Health Benefits for Persons with Breast or Cervical Cancer (BCC) program administered by the central BCC Unit. The category designator for these cases is 93 with local office number 189.

A person who lives in an approved long term care facility. The category designator for these cases is 91 (aged), 92 (blind), or 93 (disabled).

Medical Benefits for Asylum Applicants and Torture Victims (AATV)

A person who has an application for asylum pending with the U.S. Bureau of Citizenship and Immigration Services (BCIS), or who receives services from a federally funded torture treatment center may receive benefits through the Medical Benefits for Asylum Applicants and Torture Victims program. The category designator is 90

IDOC cases

A person who applied for help and was determined eligible before being arrested and jailed by a peace officer from a county or unit of local government qualifies, even if they didn't get help before they were jailed. This special coverage pays for qualifying medical bills over the first $500. The category designator for these cases is 91 (aged), 92 (blind), 93 (disabled), 94 or 96.

Veterans Care (VC)

A person who is an uninsured veteran may receive benefits under the Veterans Care program administered by the central Veterans Care Unit. The category designator is 93 with local office number 196.