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Department of Human Services
James T. Dimas, Secretary
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WAG 20: Medical Program
WAG 20-19-00: Medical Equipment and Prosthetic Devices (AFDC, AABD, GA)
WAG 20-19-02: Prior Approval
Sends HFS 2240, Equipment Prior Approval Request, to BCHS for:
artificial limbs and braces,
standard and custom-built wheelchairs,
respiratory equipment and aids,
special beds, firm mattresses or bed boards,
custom molded shoes, shoe corrections, shoe braces, and
other unusual equipment or items.
Sends pulmonary function study, physician's order, past treatment, and prognosis for respiratory equipment and oxygen.
Sends HFS 2210, Medical Equipment/Supplies Invoice, to Bureau of Claims Processing for allowable oxygen charges for residents.
Decides on request for prior approval, including if item should be purchased or rented.
Sends Family Community Resource Center:
HFS 2352, Notice of Decision on Request for Medical Service/Item, and
copy of HFS 2240.
File HFS 2352 in case record.
WAG 20-19-02-a: Artificial Limbs and Braces
WAG 20-19-02-b: Standard Wheelchair
WAG 20-19-02-c: Custom Wheelchair
WAG 20-19-02-d: Hearing Aids
WAG 20-19-02-e: Respiratory Aids
WAG 20-19-02-f: Standard Hospital Bed, Firm Mattress and/or Bed Board
WAG 20-19-02-g: Special Beds, Flotation or Alternating Pressure Pads
WAG 20-19-02-h: Custom Molded Shoes, Shoe Corrections, Shoe Braces
WAG 20-19-02-i: Other Equipment
State of Illinois
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