Use the TARs in this sub-topic for FHP, RRA and CountyCare Medical to:

  • deny an application (TA 05) or person in an application; or
  • progress a denied application or person to another category (TA 62).

Deny a Case or Person or Case Progression (FHP and RRA Medical)

For denials (TA 05) and case progression (TA 62) processed through AIS or IPACS, the following TARs generate a central denial notice (Form 360C) with the related reason, unless Item 39 is coded to suppress the notice. If the central notice is suppressed, the Family Community Resource Center must complete and send the Notice of Decision on Application for Medical Assistance - MANG - Non-spenddown (Form 458).

NOTE: If a TAR applies only to case denial, the Reason for Denial box shows TA 05 Only. If a TAR applies only to case progression, the Reason for Denial box shows TA 62 Only.

Some of the TARs are used to notify the unit of the reason why a person was excluded for benefits. If a TAR applies to person-level only, the TAR Box shows (Person Only). If the TAR applies to both person-level and case-level, the TAR Box shows (Person & Case).

NOTE: Send the Notice of Decision on Applications for Payment of Medicare Premiums, Deductibles and Coinsurance (Form 458M), to approve or deny QMB/SLIB/QI-1 benefits when a unit member claims to be a Medicare Part A beneficiary and Form 458 is sent.

Deny an All Kids Share, Premium or Rebate Case

For the denial (TA 05) of an All Kids Share, Premium or Rebate application processed through AIS or IPACS, the following TARs generate a central Notice of Decision on Application for Health Benefits -- All Kids (Form 360KC) with the related reason, unless Item 39 is coded to suppress the notice. If the central notice is suppressed, the Family Community Resource Center must complete and send a local Form 360KC.

Denial and Case Progression- FHP (Category 94 and 96), RRA Medical (Category 90), CountyCare (Category 94)
TAR REASON FOR DENIAL MESSAGE
01

Funeral or burial application not received on time.

revised text(All except S/P/R, RRA Medical, CountyCare)

TA 05 Only

We did not receive the application for funeral/burial payments by the last day of the 3rd month after the month of death. PM 15-07
02

Applicant could not be located

TA 05 Only

The Department has been unable to locate you. Your eligibility for assistance cannot be established. PM 02-06
deleted text
05

Applicant does not meet citizen/INS requirements.

(All except S/P/R)

TA 05 Only

You do not meet Department citizenship/ alienage requirements. PM 03-01
05
(Person & Case)

Applicant does not meet citizen/INS requirements.

(Not valid for children under age 19)

TA 05 Only

You do not meet Department citizenship/ alienage requirements. PM 03-01
06
(Person Only)

Refused to cooperate with CSE without good cause.

(All except S/P/R and RRA Medical)

You failed or refused to cooperate, without good cause, with the Child Support Enforcement Program. PM 24-01
07

Applicant not an Illinois resident, or Illinois residency not verified.

TA 05 Only

You do not meet the Department residence requirement. PM 03-02
14
(Person & Case)

SSN requirement not met.

(Case Only for RRA Medical)

TA 05 Only

Due to your failure/refusal to provide a Social Security number for a persons(s) for whom you requested assistance. PM 03-11
17

All Kids and Family Care Assist out of funds.

(S/P/R Only)

TA 05 Only

Enrollment is now closed. PM 06-08
deleted text
19

No eligible child in the home.

revised text(All except S/P/R, RRA Medical, CountyCare)

There is no eligible child in your home. PM 03-05
22

Parent not incapacitated.

TA 62 Only

Revised text(All except S/P/R, CountyCare)

Change Category from 96 to 94.

No notice is sent.

23

Applicant failed to give financial information needed to decide eligibility.

(All except S/P/R)

TA 05 Only

Your eligibility cannot be determined due to your failure to provide necessary information. PM 02-07
26

Applicant institutionalized.

(All except RRA Medical)

TA 05 Only

Your needs are currently being met by the institution. PM 03-02
30

Applicant refused or unable to verify pregnancy.

(Moms and Babies Only)

TA 05 Only

You did not provide the Department with medical verification of your pregnancy. PM 06-09
33

Applicant is not child(ren)'s caretaker relative.

Revised text(All except S/P/R, RRA Medical, CountyCare)

TA 05 Only

You are not the child(ren)'s caretaker relative. The child(ren)'s caretaker relative can request an application by calling 1-800-226-0768 (TTY: 1-877-204-1012). PM 02-02
35

Application withdrawn due to objection to CSE assignment policy.

(All except S/P/R and RRA Medical)

TA 05 Only

Only Your application has been withdrawn at your request due to your objection to the Agency assignment of support rights. PM 24-01
36

Family did not pay their premium.

(S/P/R Only)

TA 05 Only

You did not pay your All Kids premium. PM 06-08
40
(Person & Case)

Did not give nonfinancial information. Use SSN reason (TAR 14) if SSN requirement not met.

(All except S/P/R and RRA Medical)

TA 05 Only

Your eligibility cannot be determined due to your failure to provide necessary information. PM 02-07
40

Did not give nonfinancial information. Use SSN reason (TAR 14) if SSN requirement not met.

(RRA Medical Only)

TA 05 Only

Your eligibility cannot be determined due to your failure to provide necessary information. PM 02-07
42

Excess Income.

Revised text(Assist, FamilyCare & RRA Medical - Not valid for children under age 19, CountyCare)

FCRC:
Your countable income exceeds the appropriate limit after applying your medical expenses. PM 15-08

Central All Kids Unit:
Your income is above the limit. If you have large medical expenses and still need medical, contact your local DHS office. For the number of this office, call 1-866-468-7543. PM 15-08

43

Definition of emergency medical condition not met.

Revised text(All except S/P/R, RRA Medical, CountyCare)

TA 05 Only

You do not meet Department definition of emergency medical condition. PM 06-05
55

Applicant did not comply with policy on potential income sources.

(All except S/P/R)

TA 05 Only

You did not comply with Department policy regarding potential sources of income. PM 09-03 PM 01-02
60

Application withdrawn.

TA 05 Only

You withdrew your application. PM 17-04
65

Eligible to be included in another active 94 or 96 case.

(All except S/P/R and RRA Medical)

TA 05 Only

No notice sent.
66

Received All Kids Rebate overpayment, therefore ineligible for All Kids Share or Premium.

(Share/Premium Only)

TA 05 Only

You have received a Rebate overpayment. PM 06-08
70 (Person Only) Person withdrew request for assistance. Per your request, you have not been included in the unit. PM 17-04
72 (Person Only) Person no longer lives with the unit. You are no longer living with the assistance unit/household. PM 03-05
73

Not pregnant or under age 19.

Revised text(All except S/P/R, RRA Medical, CountyCare)

TA 05 Only

Person(s) is not pregnant or a child age 18 or younger. Please go to the local DHS office and apply if you want assistance for this person(s). PM 06-10
76 (Person & Case)

Does not meet the federal definition of an eligible refugee.

(RRA Medical Only)

TA 05 Only

You do not meet the Federal definition of an eligible refugee. PM 06-01
79

Refused to cooperate with medical support policy.

(FamilyCare Assist & RRA Adult-Only Medical)

TA 62 Only

You did not cooperate regarding medical support rights. PM 03-19
88 (Person Only)

2nd adult ineligible.

Revised text(All except S/P/R and RRA Medical, CountyCare)

You are not the caretaker relative, parent of an eligible child, or spouse of the caretaker relative. PM 04-01
90

Change or correct ID number or category.

TA 62 Only

No notice is sent.
91

Countable income exceeds limits for all Family Health Plans programs.

New Text(All except CountyCare)

TA 05 Only

FCRC:
After considering your medical expenses, your income is above the limit for medical benefits. You or your family members are not eligible for All Kids or FamilyCare. PM 06-08 and PM 15-08

Central All Kids Unit:
Your income is above the limit for medical benefits. If your family has large medical expenses and still needs medical benefits, you should reapply as soon as possible through your local DHS office. If you need the address and phone number of your local DHS office, call 1-866-468-7543 (TTY 1-877-204-1012). PM 06-08

92

MPE applicant approved under a different category.

(MPE Only)

TA 05 Only

No notice sent.
93

Failed to complete application process for ongoing benefits within 90 days.

(MPE Only)

TA 05 Only

No notice sent.
97

Failed to return All Kids Rebate Form.

(S/P/R Only)

TA 05 Only

Your income is above the limit for All Kids  Assist (formerly medical assistance) after applying your medical expenses.

Your children are not eligible for All Kids  Share, All Kids Premium, or All Kids Rebate because you failed to return the necessary information. PM 06-08

D2 (PE only) Declared family income is above the income standard Form 3818 sent.
D3 (PE only) Received PE within last 12 months Form 3818 sent.
D4 (PE only) Insufficient information provided Form 3818 sent.
D5 (PE only) Immigration status not met Form 3818 sent.
E3 Applicant failed to provide signature page. We cannot decide if you can get the benefits you applied for. We did not receive the page with your signature or other information we asked for. PM 02-04, 02-07
E4 Countable monthly income is more than 200% of the FPL and the child has health insurance. Your children have health insurance now or have not been uninsured long enough to get All Kids. PM 06-08
E5 Countable monthly income is more than 200% of the FPL and the family withdraws the application because they object to the amount of the All Kids monthly premiums and co-pays. You withdrew your application. PM 17-04
E6 Applicant already receiving requested assistance. You are already receiving the benefits you requested. PM 02-04-09
New textG6

Person is categorically eligible for AABD or Family Health Plans.

(CountyCare only)

No central notice is sent.
New textG7

Income exceeds the standard.

(CountyCare only)

Your income is above the limit for medical benefits. PM 06-26
New textG8

Person does not live in Cook County.

(CountyCare only)

You are not living in Cook County. Enrollment in CountyCare is limite to persons living in Cook County. PM 06-26