WAG 06-25-04

Case Maintenance

A person becomes ineligible for CountyCare in the following circumstances:

  • Reaches age 65;
  • Is enrolled in Medicare;
  • Has a dependent child move in with him or her;
  • Becomes pregnant;
  • Receives Social Security Disability Income (SSDI) or Supplemental Security Income (SSI) as a result of a finding of disability by the Social Security Administration;
  • Has income that exceeds 133% of the FPL;
  • Not living in Cook county; or
  • No longer meets eligibility criteria.

There is no spenddown available for persons in CountyCare.

Active cases in Office 197 will appear on program integrity reports including the Priority Action List and various crossmatch reports. Follow up is required per PM 19-06-00.

Illinois Healthy Women

Women age 19-44 whose CountyCare is terminated will be auto-enrolled in Illinois Healthy Women unless they move out of state.

Deletions

When a spouse moves out of the home of an active CountyCare case, delete the spouse using TAR 07, suppress the central notice if the spouse is eligible for his/her own CountyCare case. If the spouse is a woman who is no longer living in Illinois, contact HFS medical policy for guidance.