MR #13.04: Revised Medical Program Standards for 2013

02/13/13

Summary:

• Updates the various medical program income standards which are based on the Federal Poverty Level Income Guidelines effective 01/01/13.
• Updates the Program Standards Desk Aid.
• Updates the co-payments in WAG 25 for children receiving All Kids Share and adults receiving Medicaid.
• Information regarding the central conversions will be sent in an Action Memorandum.  The anticipated effective date for the annual conversions is April 2013.

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1. Increase in the Monthly Medical Income Standards
   1. Family Health Plans Income Standards
   2. Monthly Income Standards for AABD, Medicare Cost Sharing
   3. Monthly Income Standards for Other Programs
   4. Family Assist and Family Health Spenddown Standards
   5. Program Standards Desk Aid
2. Co-payments Updated
3. MANUAL REVISIONS

Increase in the Monthly Medical Income Standards

This release places in the manual the updated income standards for the programs listed below based on the 2013 Federal Poverty Level (FPL).

The new standards are effective 01/01/13 for all programs except MPE. The new standards are effective for MPE on 02/21/13.

Family Health Plans Income Standards

Program	Link to Amount
All Kids Assist, Share, Rebate and Premium Level 1	WAG 25-03-02(2)
All Kids Premium Level 2	WAG 25-03-02(4)
FamilyCare Assist	WAG 25-03-02(2)
Moms & Babies	WAG 25-03-02(2)
MPE	WAG 06-10-05

Monthly Income Standards for AABD, Medicare Cost Sharing

Program	Link to Amounts
AABD (community)	WAG 25-03-02(2)
Medicare Cost Sharing (QMB, SLIB, QI-1)	WAG 25-03-02(2)

Monthly Income Standards for Other Programs

Program	Link to Amounts
HBWD	WAG 25-03-02(2)
Illinois Healthy Women	WAG 25-03-02(2)

Family Assist and Family Health Spenddown Standards

There is no change in the Family Assist and Family Health Spenddown standards. Persons with monthly income that is more than the FamilyCare standard must spend down to the Family Health Spenddown standard.

Program Standards Desk Aid

The Program Standards Desk Aid in WAG 25-03-02 (pdf) has been updated with the new income standards.

Co-payments Updated

The Premium and Co-payment chart in WAG 25 is revised with the new co-payment amounts for children receiving All Kids Share and adults receiving FamilyCare Assist.  These co-payments went into effect July 1, 2012 as a result of the Saving Medicaid Access and Resources Together act (P.A. 097-0689).

MANUAL REVISIONS

WAG 06-10-05

WAG 15-06-01-l

WAG 25-03-02(2)

WAG 25-03-02(3)

WAG 25-03-02(4)

[signed copy on file]

Michelle R.B. Saddler

Secretary, Illinois Department of Human Services

Julie Hamos

Director, Illinois Department of HealthCare and Family Services