Illinois Department of Healthcare and Family ServicesIllinois Department of Human Services

02/06/14

Summary:

  • Effective January 1, 2014, persons who were previously eligible for medical benefits under the Refugee Resettlement Program (RRP) may qualify for ACA Adult coverage.
  • For persons who meet the RRP immigration status criteria, IES considers eligibility for medical benefits under TANF, Family Health Plans, AABD or the ACA Adult group; IES does not determine eligibility for RRP medical only (category 90).
  • For months prior to January 2014 only, use IPACS to approve and cancel benefits for applicants who request and qualify for medical benefits under the RRP program.
  • Review active RRP cash and medical only cases when they reach their 8 month time limit to determine if they qualify for medical benefits under another program, including ACA Adult.
  • Procedures to include RRP cases in the Illinois Medicaid Redetermination Project (IMRP) will be provided in an upcoming policy memorandum.
  • Persons approved for RRA Cash will continue to receive medical benefits with the cash program.
  • Category 90 cases will be used for Medical Benefits for Asylum Applicants and Torture Victims (AATV) cases only.

Effective January 2014, persons with immigration statuses listed in PM 06-01-01, may qualify for medical benefits under the new ACA Adult program. Persons who are otherwise eligible for Medicaid do not qualify for RRP medical only benefits. For that reason, IES was not programmed to determine eligibility for RRP medical only cases (category 90). IES determines eligibility for medical benefits for these persons under TANF, Family Health Plans, AABD or the ACA Adult group. IES does not determine eligibility for RRP medical only (category 90).  However, these persons may qualify for medical benefits under the Refugee Resettlement Program (RRP) for months prior to January 2014.

This policy does not apply to RRA Cash assistance (category 00) or to the Medical Benefits for Asylum Applicants and Torture Victims (AATV) program (PM 06-21-00). AATV cases will continue to be designated under category 90. IES will determine eligibility for RRA Cash and AATV. Persons approved for RRA Cash will continue to receive medical benefits with the cash program.

New Applications That Include RRP Months Prior to January 2014

Take the following actions for applicants who qualify for RRP medical for months prior to January 2014, and who qualify for ACA Adult effective January 2014, ongoing.

  • Use IPACS to approve the category 90 case for the months prior to January only.
  • Suppress the central notice, and send a notice with the message: "You qualify for medical benefits under a new program starting in January 2014."
  • Approve the ACA Adult case in IES for ongoing months.

Active RRP Cases

Since RRP has a maximum eligibility period of 8 months, determine whether eligibility exists under any other medical assistance program, including the ACA Adult program, prior to canceling the RRP Cash or RRP Medical case. To determine eligibility for any medical program that uses the MAGI budgeting methodology, including the ACA Adult program, complete a redetermination by taking the following steps:

  • ask the tax filer/tax dependent and relationship questions to determine EDG size,
  • verify income and Illinois residence,
  • process the REDE in IES as a new application,
  • cancel the RRP case before you certify the FHP or ACA Adult case (approve the ACA Adult case no earlier than effective January 2014), and
  • complete a case write-up in IES.

Note: RRP cases (categories 00 and 90) will be included in the IMRP redetermination process to determine continued eligibility for medical benefits. Look for an upcoming policy memo titled "Changes to the Illinois Medicaid Redetermination Project".  Until then, use form HFS 643 (pdf) or HFS 643S (R-1-14) (pdf), Medical Renewal Form to complete the REDE. Form HFS 643 is revised to include the MAGI budgeting questions.

[signed copy on file]

Michelle R. B. Saddler

Secretary, Illinois Department of Human Services

Julie Hamos

Director, Illinois Department of Healthcare and Family Services 

Forms referenced

  • HFS 643
  • HFS 643S