Illinois Department of Healthcare and Family ServicesIllinois Department of Human Services

3/20/15

Obsoletes Policy Memorandum, Refugee Medical Coverage Under the Affordable Care Act, dated 02/06/14.

Summary:

  • On or about February 25, 2015, IES was updated to set up a separate ACA Adult medical case for adults approved for RRP (Refugee Resettlement Program) Cash rather than linking medical benefits to the RRP category '00' cash case.
  • Category 90 is used for the Medical Benefits for Asylum Applicants and Torture Victims (AATV) program only (see PM 06-21-00).
  • For RRP cash cases approved prior to the IES update, continue to complete a redetermination of eligibility for medical benefits under another program, including ACA Adult, prior to the end of the 8 month RRP period: see the 2/06/14 policy memo, Changes to the Illinois Medicaid Redetermination Project (IMRP).
  • This release updates the Medical Programs page in PM I-03-00 and corrects outdated federal poverty level (FPL) standards for medical programs on the affected pages.
  • This release also removes some references to the All Kids Rebate and CountyCare medical programs; see policy memos: All Kids Rebate Ending 12/31/13, and CountyCare Changes Effective July 2014 for more information. 

IES System Enhancement for Refugee Cases

IES is updated to set up a separate ACA Adult medical case for adults who are approved for RRP Cash, rather than linking medical benefits to the RRP category '00' case. The ACA Adult case is certified for 12 months, while the RRP cash case has a limited period of up to 8 months.

The system will enter a '4' in Item 78 (Type Benefit) to suppress medical benefits on the RRP cash case. A determination of continued eligibility for medical will no longer be needed when the 8 month limit expires on the cash case.

  • Note: This policy does not apply 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.
  • Children on an RRP family cash case qualify for medical benefits under the All Kids (94R) program.

Active RRP Cash Cases

For active RRP Cash cases that still contain medical, continue to determine whether eligibility exists under any medical assistance program, including the ACA Adult program, prior to canceling the RRP Cash 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, and
  • complete a case write-up in IES.

Note: RRP cases are included in the IMRP redetermination process to determine continued eligibility for medical benefits. See the policy memo titled Changes to the Illinois Medicaid Redetermination Project, IMRP.

MANUAL REVISIONS

[signed copy on file]

Greg Bassi

Acting Secretary, Illinois Department of Human Services 

Felicia F. Norwood

Director, Illinois Department of Healthcare and Family Services