MR #18.04: Revised Medical Program Standards for 2018

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  • Effective 01/01/18, updates the various medical program income standards which are based on the Federal Poverty Level Income Guidelines.
  • Provides information on the mass change update of medical cases effective April 2018 based on the revised income standards.
  • Updates the Program Standards Desk Aid.
  • Updates the current income thresholds for when a tax dependent, or child of another person in their eligibility determination group (EDG), is expected to be required to file a tax return. 
  • Updates the maximum monthly Health Savings Account (HSA) MAGI deduction. 
  • Clarifies the resource standard for Medicare Savings Program (QMB, SLIB, QI-1).

Increase in the Monthly Medical Income Standards

This release places in the manual the revised income standard for the programs listed below based on the 2018 Federal Poverty Level (FPL). The revised standards are effective 01/01/18 for all programs except MPE. The revised MPE standards are effective 2/16/18.

The revised standards will be updated in IES on the first processing day for April 2018 (02/16/18). For pending applications and active cases, the new standards will be applied for any budget month beginning with January 2018.

Family Health Plans & ACA Adult Income Standards

Program Link to WAG for Amounts 

All Kids Assist

All Kids Share

All Kids Premium Level 1

FamilyCare Assist

Moms & Babies

ACA Adult

WAG 25-03-02 (2)
All Kids Premium Level 2 WAG 25-03-02 (4)
MPE WAG 06-10-05

Monthly Income Standards for AABD, Medicare Cost Sharing

Program Link to WAG for Amounts

AABD (community)

Medicare Savings Programs (QMB, SLIB, QI-1)


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. Children and pregnant women who qualify for spenddown must spend down to the Family Health Spenddown standard.

Mass Change Action in IES

IES will process a mass change action as a result of the 2018 income standards update.  The mass change will occur effective April 2018.  The following changes will be certified for individuals whose countable income is below the income limit for 2018:

  • All Kids Premium Level 2 to All Kids Premium Level 1;
  • All Kids Premium Level 1 to All Kids Share;
  • All Kids Share to All Kids Assist;
  • Family Health Spenddown to full coverage for certain children and pregnant women;
  • AABD spenddown to full coverage for certain AABD individuals;
  • QI-1 to SLIB; and
  • SLIB to QMB.

Note:  if the case is in benefit mismatch, Case Change or Redetermination Mode at the time of the mass change, IES will not update the case.

WAG 25 and the Program Standards Desk Aid

The Program Standards Desk Aid (pdf) in WAG 25-03-02 has been updated with the revised income standards.  The legacy coding charts in the Program Standards Desk Aid are removed, the 185% income standard for Medical Extension and the income thresholds for a tax dependent who may be expected to be required to file a tax return are added.  WAG 25-03-02 (3) is obsolete and removed from the manual.

Income Thresholds for a Tax Dependent Who May be Expected to be Required to File a Tax Return

The income amounts used to determine whether a tax dependent may be expected to be required to file a tax return using modified adjusted gross income (MAGI) budgeting in the 2018 calendar year are based on IRS rules for the 2017 tax year. The thresholds in IES are updated as follows:

  • Earned income exceeds $529 per month, or
  • Unearned (excluding SSA) income exceeds $88 per month.

See PM 15-06-01-h.

MAGI Deduction-Contribution to a Health Savings Account (HSA)

The maximum allowable monthly MAGI deduction for HSAs for the 2017 tax year are:

  • $283 for a single person; and
  • $563 for a family.

Resource Limit for Medicare Savings Program (MSP)

As of the publication of this release, the Social Security Administration has not announced the 2018 MSP resource limits.  Continue to use the 2017 limits until further notice.


[signed copy on file]

James T. Dimas

Secretary, Illinois Department of Human Services

Felicia F. Norwood

Director, Illinois Department of Healthcare and Family Services

Forms Referenced