MR #21.09: 2021 Revised Medical Program Standards

Illinois Department of Healthcare and Family Services LogoIllinois Department of Human Services Logo



  • Effective 01/01/2021, 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 2021 based on the revised income standards.
  • Updates the Program Standards Desk Aid.
  • Updates the Spousal Home Equity Limits.
  • 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.
  • Updates 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 2021 Federal Poverty Level (FPL). The revised standards are effective 01/01/21 for all programs except MPE. The revised MPE standards are effective 02/22/2021. The revised standards will be updated in IES on 03/01/2021 effective for April 2021 for active cases. For pending applications, the new standards will be applied for any budget month beginning with January 2021.

Family Health Plans & ACA Adult Income Standards

Program Link to WAG

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 25-02-02(4)

Monthly Income Standards for AABD, Medicare Cost Sharing

Program Link to WAG

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 2021 income standards update. The mass change will occur in March, effective April 2021. The following changes will be certified for individuals whose countable income is below the income limit for 2021:

  • 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;
  • QI-1 to QMB; and
  • SLIB to QMB.

A form 360C Notice of Decision will be generated in IES.

Note: the mass update will not certify the following types of cases and the case will appear on the MU-100/MUE-100 report:

  • Cases in case change mode
  • Cases in redetermination mode
  • Cases with a benefit mismatch
  • Cases with conversion information that has not been updated.

WAG 25 and the Program Standards Desk Aid

The Program Standards Desk Aid in WAG 25-03-02 has been updated with the revised income standards.

Home Equity Limits

Home Equity Limits have been updated in WAG 25-03-02(2).

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 required to file a tax return using modified adjusted gross income (MAGI) budgeting in the 2021 calendar year are based on IRS rules for the 2020 tax year. See WAG 25-03-02(2) for the income threshold for the 2020 tax year.

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

The maximum allowable monthly MAGI deduction for HSAs for the 2020 tax year are:

  • $300 for a single person; and
  • $600 for a family.

Resource Limit for Medicare Savings Program (MSP)

The Medicare Savings Program (MSP) Resource Limits for 2021 have been updated in WAG 25-03-02(2).


WAG 15-06-01-g

WAG 25-03-02(2)

WAG 25-03-02(4)

[signed copy on file]

Grace B. Hou

Secretary, Illinois Department of Human Services

Theresa Eagleson

Director, Illinois Department of Healthcare and Family Services

Forms referenced

  • 360C