The Illinois Department of Healthcare and Family Services began a new process in March 2020 to pay for uninsured individuals who receive COVID-19 tests. The COVID-19 tests will be funded by the State or federal funds depending on the individual's eligibility for a special Medicaid category for individuals not enrolled in Medicaid.
COVID testing through this special Medicaid category is authorized through the Families First Coronavirus Response Act. This new eligibility is for uninsured Illinois residents who are not already enrolled in Illinois Medicaid.
The Integrated Eligibility System (IES) will receive a file with information about each uninsured individual who received a COVID test. IES will generate a new Recipient ID Number (RIN) for each person in the new uninsured population who does not match an individual already known to IES. IES will be able to find and assign a previous RIN in IES for the client if they were previously a customer of HFS or DHS with a RIN in IES. COVID-19 testing coverage will automatically process without staff involvement. This eligibility group will not be visible in IES but will be visible to workers in MMIS and to providers in MEDI.
There may be duplicate RINs created with this process, but caseworkers should not take any action to resolve duplicate RINs related to COVID Testing for the Uninsured. Providers are instructed to submit claims on the medical RIN for all services including the COVID testing services when the client has two RINs.
The eligibility will be displayed in the Recipient Database (RDB) in MMIS (PF8) under the Special Eligibility Segment, "COVID TESTING COVERAGE". This is a limited benefit package that covers ONLY COVID testing and testing related services. No other services are covered for clients with this special eligibility. The MangP Codes include MX, MY, and MZ.
||COVID Screening - with TPL
||COVID Screening - without TPL meets citizenship requirements
||COVID Screening - without TPL does not meet citizen requirements
[signed copy on file]
Grace B. Hou
Secretary, Illinois Department of Human Services
Director, Healthcare and Family Services