WAG 19-02-04-b
Criteria For Ex Parte Eligibility
Each customer due for a medical redetermination will be evaluated for ex parte eligibility. Specific criteria must be met to qualify for ex parte redetermination. IES will determine if a customer is eligible based on their eligibility group, clearance results (financial and non-financial), and certain case characteristics.
Eligibility Group Criteria
The table below identifies whether an eligibility group/Type of Assistance (TOA) qualifies for ex parte redetermination.
| Eligibility Group/TOA |
Qualifies for Ex Parte Redetermination |
| Pregnant Women |
Yes |
| FamilyCare |
Yes |
| Newborn |
Yes |
| All Kids Assist (non spenddown) |
Yes |
| Family Planning |
Yes |
| Former Foster Care |
Yes |
| ACA Adult |
Yes |
| Medical Extension- Spousal Support |
No |
| Medical Extension- Earned Income |
No |
| Family Health Spenddown-Pregnant |
No |
| Family Health Spenddown- Child |
No |
| AABD Medical |
Yes |
| Health Benefits for Workers with Disabilities |
No |
| Disabled Adult Children (DAC) |
Yes |
| Widow(er) |
Yes |
| Section 1619 |
Yes |
| Veterans Care |
No |
| Breast and Cervical Cancer |
No |
| Shelter Care Medical |
No |
| AABD Spenddown |
No |
| Shelter Care Spenddown |
No |
| Nursing Home |
Yes |
| Supportive Living Facility |
Yes |
| Department on Aging |
Yes |
| NH/SLF Spenddown |
No |
| DOA Spenddown |
No |
| MSP |
Yes |
Income Criteria
Prior to the redetermination due date, IES will run income clearances and review income on the case record. To be eligible for ex parte redetermination, all income counted in a customer's EDG must:
- be verified electronically
- not exceed the customer's income standard
Income that cannot be verified electronically, including self-employment, rental room & board income, private pensions/retirement benefits, unemployment benefits received from another state, and any electronically unverifiable unearned income types will disqualify a customer from ex parte redetermination.
If clearance results show income is above the TOA income standard, the customer will not qualify for ex parte redetermination and will receive a manual redetermination.
Note: If the customer has no income record in IES, but the clearance results show income that is within the customer's income standard, the customer will not be disqualified from ex parte redetermination.
IMPORTANT: SSI income does not exclude customers from ex parte redetermination. Customers receiving SSI income are exempt from all other financial verifications of the ex parte redetermination process. Example: A customer has both SSI and room & board income. Since the customer is receiving SSI, the room & board income does not disqualify the customer from an ex parte redetermination. However, the customer must still meet the non-financial criteria to be determined ex parte eligible.
Non-financial Criteria
IES will run non-financial clearances before the redetermination due date. Customers who do not meet the non-financial criteria as described below will not be eligible for ex parte redetermination.
- IL residency
- SSN- If an SSN is not provided the customer will not be eligible for ex parte redetermination. Additionally, if a customer who does not have an SSN is included in another customer's medical EDG (not excluded), the other customer will also be ineligible for ex parte redetermination.
- Immigration status- Customers who are undocumented, or not qualified immigrants will not be ex parte eligible.
- U.S. Citizenship- Customers who reported to be U.S. citizens but whose citizenship has not been verified will not be ex parte eligible.
Other Criteria
The following reasons will also disqualify a customer from ex parte eligibility:
- being included in a medical EDG in more than one case.
- having an identity/relationship/income that is marked as "unknown" in IES.
Reminder: Each customer is evaluated for ex parte eligibility. A case can contain both ex parte eligible and ineligible customers.
