PM 19-02-04-c: Manual Redeterminations

WAG 19-02-04-c

Manual Redeterminations

Customers due for medical redetermination who were not found eligible for ex parte will be sent a 2381C Notice and a manual redetermination form.  These will be sent both in the postal mail and electronically via ABE approximately 60 days before the redetermination due date. Customers who would like to continue receiving benefits past their current certification must submit the manual redetermination form. Customers can do this in the following ways:

  1. Complete and mail the paper redetermination to the return address listed on form.
  2. Complete and submit the redetermination online via Manage My Case in ABE.
  3. Complete in person by visiting a Family Community Resource Center (FCRC).
  4. Complete over the phone by calling the ABE Customer Call Center (see WAG 02-04-00: Application and WAG 02-04-03-d: Application Signatures for more information).
  5. Complete and fax to the return fax number listed on form.

Manual Redetermination Forms

The type of redetermination form the customer will receive depends on the benefits due for redetermination. For medical only, the customer will receive a 643 form. The Form IL 444-1893 will be sent to customers also due for SNAP and/or TANF redetermination. Even if a customer is found ex parte eligible for medical, if they are due for SNAP/TANF/AABD cash, the customer must complete the 1893 redetermination form to be evaluated for ongoing benefits for these programs.  The 2381C Notice and Forms 643M, 643N and 643X are auto-populated with IES clearance data.  See PM 19-02-04-g for more information.

Due Dates

Customers have 30 days to respond to the redetermination. If the customer returns the redetermination, the date the redetermination is received by the State is recorded in IES to prevent auto-cancelation of medical benefits. or cash assistance. If the redetermination received date is not recorded 90 days after the redetermination due date, IES will auto-cancel for failure to complete the redetermination.

Note: If the household receives SNAP, the SNAP will end when the certification date expires unless a SNAP redetermination is completed to reset the SNAP benefit certification period for another year. Receipt of the SNAP redetermination will not stop IES from ending the SNAP if the redetermination has not been completed by cutoff.

Customer Reminder

IES will generate a reminder form, 643RNW, which is both mailed and sent electronically via ABE if the medical redetermination received date has not been updated in IES within 20 days from the manual redetermination sent date.

Processing Returned Redeterminations

Upon receipt of a completed manual redetermination, caseworkers must update data collection, run eligibility, and certify results prior to cutoff of the month the redetermination is due.  See PM 19-04-02 for information on how to process a redetermination received after cutoff.

If a customer submits their manual redetermination but required information is missing and cannot be verified electronically, a 267 VCL Form must be sent to the customer to request the necessary information.

The following must be verified at redetermination:

  • Current income
  • Documentation of citizenship and identity for U.S. citizens (if not yet documented and not exempt).
  • Documentation of immigration status if undocumented or unknown.
  • Illinois residency

Pending Citizenship Verification

For U.S. citizens whose verification is not yet complete, caseworkers must complete an SSA citizenship inquiry for each person for whom citizenship and identity have not been documented. If citizenship and identity cannot be confirmed via the SSA inquiry, IES will send a VCL (with the Form 3859A-Help Sheet for Citizenship & Identity Documentation) to provide documentation within 90 days. If otherwise eligible, IES will permit certification of the medical redetermination while U.S. citizenship documentation is pending and will create a task for follow-up.

If the required documents are not provided by the end of the 3-month period, IES will create a task for caseworkers to manually close eligibility unless the person is:

  • a child under age 19, or
  • an adult who had an active case AND has been continuously living in a long-term care facility, Community Integrated Living Arrangement (CILA), or Supportive Living Facility (SLF) since 11/30/11 or earlier.

Reviewing Information

Accept the customer's statement for presence in the home unless it is questionable.

Always review third party liability (TPL) health insurance information at each redetermination and complete the necessary forms.

Report any changes relating to child support to the Division of Child Support Services.

Although the customer has the right to come to the FCRC to complete and submit their redetermination, never ask or require a customer, who receives medical only, to come to the FCRC to complete their redetermination.