Only applies to non-citizens age 65 or over who are not eligible for Medicaid assistance in Illinois due to immigration status
Policy Memo
10/30/2020
REVISION
01/06/2021
Summary
Effective 12/01/2020 medical benefits similar to those offered under Assistance for Aged, Blind or Disabled (AABD) will be offered to non-citizens age 65 and over who do not meet immigration status for Medicaid. This entirely state-funded special program is called Health Benefits for Immigrant Seniors.
This program becomes effective in IES with the next release, a tentative date of 10/26/2020. Since the new benefits official start date is 12/01/2020, the backdated months are considered 09/2020-11/2020. Coverage cannot be given prior 09/01/2020 regardless of the application date.
- Example: If an application is received 10/30/2020 and requests backdating, ONLY eligibility for 09/01/2020 should be reviewed. The only eligible month for backdating in this situation is September.
REMINDER: The earliest date of coverage for Health Benefits for Immigrant Seniors is 09/01/2020 which includes backdating. The program doesn't exist in IES prior to 09/01/2020.
Applications for Emergency Medical for Noncitizens should also be reviewed for eligibility for Health Benefit Coverage for Immigrant Seniors when the applicant is age 65 or over.
Eligibility Criteria:
This program follows the current AABD community eligibility criteria, including AABD spenddown. An individual may be eligible for this program provided all the following criteria are met:
- Not a U.S. citizen
- Not eligible for health benefits through Medicaid due to immigration status
- If the age cannot be verified electronically, we accept self-attestation
- The individual has a non-citizen status that does not meet the criteria for Medicaid
- Is a resident of the State of Illinois
- Income is at or below 100% FPL
- If income is above the 100% FPL limit, individual will be considered for spenddown
- See PM 15-08-00 for more details on AABD spenddown
- Non-exempt resources are $2,000 or less for one person, $3,000 or less for 2 people, plus $50 for each additional household member
- If resources are over, will be considered for AABD spenddown
- See PM 15-08-00 for more details on AABD spenddown
An individual is not eligible for this program if the person is:
- An inmate of a public institution
- Is eligible to be enrolled in a federally-funded Medicaid program
Case Maintenance:
These cases are processed and maintained the same as AABD cases.
- Cases will be redetermined annually
- Cases may be cancelled when:
- Client does not respond timely to requests for information
- Client requests cancellation
- Client moves out of state
- Client status no longer meets eligibility criteria listed below
- Income
- Resources
- Spenddown
- Becomes eligible for Medicaid programs.
As with other medical programs, coverage will not be ended during the COVID-19 PHE. Redeterminations will not be completed during the COVID-19 PHE and once spenddown is met, they will remain in met status until after the Public Health Emergency (PHE) ends.
Integrated Eligibility System (IES):
IES will be updated to reflect the processing changes necessary to include this new eligibility group.
A new indicator "A" will be added to the existing AABD Type of Assistance (TOA) within eligibility summary to identify the individual found eligible for Health Benefits for Immigrant Seniors.
Example below:
An additional statement will also be displayed in the EDG information. Example below.
New MANG P codes will be set in IES and sent to MMIS. MANG P Code 6I indicates regular AABD and MANG P Code 7I indicates AABD SPD.
Examples below:
NOTE: Due to the Public Health Emergency, individuals should not lose coverage. If eligibility is approved in a previous month but closed the ongoing month, an override needs to be added to keep case approved ongoing.
Covered services:
The program will cover all the same services as AABD except the services below:
- Nursing facility services
- Coverage of funeral and burial expenses
- Home and Community Based Waiver Services provided under Section 1915c
Public Charge:
If individuals have questions about how enrollment in this program would affect current or future requests to change their immigration status, they should email Protecting Immigrant Families at pifillinois@povertylaw.org or call the Immigrant Family Resource Program at 1-855-437-7669. Program staff will help find an organization to answer questions.
[Signed copy on file]
Grace B Hou
Secretary, Illinois Department of Human Services
Theresa Eagleson
Director, Healthcare and Family Services
