07/08/2022
Policy Memo
Summary
- Healthcare and Family Services (HFS) expands Health Benefit Coverage for Immigrant Adults (HBIA) to begin at age 42.
- Covers immigrants not otherwise eligible for any other medical benefits.
- Eligibility is determined by using Modified Adjusted Gross Income (MAGI) budgeting.
- Medical backdating is available to individuals who are approved for coverage.
- Individuals enrolled in Health Benefits for Immigrants, with emergency medical needs, must apply for Emergency Medical Coverage for Noncitizens.
Effective 07/01/2022, in accordance with House Bill 4343, Healthcare and Family Services (HFS) expands the Health Benefit Coverage for Immigrant Adults to cover ages 42 to 54 who are not otherwise eligible for medical coverage in the state of Illinois. Previously HBIA only covered ages 55 to 64.
Eligibility Criteria:
This program follows MAGI eligibility budgeting. An individual may be eligible for this program provided all the following criteria are met:
- Customer is not a U.S. Citizen;
- Customer has a non-citizen status that does not meet the criteria for Medicaid (see PM 03-01-00);
- Customer is a resident of Illinois;
- Customer's income is at or below 138% FPL; and
- Customer is age 42 through 54 years old. If the age cannot be verified electronically, we accept self-attestation.
Note: For Immigrant Adults, age 55 to 64, refer to Health Benefits Coverage for Immigrants Age 55 through 64 Years Old.
An individual is not eligible for this program if the person is:
- eligible to be enrolled in a federally funded Medicaid program; or
- an inmate of a public institution, although they may be considered eligible with limited benefits.
Medical Backdating
Eligibility start date for this program is 07/01/2022. Medical backdate months are available no earlier than April 2022.
Example: If an application is received 05/28/2022 and requests backdating, the only eligible month for backdating in this situation is April 2022.
Services not Covered
- long term care;
- funeral and burial expenses; and
- home and community-based waiver services
Emergency Medical Need
Individuals enrolled in HBIA (ages 42-64), with emergency medical needs, must apply for Emergency Medical Coverage for Noncitizens. Emergency Medical for Noncitizens should be evaluated and determined as described in MR #18.05: Emergency Medical Coverage for Noncitizens Not Meeting Immigration Status. Customers may be eligible for Emergency Medical while enrolled in HBIA. This also applies to providers who are applying on behalf of non-citizen customers with an emergency medical need.
Integrated Eligibility System (IES)
IES has been updated to reflect the processing changes necessary to include the HBIA eligibility group. An indicator (A) is added to the existing ACA Adult and Family Health Plan Types of Assistance (TOA) to identify this population. The indicator is displayed on the Eligibility Summary page to identify the individual found eligible for HBIA. This is the same indicator for individuals enrolled in Health Benefits for Immigrants Age 55 through 64 Years Old. See example below.
The additional statement, "State Non-Citizen Program", will also be displayed in the EDG information. See example below.
MMIS
MangP Code 'NI' will be set in IES and sent to MMIS, example below:
[signed copy on file]
Grace B. Hou
Secretary, Illinois Department of Human Services
Theresa Eagleson
Director, Illinois Department of Healthcare and Family Services
