PM 06-26-04 Presumptive Eligibility

WAG 06-26-04

Family Planning Presumptive Eligibility (FPPE) is available to customers applying through providers approved and trained by HFS. Only approved providers may determine eligibility for FPPE. This process will mirror the Medicaid Presumptive Eligibility (MPE) process for pregnant women. The same providers who are eligible to be MPE providers are eligible to be FPPE providers. FPPE providers will use the same presumptive eligibility online portal they use for MPE.

FPPE providers will determine eligibility for FPPE based on:

  • applicant attestation to not being currently pregnant.
  • applicant attestation to IL residency.
  • applicant attestation of current monthly income meeting standard limit of household size of 2.
  • verification that individual is not currently enrolled in full medical program coverage.

All regular family planning services and related services are available under FPPE. FPPE will provide immediate temporary coverage from the day the individual signs the application and continues through the last day of the following month. If the individual applies for ongoing medical and/or Family Planning benefits, FPPE will continue until a decision is made on the full application.

FPPE coverage cannot be backdated.

The All Kids unit will be responsible for processing FPPE requests.

Customers may only receive two presumptive eligibility periods within one calendar year. All types of presumptive eligibility are included when determining the limit (MPE, FPPE, Adult PE, Child PE).

Note: Pregnant individuals are not eligible for FPPE.