Health Benefit Coverage for Immigrant Adults: Enrollment Pause

Illinois Department of Human Services logo
Illinois Department of Healthcare and Family Services logo

06/28/2023

Policy Memo

Summary:


The Health Benefits for Immigrant Adults (HBIA) program covers immigrant adults ages 42 to 64 who are not otherwise eligible for medical coverage in the State of Illinois.

Effective 07/01/2023, new enrollment for the HBIA program will be temporarily suspended. Enrollment for the HBIA is being paused to ensure the program does not exceed available funding. Customers currently enrolled in the HBIA program will remain eligible for medical coverage.

Applications for the Health Benefits for Immigrant Seniors (HBIS) program will continue to be available at this time.

Processing Applications for Health Benefits for Immigrant Adults

HBIA applications with a received date prior to 07/01/2023 should be processed and may be eligible for approval if the customer meets program criteria.

Example: Application for HBIA is received on 06/28/2023 and processed on 07/15/2023. The application may be approved if the customer meets HBIA eligibility criteria.

HBIA applications with a received date on or after 07/01/2023 should be processed and will not be eligible for approval. The Integrated Eligibility System (IES) will generate a notice stating "Enrollment cap for State Non-Citizen Program benefits has been reached and no additional approvals are allowed". Staff should document the denial reason in Case Comments.

Example: Application for HBIA is received on 07/15/2023 and processed on 08/01/2023. The application will be denied and the denial notice will be sent.

Co-Payments and Cost Sharing - Health Benefits for Immigrant Adults and Seniors

Beginning 07/01/2023, providers may collect co-payments and cost sharing on the following services when they do not qualify for federal match under the Emergency Medical for Noncitizens program:

  • Inpatient hospitalizations: $250 co-pay
  • Hospital emergency room visits: $100 co-pay
  • Hospital or Ambulatory Surgical Treatment Center outpatient services based on the applicable Department rate

[signed copy on file]

Grace B. Hou

Secretary, Illinois Department of Human Services

Theresa Eagleson

Director, Healthcare and Family Services