04/09/2025
Summary:
- Effective 01/01/2025, updates the various medical program income standards based on the Federal Poverty Level Income Guidelines.
- Provides information on the mass change update of medical cases effective April 2025 based on the revised income standards.
- Updates the Home Equity Limits.
- Updates the current income thresholds for when a tax dependent or child of another person in their eligibility determination group (EDG) is expected to be required to file a tax return.
- Updates the maximum monthly Health Savings Account (HSA) MAGI deduction.
- Updates the resource limit for Medicare Savings Program (QMB, SLIB, QI-1).
Increase in the Monthly Medical Income Standards
This release places in the manual the revised income standards for the programs listed below based on the 2025 Federal Poverty Level (FPL). The revised standards are effective 01/01/25 for all programs except Medicaid Presumptive Eligibility (MPE). The revised MPE standards are effective 3/01/2025. The revised standards will be updated in IES on 03/01/2025 effective April 2025 for active cases. For pending applications, the new standards will be applied for any budget month beginning with January 2025.
Family Health Plans & ACA Adult Income Standards
| Program |
Link to WAG |
|
All Kids Assist
FamilyCare Assist
Moms & Babies
ACA Adult
MPE
Medical Extension
Family Planning
|
WAG 25-03-02(2) |
Monthly Income Standards for AABD, Medicare Cost Sharing
| Program |
Link to WAG |
|
AABD (community)
Medicare Savings Programs (QMB, SLIB, QI-1)
HBWD
|
WAG 25-03-02(2) |
Family Assist and Family Health Spenddown Standards
See PM 15-06-01-a for Family Assist and PM 15-06-01-e for Family Health Spenddown standards. Children and pregnant women who qualify for spenddown must spend down to the Family Health Spenddown standard.
Mass Change Action in IES
IES will process a mass change action due to the 2025 income standards update. The mass change will occur in March, effective April 2025. The following changes will be certified for individuals whose countable income is below the income limit for 2025:
- Family Health Spenddown to full coverage for certain children and pregnant women;
- AABD spenddown to full coverage for certain AABD individuals;
- QI-1 to SLIB;
- QI-1 to QMB; and
- SLIB to QMB.
A form 360C Notice of Decision will be generated in IES.
Note: the mass update will not certify the following types of cases and these cases will appear on the MU-100/MUE-100 report:
- Cases in case change mode;
- Cases in redetermination mode;
- Cases with a benefit mismatch; and
- Cases with conversion information that has not been updated.
WAG 25 and the Program Standards Desk Aid
The Program Standards Desk Aid in WAG 25-03-02 has been updated with the revised income standards.
Home Equity Limits
Home Equity Limits have been updated in WAG 25-03-02(2).
Income Thresholds for a Tax Dependent Who May be Expected to be Required to File a Tax Return
The income amounts used to determine whether a tax dependent may be required to file a tax return using modified adjusted gross income (MAGI) budgeting in the 2025 calendar year are based on IRS rules for the 2024 tax year. See WAG 25-03-02(2) for the income threshold for the 2025 tax year.
MAGI Deduction-Contribution to a Health Savings Account (HSA)
The maximum allowable monthly MAGI deduction for HSAs for the 2024 tax year has been updated. See WAG 25-03-02(2).
Resource Limit for Medicare Savings Program (MSP)
The Medicare Savings Program (MSP) Resource Limits for 2025 have been updated in WAG 25-03-02(2).
MANUAL REVISIONS
[signed copy on file]
Dulce M. Quintero
Secretary, Illinois Department of Human Services
Elizabeth Whitehorn
Director, Illinois Department of Healthcare and Family Services
