NOTE: See PM 20-08-15 for 3 exceptions.
NOTE: Do not complete Form 2299 for a spenddown case.
Example: A client enters a facility on 08/01. The screening requirement is met on 07/25. Medical eligibility is effective 07/01. Enter 08/01 in Section A and in Section D of Form 2299.
Example: A client applies for benefits on 08/07 and enters a facility on 08/10. The screening requirement is met on 08/15. Enter 08/15 in Section A and in Section D of Form 2299.
Example: A person enters a facility on 09/03 and applies for benefits on 09/05. Medical eligibility is effective 09/01. Enter 09/03 in Section A and in Section D of Form 2299.
Since the person applied for benefits after admission, a screening is not required.
Example: A client enters a facility on 04/01. The screening requirement is met on 03/25. Medical eligibility is effective 03/01. Enter 04/01 in Section A and in Section D of Form 2299.
Example: A client enters a facility on 08/10. The screening requirement is met on 08/15. Enter 08/15 in Section A and in Section D of Form 2299.
Example: A person enters a facility on 09/03 and pays the private rate through 10/31. Enter 11/01 in Section A and in Section D of Form 2299.
Since the person converted from private pay to Medicaid, the date of the screening does not affect the date of payment authorization. However, do not authorize payment until the screening requirement is met.
Illinois Department of Human ServicesJB Pritzker, Governor · Dulce M. Quintero, Secretary
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