PM 06-24-01 Who Is Eligible

WAG 06-24-01

new textTo be eligible for medical assistance under HBWD, an individual must meet the following eligibility requirements:

Non-Financial Requirements

  • Person must be age 16 through 64 years of age.
  • Person must have a disability. A person who has not already been found to have a disability, according to SSA/SSI standards, must have a disability determination by the Client Assessment Unit (CAU). The person's earnings will not be considered in the CAU disability determination.

Person must meet all other AABD(D) nonfinancial eligibility requirements.

To be eligible for HBWD, the person must be considered employed.

In addition to providing proof of income, the person must show proof of payment of Federal Insurance Contributions Act (FICA), Illinois Municipal Retirement Fund (IMRF), or the equivalent.

If the following situations exist, a person may be enrolled in the program without providing proof of current employment or self-employment:

  • Person has proof of starting a new job within 60 days of the date of application. Eligibility will not begin until employment begins and the premium is paid; or
  • Person is unable to work due to medical reasons after enrollment begins.

To be eligible for continued medical benefits when unable to work due to medical reason the client must:

  • report unemployment within 30 days after the first day unemployment began;
  • provide a written physician's statement with the anticipated date of return to work within 90 days; and
  • continue to pay monthly premiums.

To be eligibile for continued medical when employment ended for another reason, the person may continue to be enrolled for 30 days after employment ends, if they pay their premium(s).