08/28/13
Summary
- Effective January 2014 the Affordable Care Act (ACA) and recent state legislation provides that childless adults who are age 19-64 and not disabled will qualify for Medicaid. Applications for this new group will be accepted beginning 10/01/13.
- It is anticipated hundreds of thousands of adults across Illinois will become eligible for medicaid. Many of those adults are currently receiving SNAP. Because of this, we developed a simple process to enroll a large number of people quickly without disruption to our local offices and without the customer having to go through the regular application process.
- Illinois requested and received special approval to offer an express enrollment to SNAP adult only customers. Express enrollment targets Category 08 SNAP one person households with adults age 19 through 64 whose gross income is at or below 130% FPL.
- The week of August 26, 2013 SNAP households with an Item 24 expiration date of October 2013 or later will be centrally mailed a simplified short application (Form 2379) and CN 13.21.
- Selected one person SNAP units are asked to complete and return Form 2379 by September 13, 2013 to enroll in the Medicaid Program.
- Form 2379 is a new application created for Express Enrollment only.
- Applications will be received by Region 4 and distributed to designated locations.
- Applications for medical assistance for these households will be processed by staff at select locations throughout the state. Most cases will be eligible based on their current SNAP eligibility.
- Staff verify U.S. citizenship requirements and any Third Party Liability (TPL) information.
- Once staff determine the case eligible, the existing case information is used to change the case from a Category 08 to a Category 94.
- Upon approval, a medical card is mailed to the customer but coverage does not begin until January 1, 2014.
- Upon approval, Form 360C is produced showing medical eligibility as of January 1, 2014.
- Form 2807 is mailed to the customer notifing them of their new SNAP availability date. They continue receiving SNAP benefits on their current Link card.
What is Express Enrollment in Medicaid?
Effective January 2014 the Affordable Care Act (ACA) and recent state legislation provides that childless adults who are age 19-64 and not disabled will qualify for Medicaid. Applications for this new group will be accepted beginning 10/01/13. It is anticipated hundreds of thousands of adults across Illinois will become eligible for Medicaid. Many of those adults are currently receiving SNAP. Because of this, we developed a simple process to enroll a large number of people quickly without disruption to our local offices and without the customer having to go through the regular application process.
Illinois requested and received special approval to offer an express enrollment to SNAP adult only customers. Express enrollment targets Category 08 SNAP one person households with adults age 19 through 64 whose gross income is at or below 130% FPL. A simplified Application for Medical Assistance (Form 2379) is the new application created for Express Enrollment only. Selected one person SNAP households are asked to complete and return Form 2379 by September 13, 2013 to enroll in the Medicaid Program.
Who Is Included in Express Enrollment?
One person Category 08 cases with an Item 24 date of 10/13 or later are being sent Form 2379 unless:
- the person is active on Medicaid, except persons only receiving services from local office 193 and 194;
- the person is active Department of Corrections (DOC) local office 195;
- the gross income is greater than 130% FPL;
- Item 90 contains codes 510, 511, and 691; or
- Item 80 contains code 372 CS (child support deduction).
Receipt of Applications
The applications have a Region 4 return address in Springfield. Region 4 staff will review the application to ensure that it is signed. If it is not signed, they will return the application and request a signature. Once a signed application is received, Region 4 staff will track receipt and scan the application. Once scanned, Region 4 will electronically forward the applications to designated staff in Kane Elgin, Champaign, Springfield, or East St. Louis.
If Form 2379 is received by FCRC staff, scan and email the Form 2379 to Julie Settles (Julie.Settles@illinois.gov) in Region 4.
Action by Designated Staff Processing the Applications
Do not register an application.
Eligibility and Processing the Application
To process an application, staff take the following actions:
- Run a clearance to ensure the applicant is currently receiving SNAP and not currently active for Medical, including FCRC #197.
- Staff review citizenship coding. If the person is coded as an eligible noncitizen (Item 74 or screen 3 in ACID coded a 31, 32, 33-35, or 44) no action is needed to verify that the person is an eligible noncitizen for Medicaid. This was already verified for the SNAP program. If the person is a citizen (Item 74 or screen 3 in ACID coded a 30), staff verify through WTPY that they are a U.S. citizen. See WAG 22-14-03-e for processing WTPY inquiries.
- If health insurance coverage is checked on the application, staff call the applicant and requests the information needed to complete Form 1442. If staff cannot reach them by phone, they send Form 267 to obtain the Third Party Liability (TPL) information and allow 10 days for them to provide the TPL information.
Approving Applications
If the conditions above are met including verification of U.S. citizenship/immigration requirements and providing TPL information, approve the application.
To approve the application staff enter the existing Category 08 case number in IPACS, using TA 40/TAR P5. A special screen has been developed and special procedures are required to access the IPACS screen using the TA 40/TAR P5. The information for approving these applications and accessing the screens in IPACS will be provided to the staff responsible for these actions.
Staff cannot enter transactions the date of schedule cut-off for Group 22 through date of the cut-off for Group 01.
Staff document the approval on Form 2379. Each Region is responsible for saving an electronic version of Form 2379.
The TA 40/TAR P5 will transfer the case to a Category 94 with a K in Item 25. All SNAP coding will be transferred to the 94 case including Item 73 SNAP E & T coding. They continue receiving SNAP benefits on their current Link card.
Approval Notices
The following notices are generated when the TA 40/TAR P5 is processed:
- Notice of Decision on Your Application (Form 360C) is centrally produced showing medical eligibility as of January 1, 2014. A medical card is mailed to the customer upon approval, but coverage for the card does not begin until January 1, 2014.
- Notice About Change in Availability Date (Form 2807) is mailed to the customer notifying them of their new SNAP availability date.
Denying Applications
If the applicant is currently receiving medical benefits, does not meet citizenship/immigration requirements, is no longer a one person adult household, is no longer receiving SNAP or, failed to provide the TPL information, deny the application. Complete Form 360 I to inform the customer and attach the flyer, "Important News - You Can Get Help to Buy Health Insurance".
If a customer indicates they want to appeal a denial action, staff advise them to reapply for medical benefits through ABE beginning 10/01/13.
Mobius Reports
Two reports are available in Mobius:
- #84504083, "Cases Selected For DHS 2379"
- #84504084, "Statewide Summary of Cases Processed for DHS 2379"
[signed copy on file]
Michelle R. B. Saddler
Secretary, Illinois Department of Human Services
Julie Hamos
Director, Healthcare and Family Services
Forms referenced:
- Form 360
- Form 1442
- Form 2379
- Form 2807
