05/08/14
Action Memo
Summary:
- Effective January 1, 2014, the Affordable Care Act (ACA) and recent state legislation provided that childless adults who are age 19-64 and not disabled may qualify for medical benefits. Some of the pending Applications for Benefit Eligibility (ABE) applications include applications for this new group.
- Many of those adults who are currently receiving Supplemental Nutrition Assistance Program (SNAP) benefits only, are eligible for medical benefits. 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 has been developed.
- Illinois received special approval to offer an express enrollment for medical to adults who receive only SNAP benefits.
- Express enrollment targets Category 08 SNAP one person households with adults age 19 through 64 whose gross income is at or below 130% FPL.
- Beginning the week of April 7, 2014, SNAP households for which a medical only application has been received only in office 180 (AllKids) with an Item 24 expiration date of April 2014 or later will be centrally enrolled for Medicaid.
- Applications are being stored in Content Management and will be available for review if needed.
- Citizenship will be centrally verified on the applicants and referred to Region 4 staff for processing. To process the application, Region 4 staff must run a clearance to ensure the applicant is a one person Category 08 case and not currently active for medical, including CountyCare.
- When determined eligible for medical benefits, 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 and coverage begins 01/01/2014.
- Upon approval, Form 360C is produced showing medical eligibility as of the month of application.
- Form 2807 is mailed to the customer notifying them of their new SNAP availability date. They continue receiving SNAP benefits on their current Link card.
What is Phase 3 of Express Enrollment?
Effective January 1, 2014, the Affordable Care Act (ACA) and recent state legislation provided that childless adults who are age 19-64 and not disabled may qualify for medical benefits. Some of the pending Applications for Benefit Eligibility (ABE) include applications for this new group.
Many of those adults who are currently receiving SNAP benefits only, are eligible for medical benefits. 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 has been developed. Illinois received special approval to offer an express enrollment for medical to adults who receive only SNAP benefits. Express enrollment targets Category 08 SNAP one person households with adults age 19 through 64 whose gross income is at or below 130% FPL. Beginning the week of April 7, 2014, SNAP households for which a medical only application has been received in office 180 (All Kids) with an Item 24 expiration date of March 2014 or later will be centrally enrolled for Medicaid. Applications will be referred to and processed by Region 4. Most cases will be eligible based on their current SNAP eligibility.
Who Is Included in Phase 3 of Express Enrollment?
One person Category 08 cases with an Item 24 date of April, 2014 or later are referred to Region 4 unless:
- the person is active on a medical case (excluding local office 193, 194, and 195).
Action by Designated Staff Processing the Applications
Do not register an application.
Eligibility and Processing the Application
Citizenship will be centrally verified on the applicants and referred to Region 4 staff for processing. Region 4 staff must run a clearance to ensure the applicant is a one-person Category 08 case and not currently receiving medical benefits (including CountyCare).
Individuals currently receiving Medicare are not eligible.
Approving Applications
To approve the application, Region 4 staff must 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 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 will continue receiving SNAP benefits on their current Link card.
Once approved the applications will be centrally removed from IES and saved.
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 01/01/2014. A medical card is mailed to the customer upon approval.
- Notice About Change in Availability Date (Form 2807) is mailed to the customer notifying them of their new SNAP availability date.
Mobius Reports
Report #R8451075-01, "SNAP Cases Enrolled in Medical", is available in Mobius.
[signed copy on file]
Michelle R. B. Saddler
Secretary, Illinois Department of Human Services
Julie Hamos
Director, Healthcare and Family Services
Forms referenced:
