- A new state law requires Nursing Facilities (NF) and Supported Living Program (SLP) facilities to use the online Application for Benefit Eligibility (ABE) system to submit applications.
- Facilities are encouraged to upload Form HFS 3654, Additional Financial Information for Long Term Care Applications and verification documents with ABE application to expedite processing.
- Accept paper applications when an individual applies for medical benefits.
Public Act 98-0651 requires all long term care facility providers to submit applications using online ABE system when filing an application for an individual in their facility.
NFs and SLPs Required to use ABE
Beginning 12/08/2014, NF and SLP facilities are required to use the online ABE system when filing an application for an individual in their facility.
Do not accept paper applications submitted by an LTC facility including Mail-In Application for Medical Benefits (HFS 2378H) or Request for Cash Assistance - Medical Assistance - Supplemental Nutrition Assistance Program (IL 444-2378B).
When a facility submits a paper application, return the paper application to facility and request the facility to resubmit using ABE.
Never request a paper application when the application has been submitted using ABE.
HFS 3654 and Verification Documents
Facilities are encouraged to scan and upload HFS 3654 (R-10-14) (pdf)/HFS 3654S (R-10-14) (pdf)Form HFS 3654, Additional Financial Information for Long Term Care Applications and any available verification documents when submitting ABE application to expedite processing.
Accept hard copy Form HFS 3654 and verification documentation from the facility.
FCRC sends form HFS 3654, PM 01-02-01-a/WAG 01-02-01-a when the form is not included with the application.
When to Accept Paper Applications
Accept paper applications when an individual or someone applying on behalf of an individual, other than the facility, submits the application.
[signed copy on file]
Michelle R.B. Saddler
Secretary, Illinois Department of Human Services
Director, Healthcare and Family Services
- HFS 3654 (Rev 10/14)
- HFS 3654S (Rev 10/14)
- HFS 2378H
- IL 444-2378B