PM-06-27-02 DCFS Non-Financial Medicaid Eligibility

WAG 06-27-02

Medicaid eligibility must be redetermined once every 12 months.

A child/youth is Medicaid eligible if he or she meets the following conditions:

• Under age 21;
• Illinois resident;
• U.S. citizen or eligible non-citizen (see PM 03-01-02-j); and
• Has a valid Social Security Number (SSN) or proof of application for one.

Note:  A child/youth receiving DCFS services qualifies for medical coverage regardless of Medicaid eligibility.  A Medicaid eligibility determination is required to identify eligible cases for federal claiming.

Electronic Sources of Verification

The child's age, U.S. citizenship/immigration status and Social Security Number (SSN) can be verified through IES Data Exchange or through BlueZone PACIS clearances as needed. 

Deeming Medicaid Eligibility

The following children/youth are deemed eligible for Medicaid (a separate Medicaid determination is not required):

• Children/youth who are determined Title IV-E eligible; or 
• A child of youth in care (formerly known as child of ward) when the child is born while the youth parent is receiving a medical card and the child is under the age of 1.