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Learn About Requirements for Medicaid in Illinois

“What are the requirements for Medicaid in Illinois?” is a frequent question individuals interested in acquiring medical assistance ask when they first begin to explore government programs. It is important to understand how to qualify for Medicaid, since there are various requirements applicants must fulfill to be considered eligible for benefits. In addition to wondering who is eligible for Medicaid, applicants typically inquire, “What are the income requirements for Medicaid in ?” because Medicaid was especially created for financially needy families who cannot afford private health insurance and do not receive health care benefits through their employer, if they are employed. Knowing who is and who is not eligible for Medicaid will lead applicants to a better prepared application, increasing their chances of acceptance into the program.

Who qualifies for Medicaid in Illinois?

Qualifications for Medicaid in Illinois expanded in 2013 due to the Affordable Care Act (ACA) Medicaid expansion, which was passed in 2012. Medicaid benefits eligibility now extends to adults between the ages of 19 and 64 who do not have children. Furthermore, IL Medicaid eligibility still consists of the same main requirements as it did before the expansion. Every applicant must meet these main requirements despite their extenuating circumstance, unless an exception has been ratified for a particular group of people. The standard Medicaid eligibility requirements for all Illinois applicants include the following:

  • Applicants must be a United States citizen or permanent resident.
  • Applicants must be categorized as low-income or very low-income.
  • Applicants must be residents of the state of Illinois.

The requirements for Medicaid in Illinois allow anyone who is a former member of foster care to qualify for Medicaid regardless of income until he or she is 26 years old. In order to qualify under this provision, the applicant should have aged out of the foster care system at 18 years of age. Additionally, children currently in foster care qualify for Medicaid if they also meet the income limit. Other groups of people who are eligible for Medicaid in IL include pregnant women and those suffering from a qualifying disability, including blindness.

Multiple groups of people can be eligible for Medicaid subprograms through the Illinois Department of Healthcare and Family Services. These programs help determine who is eligible for Medicaid by specifically targeting individuals and families who fall within certain guidelines. For instance, parents and caretakers of children who are younger than 18 years of age can qualify for the FamilyCare/All Kids Assist program if they meet Medicaid’s income limit.

Furthermore, pregnant women and their newborns can be eligible for Medicaid coverage in IL for up to one year with qualifying income through the Moms and Babies programs. These Medicaid benefits eligibility programs go on to include women diagnosed with breast cancer and cervical cancer, veterans and refugees.

As there are a wide range of programs available for different low-income households, individuals and families are encouraged to apply if they meet the basic Medicaid requirements to see if there is a program that can provide assistance for them.

What are the income requirements for Medicaid in Illinois?

Income requirements for Medicaid in Illinois are in place to ensure only those individuals and families who are in the most need of assistance receive benefits. To meet Medicaid eligibility requirements, The income limits required for each household to qualify for medical assistance will account for the size of the household. For example, a household with a single individual needs to make less money to qualify for Medicaid than a household of two parents and two children. IL Medicaid income requirements vary among different Medicaid programs. For example, Medicaid benefits eligibility requirements for income differ among ACA Adults, Moms and Babies and All Kids Share.

If an applicant fails to meet Medicaid income eligibility requirements, then he or she will be disqualified from the program. Learn more about the Medicaid income limit with our free guide.

What are the Medicaid application guidelines in Illinois?

Medicaid application guidelines in Illinois require applicants to demonstrate their eligibility for Medicaid assistance. Typically, petitioners are asked to provide the state with a birth certificate, Social Security Number or alien registration number to confirm their identity. Additionally, all Medicaid eligibility requirements must be met to submit a potentially successful application. Therefore, to qualify for medical assistance in IL, applicants may also be asked to submit supplemental documentation for proof of income or medical records if the applicant claims pregnancy or a disability. It is in the best interest of the Medicaid applicant to be prepared with this information before beginning the application process. To obtain more information on the Medicaid application process, download our free guide.