Qualifications for Medicaid in Illinois

Do you need health insurance, but wonder how you can afford coverage? Learning how to qualify for Medicaid in Illinois is your crucial first step if you need free or reduced-cost medical assistance. The Illinois health program has several requirements to be eligible for Medicaid. Only those applicants who meet the Medicaid eligibility requirements may be accepted into the program. Note that applicants who fall into different categories of living situations, disabilities and incomes may be subject to different Medicaid qualifications. To gain Illinois Medicaid benefits eligibility, you must meet any income-related and non-income-related requirements established by the state of Illinois.

What are the Medicaid application guidelines? Start by looking through the sections below to learn more about eligibility requirements for medicaid in Illinois. You will find important information on application guidelines for Medicaid, including topics addressing:

  • What are the income requirements for Medicaid in Illinois?
  • What are the requirements for Medicaid not related to income?
  • Illinois Medicaid eligibility through other program enrollment

What are the income requirements for Medicaid in Illinois?

What are the Medicaid application guidelines in relation to a patient’s finances? To obtain Medicaid benefits eligibility, you must meet the income requirements. The income required to abide by Medicaid eligibility requirements in Illinois is based on both the number of members in an applicant’s household and the total income. This is standard in every state within the nation that offers the Medicaid assistance program.

Are you wondering how to qualify for Medicaid in Illinois based on income? Financial application guidelines for Medicaid take your entire family into consideration. Your household income (dependent on your family’s size) must not exceed 138 percent of the Federal Poverty Level. This means that if you are the only member of your household, your annual income cannot exceed $16,395 to be eligible to receive Medicaid. If your household is composed of two individuals, you are allowed to earn $22,108 and still receive state medical assistance.

As the number of members in your household increases, your maximum allowable income increases, according to the following chart:

  • 3 members: $27,821
  • 4 members: $33,534
  • 5 members: $39,248
  • 6 members: $44,961
  • 7 members: $50,688
  • 8 members: $56,429
  • 9 members: $62,169
  • 10 members: $67,910
  • 11 members: $73,651
  • 12 members: $79,392

If your household has more than 12 members, simply add $5,741 for each additional person living in your home. The total will tell you how much income you can earn and still receive healthcare benefits from the Illinois Medicaid program. As long as your income is below the threshold, you very well may fall into the bracket regarding who is eligible for Medicaid.

What are the requirements for Medicaid not related to income?

Beyond the Illinois Medicaid eligibility requirements related to household income, the Medicaid program may also ask prospective beneficiaries to meet various other qualifying criteria. Illinois Medicaid benefits eligibility applies only to United States citizens who are also Illinois state residents, United States permanent residents, legal aliens or United States nationals. In addition, regarding who is eligible for Medicaid, applicants must be considered in need of medical insurance assistance or health care, and they must be considered low-income or very low-income.

Beyond the income, residency in IL, citizenship in the U.S. and medical necessity Medicaid eligibility requirements, certain groups of individuals in Illinois are granted access to medical assistance benefits automatically. For instance, applicants who are 65 years of age or older can get medical assistance from Medicaid in Illinois. In addition to elderly people, Medicaid benefits eligibility is also granted automatically to the people of the state who are blind and patients who have other disabilities.

While learning how to qualify for Medicaid in Illinois, many people may wonder what other groups are eligible to receive medical help. Each of the following groups of individuals can get Medicaid benefits.

If you are younger than 21 years of age, you also qualify for Medicaid in IL. If you are pregnant or you live in an intermediate care home or a nursing facility, you can get Medicaid. If you have been in the United States for a limited duration of time as a refugee, you can receive medical assistance, as well. In addition, participants of Breast and Cervical Cancer Treatment Programs are eligible for benefits through the Medicaid program.

Parents or caretakers of children younger than 21 can also be accepted as beneficiaries of Medicaid if the child’s parent is:

  • Deceased.
  • Unemployed.
  • Under employed.
  • Not living with the child.

You will be accepted into the healthcare program as long as you can provide proof of your income and your other eligibility qualifications when you apply for medical assistance benefits.

Illinois Medicaid Eligibility through Other Program Enrollment

As it relates to how to qualify for Medicaid in Illinois, there are several factors involved –as the information provided in the sections above clearly demonstrates. However, there is another way to determine who is eligible for Medicaid in Illinois. Applicants who are already members of certain other accepted state programs including SSI and TANF may also receive medical assistance from Medicaid.

In the event you receive benefits from any of these other programs within the state, you can apply for Medicaid assistance as well. This will get you the medical help required to maintain your health and the health of every member of your household. Simply review the requirements to be eligible for Medicaid provided above concerning income, residency, citizenship and other factors in order to verify your qualifications before submitting an application for IL Medicaid.

If your application for Medicaid is denied, you may appeal the decision. In most cases, you will have 90 days from the date of the action. Once your appeal request is received, the Illinois Department of Health Care Services will make a ruling regarding your application within 45 days. If your application is approved after the IHFS’s reconsideration, you – and your household – will begin to receive medical assistance benefits through the Illinois Medicaid program.