Haris Ashley
Medicaid is a federal and state program that helps low-income individuals and families with healthcare costs. In Illinois, Medicaid is available to US citizens and qualified non-citizens, including refugees and persons lawfully present in the US for over five years. The program covers young adults under 26 who were formerly in foster care, pregnant women, and children. As of 2021, people in Illinois are allowed to use Medicaid as their secondary insurance.
| Characteristics | Values |
|---|---|
| Can Medicaid be used as secondary insurance in Illinois | Yes |
| Who can use Medicaid as secondary insurance | People with a low income, unemployed people, pregnant women, children, and adults under 65 |
| Medicaid eligibility in Illinois | Children aged 0-18 with family income up to 142% to 147% of the FPL, pregnant women with family income up to 208% to 213% of FPL, adults with family income up to 138% of FPL |
| Medicaid enrollment in Illinois | Approximately 3.9 million people |
| Medicaid application process | Apply online, apply in person at the Department of Human Services, apply by mail or fax, or call 1-800-843-6154 |
| Medicaid coverage | Doctor visits, medicine, dental care, podiatry services, hospital and nursing home reimbursement, and more |
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What You'll Learn
Medicaid as secondary insurance
In the United States, Medicaid provides free or low-cost medical benefits to people with low incomes. Each state has its own eligibility requirements, which are set at or above the minimum threshold specified by the federal government. In Illinois, Medicaid is handled by the state's Department of Human Services (DHS) and Healthcare and Family Services (HFS).
Medicaid can be used as secondary insurance in Illinois. People on Medicaid are allowed to use it as their secondary insurance, with any other insurance being used first. If there are any remaining costs, Medicaid will cover them. This is known as Medicaid being the "payer of last resort".
If you have private insurance and Medicaid, your bills will be handled by the state directly and not by your Managed Care Organization (MCO). You may also no longer be in your MCO's Managed Care network of doctors. It is important to note that some doctors do not accept Medicaid due to slow payment processes.
To enrol in Medicaid in Illinois, you can apply online, in person, by mail, or by fax. You can also call 1-800-843-6154 (TTY: 1-800-447-6404) to request an application form or for assistance with your Recipient Identification Number (RIN).
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Medicaid eligibility in Illinois
Medicaid is a federal and state program that helps people in need with healthcare costs. In Illinois, Medicaid is available to people who meet certain income, age, disability, and/or citizenship status requirements. Illinois was the first state to extend postpartum Medicaid coverage to 12 months after the baby is born. The state also provides Medicaid coverage to children who have been without private insurance for three months.
To be eligible for Medicaid in Illinois, you must be a U.S. citizen or fall within one of the qualified categories of non-citizens, such as refugees and persons lawfully present in the U.S. for over five years. If you are not eligible for Medicaid because of your immigration status and you are 65 years or older, you may be eligible for Illinois' Health Benefits for Immigrant Seniors program.
In Illinois, residents aged 65 or older can qualify for both Medicaid and Medicare coverage through the state's Medicare-Medicaid Alignment Initiative. To qualify for Medicaid as a senior, a single person must have an income below $981 a month and countable assets below $2,000. Income and asset requirements are subject to change year to year. Adults aged 19 to 64 may be eligible for Medicaid in Illinois as long as they meet the state's income or disability requirements and are not receiving Medicare coverage.
Children aged 18 and younger may qualify for either Illinois Medicaid or the State Children's Health Insurance Program (SCHIP), depending on their family's income level. The SCHIP program is designed for children whose families earn too much to qualify for Medicaid but not enough to afford private health insurance. Children who live in households with an income of up to 318% of the federal poverty level are eligible for Medicaid coverage. Women who have recently given birth with incomes up to 213% of the federal poverty level are eligible for Medicaid coverage for up to 12 months after giving birth.
Young adults under age 26 who were formerly in foster care are also eligible for Medicaid in Illinois. Adults with income up to 138% of the federal poverty level are eligible. Each group has a different set of income and asset requirements. If you have health insurance through your employer, you are not eligible for Medicaid in Illinois.
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Applying for Medicaid
To apply for Medicaid in Illinois, you must meet the eligibility criteria. The eligibility criteria in Illinois are as follows: Children aged 0-18 qualify with family income levels up to 142-147% of the federal poverty level (FPL); pregnant women with family income up to 208-213% of FPL; and adults with family income up to 138% of FPL.
You can apply for Medicaid in Illinois in several ways. Firstly, you can apply online using the Illinois website or Healthcare.gov (for non-disabled adults under 65). Secondly, you can apply in person by visiting the Department of Human Services (DHS) and filling out an application form. You can find your nearest DHS office using the DHS Office Locator. Thirdly, you can apply by mail or fax by requesting an application form from DHS and returning the completed form. Finally, you can apply by calling 1-800-843-6154 (TTY: 1-800-447-6404) and asking DHS to mail you an application form, which you can then return by mail or fax.
It is important to note that you must provide accurate and complete information on your application form. If any information is missing or inaccurate, you have 30 days to report changes. Additionally, DHS may request additional information or documentation to process your application, so be sure to submit any required information by the specified deadline to avoid delays or denial of benefits.
Medicaid enrollment in Illinois has increased significantly during the COVID-19 pandemic, with approximately 3.9 million people enrolled as of 2023, up from 2.9 million before the pandemic. This increase is partially due to people staying continuously covered and the economic and health impacts of the pandemic.
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Medicaid and private insurance
In the United States, Medicaid is a federal program that provides free or low-cost medical benefits to people with low incomes. Each state has its own eligibility requirements, which are set at or above the minimum threshold specified by the federal government. For example, in Illinois, children aged 0-18 qualify for Medicaid if their family income is up to a certain percentage of the federal poverty level (FPL).
Medicaid can serve as secondary insurance for individuals who also have private insurance. In such cases, Medicaid acts as the payer of last resort, meaning that any other insurance policies are utilized first, and Medicaid covers the remaining balance. This situation may occur when an individual's employer offers health insurance, but their income still qualifies them for Medicaid.
In Illinois, Medicaid coverage has expanded to include adult dental care and podiatry services, and the state has aligned its laws with federal requirements to provide Medicaid to children who have been without private insurance for three months. However, it is important to note that some doctors and specialists may not accept Medicaid due to slow reimbursement processes.
If an individual is no longer eligible for Medicaid, they should promptly seek alternative health insurance, as there is typically a 60-day special enrollment period to enroll in a new plan. They can explore options such as purchasing insurance through their employer or utilizing the Affordable Care Act marketplace for Illinois, GetCoveredIllinois.gov, which offers free enrollment assistance and financial aid.
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Medicaid and specialist doctors
In Illinois, Medicaid pays for healthcare services, including visits to the doctor and medicine. Medicaid is an important part of overall health insurance enrollment and coverage in the state. As of 2023, there are roughly 3.9 million people enrolled in Medicaid in Illinois, an increase from 2.9 million before the COVID-19 pandemic.
Medicaid in Illinois covers specialist doctor visits, as well as other services. In 2014, then-Governor Pat Quinn signed a Medicaid reform bill that restored adult dental care and podiatry services. This bill also aligned Illinois law with federal law, providing Medicaid coverage to children who had been without private insurance for three months.
To be eligible for Medicaid in Illinois, the following income requirements must be met:
- Children ages 0-18 with family income levels up to 142% to 147% of the FPL (federal poverty level).
- Pregnant women with family income up to 208% to 213% of FPL (coverage extends for 12 months after giving birth).
- Adults under age 65 with family income up to 138% of FPL.
Medicaid in Illinois can be used as a secondary insurance, as it helps with costs that other insurance may not cover, such as Medicare premiums, cost-sharing, prescription drug costs, and long-term care expenses.
If an individual is no longer eligible for Medicaid, they usually have 60 days to enroll in a new insurance plan. This period is called a "special enrollment period."
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Frequently asked questions
Yes, people on Medicaid are allowed to use it as their secondary insurance. However, Medicaid is always the payer of last resort, meaning any other insurance you have will be used first, and then Medicaid will cover the remainder.
Eligibility for Medicaid depends on a combination of factors, including income level, age, and family size. In Illinois, children aged 0-18 qualify with a family income of up to 147% of the federal poverty level (FPL). Adults under 65 qualify with a family income of up to 138% of FPL, and pregnant women with a family income of up to 213% of FPL.
You can apply for Medicaid in Illinois online, in person, by mail, or by fax. You can apply online using the Illinois website or Healthcare.gov (for non-disabled adults under 65). To apply in person, go to the nearest Family Community Resource Center or Department of Human Services (DHS) office. You can also call 1-800-843-6154 for assistance.
If you are no longer eligible for Medicaid, it is important to enroll in a new health insurance plan within 60 days, known as a "special enrollment period." You can explore other health care coverage options, such as through your employer or GetCoveredIllinois.gov, the official Affordable Care Act Health Insurance Marketplace for Illinois.
