Jeffrey Wade
Chicago residents have a variety of options when it comes to healthcare coverage. The state of Illinois funds local hospitals to ensure residents have access to healthcare services, regardless of their ability to pay. In addition, the state has expanded Medicaid managed care to include all counties across Illinois. This program is called HealthChoice Illinois. Medicaid is a state-administered health insurance program for residents with low incomes. It covers medical and surgical expenses, and in Illinois, young adults under 26 who were formerly in foster care are eligible for Medicaid. To learn about your Medicaid health plan choices, Chicago residents can call the Illinois Department of Healthcare and Family Services.
| Characteristics | Values |
|---|---|
| Type of Insurance | Medicaid is a state-administered health insurance program |
| Who is it for? | People with low incomes, young adults under 26 who were formerly in foster care, children, and pregnant women |
| What does it cover? | Medical and surgical expenses |
| Who accepts it? | The University of Chicago Medicine and University of Chicago Physicians Group |
| How to apply? | Apply through the Health Insurance Marketplace |
| Who is eligible? | U.S. citizens or qualified non-citizens, such as refugees and persons lawfully present in the U.S. for over five years |
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What You'll Learn
Medicaid eligibility requirements
Medicaid is a state and federal program that provides affordable health coverage to low-income people and families. It is available to US citizens or those who fall within certain categories of non-citizens, such as refugees and persons lawfully present in the US for over five years. Each state has its own eligibility requirements, and in Illinois, there are several different coverage groups for different populations.
To be eligible for Medicaid in Illinois, adults must have an income below 138% of the federal poverty level. However, adults who are disabled, blind, or aged 65 or older have different income limit rules. Children and pregnant women have higher income limits, with children in households with an income of up to 318% of the federal poverty level being eligible for coverage. Women who have recently given birth with incomes up to 213% of the federal poverty level are also covered for up to 12 months after giving birth. Young adults under 26 who were formerly in foster care are also eligible for Medicaid in Illinois.
If you are not eligible for Medicaid due to your income, you may still qualify for financial assistance to help cover costs on the Health Insurance Marketplace. If your ineligibility is due to your immigration status, you may be able to buy low-cost insurance with financial assistance through the Get Covered Illinois Marketplace.
To learn more about your Medicaid health plan choices in Illinois, you can call the Illinois Department of Healthcare & Family Services Client Enrollment Services or visit their website. You can also fill out a quick screening tool online or give basic information about your household and income over the phone to see if you may be eligible for Medicaid. Even if the screening tool indicates that you may qualify, you must still complete a full application.
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Income limits
Medicaid is a state and federal program that provides affordable health coverage to low-income residents of Illinois. The income limits for eligibility vary depending on the specific circumstances of the applicant or their household, such as age, disability, and family size. These income limits are subject to change annually, depending on the federal poverty level.
For adults under the age of 65, the income limit for Medicaid eligibility is generally up to 138% of the federal poverty level. However, adults who are disabled, blind, or aged 65 and above have different income rules, with their income needing to be below 100% of the federal poverty level. Additionally, they must have no more than $17,500 in non-exempt resources, which can include assets such as cash, stocks, and real estate. Exemptions may include personal belongings, an automobile, and one's primary home.
Children and pregnant women have higher income limits for Medicaid eligibility. In Illinois, children aged 0-18 qualify with family income levels up to 142% to 147% of the federal poverty level. Pregnant women are eligible with a family income of up to 208% to 213% of the federal poverty level, and this coverage can last up to 12 months after giving birth.
It's important to note that each state has its own eligibility requirements for Medicaid, and Illinois uses different coverage groups, including All Kids, FamilyCare, ACA Adults, Moms & Babies, Former Foster Care, and AABD Medical. The income limits and specific coverage details may vary within these groups.
To determine eligibility, individuals can fill out a screening tool online or contact the Marketplace Help Desk to provide basic information about their household income and composition.
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Immigrant access
Medicaid is a state and federal program that provides free or low-cost medical benefits to people with low incomes. Each state has its own eligibility requirements. In general, to be eligible for Medicaid, 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.
Illinois is one of the few states that provides Medicaid-style health care benefits to undocumented immigrants. The state has covered low-income undocumented children up to age 18 under the All Kids program. In 2020, Illinois expanded its coverage to undocumented seniors through the Health Benefits for Immigrant Seniors program. The state has also offered coverage to adults aged 42 and older through the Health Benefits for Immigrant Adults (HBIA) program. However, Governor JB Pritzker's 2025 budget plan proposes eliminating the HBIA program, which has caused concern among immigrant families and supporters of the program. The elimination of the HBIA program is expected to impact noncitizen immigrants aged 42 to 64 who do not qualify for other Medicaid categories solely due to their immigration status.
Despite the proposed cuts, Illinois remains committed to fostering healthcare equity and providing access to medical coverage for its residents. After June 30, 2025, individuals who were enrolled in the HBIA program may still have access to primary and preventative care at Federally Qualified Health Centers (FQHC) and free and charitable clinics that serve uninsured and underinsured people regardless of their immigration status and ability to pay. Additionally, undocumented adults can access federally matchable emergency services through the Emergency Medical for Noncitizens program, which provides time-limited coverage for emergency services.
For immigrants who do not qualify for Medicaid due to their immigration status, there are other options available. Illinois offers the Get Covered Illinois Marketplace, which provides financial assistance to buy low-cost insurance. Each state has different eligibility requirements, and it is recommended to check with the state's Medicaid agency to understand the specific requirements and available programs.
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Children's Health Insurance Program (CHIP)
Medicaid is a state and federal program that provides free or low-cost medical benefits to people with low incomes. Each state has its own eligibility requirements for Medicaid, which generally depend on income and resources, citizenship or immigration status, and age.
The Children's Health Insurance Program (CHIP) is a government-sponsored health insurance program that provides low-cost health coverage for children in families with incomes too high to qualify for Medicaid. CHIP is available in all states, and each state has its own rules and benefits regarding the program. CHIP typically covers medical and dental care for children and teens up to age 19, and in some states, it also covers pregnant women.
The cost of CHIP coverage varies by state but is generally limited to no more than 5% of a family's income for the year. Routine "well-child" doctor and dental visits are typically free under CHIP, but there may be a fixed amount that families must pay for covered health care services after meeting their deductible.
To apply for CHIP, families can create an account with the Health Insurance Marketplace and fill out an application. If it appears that any household members qualify for CHIP, the family's information will be sent to their state agency, which will contact them about enrollment. Families can also call the Insure Kids Now hotline at 1-877-543-7669 to learn more about CHIP and enroll.
In Illinois, children from households with incomes up to 318% of the federal poverty level are eligible for Medicaid coverage. If a family's income is too high for Medicaid, they may still qualify for CHIP. Families can check with the Illinois Department of Healthcare & Family Services for more information on Medicaid and CHIP eligibility and benefits in the state.
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Accepted insurance providers
Medicaid is a state and federal program that provides free or low-cost medical benefits to people with low incomes. Each state has its own requirements for eligibility, and in Illinois, the program is available to young adults under 26 who were formerly in foster care, children, and pregnant women. Adults with an income of up to 138% of the federal poverty line, and children in households with an income of up to 318%, are eligible for Medicaid coverage.
The University of Chicago Medicine accepts a large number of health insurance products and plans, including traditional Medicare and Medicaid plans, as well as some Medicare Advantage and Medicaid Managed Care plans. The University of Chicago Medicine Ingalls also contracts with a variety of government plans.
To receive care from the University of Chicago Medicine, patients with Medicaid must choose a HealthChoice Illinois plan that includes the University. This expanded program was introduced in 2018 by the Illinois Department of Health Care and Family Services (HFS) and includes all counties across Illinois.
It is important to note that insurance providers and plans can change at any time. Patients should always contact their insurance company and the relevant healthcare provider to confirm participation in their network before scheduling an appointment.
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Frequently asked questions
Medicaid is a state-administered health insurance program for Chicago residents with low incomes.
Chicago Medicaid covers medical and surgical expenses for eligible residents.
Eligibility for Chicago Medicaid depends on your income and other factors such as age and immigration status. You must be a US citizen or fall within certain categories of non-citizens.
You can apply for Chicago Medicaid through the Health Insurance Marketplace. You will need to provide income and household information to see if you qualify.
