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Medicaid Benefits for Illinois Residents

Illinois Medicaid is a jointly funded state and Federal government program that pays for medical assistance services.

Illinois Medicaid is a jointly funded state and federal government program that pays for medical assistance services. Medicaid pays for medical assistance for eligible children, parents and caretakers of children, pregnant women, persons who are disabled, blind or 65 years of age or older, those who were formerly in foster care services, and adults aged 19-64 who are not receiving Medicare coverage and who are not the parent or caretaker relative of a minor child.

Primary services funded through Medicaid are physician, hospital, and long-term care. Additional coverage includes drugs, medical equipment and transportation, family planning, laboratory tests, X-rays, and other medical services.

Program Name Illinois Medicaid
Expanded Medicaid Yes
Website illinois.gov
Phone 800-843-6154
Apply Online https://abe.illinois.gov/abe/access/
Appeal a Denial Appeals and Fair Hearings
Find a Local Office Office Locator

Eligibility Requirements

To be eligible for Illinois Medicaid, you must be a resident of the state of Illinois, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

You must also be one of the following:*

  • Pregnant
  • Be responsible for a child 18 years of age or younger
  • Blind
  • Have a disability or a family member in your household with a disability
  • Be 65 years of age or older

* ACA Medicaid expansion covers eligible low-income adults.

Annual Household Income Limits (before taxes)

Household Size* Maximum Income Level (Per Year)
1 $17,775
2 $24,040
3 $30,305
4 $36,570
5 $42,836
6 $49,101
7 $55,366
8 $61,631

*For households with more than eight people, add $6,265 per additional person.

Available Services Include:

Alcohol and drug abuse services Nursing home care
Chiropractic care Physical therapy
Emergency dental services Physician services
Family planning Podiatric care for diabetics
Group care Prescription drugs
Hospice care Prosthetic devices
Hospital care Psychiatric care
Lab and X-ray services Renal dialysis
Medical equipment and supplies Transportation for medical purposes
Nursing care Vision services

Copayments

Physician or clinic visit $3.90
Emergency visit for non-emergency $3.90
Over the counter medication $3.90
Brand name prescription $3.90
Inpatient hospital visits $3.90

Copays do not apply to a person who:

  • Is pregnant (including 60 days postpartum)
  • Is under age 19 on an Assist case
  • Is in a DCFS (category 98) case
  • Receives hospice care;
  • Lives in an institution
  • Lives in a supportive living facility
  • Lives in a sheltered care facility
  • Is enrolled in the Breast & Cervical Cancer (BCC) treatment program
  • Is an American Indian or Alaskan Native
  • There are no copays for the following, even if they are provided to an adult:
  • Family planning services
  • Emergency services
  • Services paid by Medicare
  • Certain medications, including insulin, AIDS drugs, and chemotherapy drugs

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