Illinois Medicaid Eligibility and Enrollment

In this article...
  • Learn how Illinois Medicaid programs help older adults access quality health care services. Find out who qualifies, what the programs cover and how to apply.

Illinois Medicaid programs help older adults and low-income individuals throughout the state access health care services. Just as in most states, Medicaid in Illinois is administered at the state level with operational and funding assistance from the federal government. While the aspects of Medicaid programs vary from state to state, each is required to include coverage for health care services such as primary care, ambulatory care and inpatient hospital care. In some states, Medicaid programs are extended to include coverage for long-term care for disabled persons and older adults. 

Below, find out what services are included in Illinois' Medicaid plans and the various programs that are available to seniors in the state and how older adults can apply for coverage.

What Is Illinois Medicaid?

In Missouri, Medicaid is known as MO HealthNet. The program provides its beneficiaries with an identification card, known as a MO HealthNet Identification Card, which enables them to receive some health care services free of charge. MO HealthNet strives to help aged, blind and disabled persons access quality care, and it also provides coverage for pregnant women, families, uninsured women, women with breast or cervical cancer, and children.

Older adults who are enrolled in Medicaid may also be eligible for Missouri Care Options, a Medicaid-funded program that provides home and community-based services for aged, blind and disabled adults. 

What Does Illinois Medicaid Cover? 

Illinois' Medicaid program provides coverage for necessary health care services, including preventative care. Its intention is to help seniors, children, pregnant women and families access quality medical services they're not able to afford on their own. Services covered by basic Medicaid include:

  • Doctor visits
  • Basic dental care
  • Mental health and substance abuse services
  • Hospital care
  • Emergency services
  • Prescription medications
  • Necessary medical equipment

On top of the traditional Medicaid program, Illinois also offers several other Medicaid program options for older adults that include varying other services. 

HealthChoice Illinois

HealthChoice is a managed care program that provides all the benefits of regular Medicaid, in addition to some of the following added benefits:

  • 24-hour nursing helpline
  • Personal care coordination
  • Routine wellness visits
  • Immunizations
  • Transportation to and from appointments
  • Transitional care (from hospital or nursing home into the community)

In addition to added health-related services, care coordinators also connect beneficiaries with resources such as nutritional assistance programs, energy assistance and support groups as needed. 

Medicaid-Medicare Alignment Initiative (MMAI)

The MMAI program helps older adults who receive Medicare and Medicaid benefits to coordinate their coverage and care. With this streamlined coverage, seniors are able to access extra supports, including:

  • Adult day care
  • Personal care services
  • Long-term home care 
  • Personal emergency response systems

Home and Community-Based Services (HCBS) Waivers

There are several HCBS waivers in Illinois. These waivers work to amend the coverage provided by regular Medicaid so that recipients can obtain additional supports and services. For older adults, an HCBS waiver is available that helps those aged 60 and older access long-term care when they're at risk of nursing home placement. This waiver provides supports such as in-home care and adult day care that can enable these individuals to stay in their own homes for as long as possible.

Supportive Living Program

The Supportive Living Program provides long-term care services in assisted living facilities or in the community for older adults that are enrolled in regular Medicaid. To qualify for this program, seniors must be at risk of nursing home placement. This program pays for services such as:

  • Personal care
  • Homemaker services
  • Laundry 
  • Medication assistance
  • Social and recreational activities
  • Health activities
  • 24-hour supervision

Those who participate in this program are required for paying their own room and board costs. 

Community Care Program

The Community Care Program is open to older adults aged 60 and older who are in need of long-term care. Participants must have less than $17,500 in non-exempt assets and are subject to the same residency requirements as regular Medicaid. 

This program helps its participants avoid nursing home placement by providing services in their homes or in a community setting. Covered services include:

  • Adult day care
  • Automated medication dispenser service
  • Emergency home response service
  • In-home care, including housekeeping

Who Is Eligible for Medicaid in Illinois?

Seniors in Illinois who wish to receive Medicaid funding must be:

  • 65 years of age or older, blind or living with a disability
  • Residing in the state of Illinois
  • A U.S. national, citizen or legal alien
  • Unable to pay for their own health care services
  • Earning no more than $1,215 per month ($1,643 for couples applying together)
  • In possession of a maximum of $2,000 in countable assets ($3,000 for couples applying together)

How Do I Enroll in Medicaid in Illinois?

Those who are eligible can apply for Medicaid coverage, along with other social assistance programs online at the Illinois Application for Benefits Eligibility website. Alternatively, applications can be downloaded online and faxed or delivered to the nearest DHS office. Seniors who wish to mail in their applications can send it to:

P.O. Box 19138 
Springfield, IL 62794

Contact Information for Illinois Medicaid

The U.S. Department of Health and Human Services, along with the Illinois Department of Healthcare and Family Services, is responsible for managing Medicaid in Illinois. Those with questions about benefits can call (800) 843-6154.