The Illinois Medicaid program provides health care services to qualifying children, parents, people with disabilities, seniors and adults ages 19-64 who are not receiving Medicare. Medicaid benefits include:
- Doctor and hospital visits
- Long-term care
- Prescription drug coverage
- Transportation to medical appointments
- Laboratory tests
To be eligible for Medicaid, Illinois residents must meet one of the following criteria:
- Have a child under 18 or be pregnant
- Be disabled, blind or age 65 or older
- Have a blind or disabled spouse, child or parent living within their household
Additionally, residents must be U.S. citizens, be U.S. nationals or have immigration status and meet the income and asset eligibility limits. The monthly income limits for seniors aged 65 and older are $1,041 for individuals and $1,409 for married couples. Additionally, assets must equal no more than $2,000 for individuals and $3,000 for married couples.
It is possible, however, for applicants with income and assets over the limits to still be eligible for Medicaid through the
Pay-in Spend-down program. Through this program, Healthcare and Family Services may assign participants a spend-down amount based on a participant’s level of income and assets that functions similarly to a deductible. Recipients would pay for their medical care up to the spend-down amount and, once reached, receive a medical spending card from HFS to help pay for additional medical costs that month. Qualified seniors aged 65 and older or those who are blind or disabled and live outside a nursing home will receive an enrollment form from HFS in the mail.
Geneva residents can
apply for Medicaid online or over the phone at (800) 843-6154.
For those wishing to live in an assisted living facility, Illinois offers two Medicaid waivers designed to help keep individuals outside of nursing homes and at home or in the community.
Supportive Living Program
HFS administers the
SLP waiver as a way for eligible Medicaid recipients to receive services not typically covered by Medicaid. Services include:
- Personal care
- Occasional nursing care
- Medication management and supervision
- Assistance with laundry and housekeeping
- Recreational, social and exercise programs
- Physical therapy, lab tests and X-rays
- Wellness consultations and a health services plan
To be eligible for SLP, seniors must show they require nursing-facility-level care, test negative for tuberculosis and not be receiving services from any other home and community based waiver. They must also earn income equal to or greater than $771 for an individual and $1,157 for a married couple. Participants living in a private room are able to keep $90 per month of their income for personal use but must contribute the rest of their income to their living facility for room, board and services. Those sharing a room are required to pay only up to $385.50 for individuals and $578.50 for married couples (one half the SSI rate) minus the $90 allowance for personal use.
Interested seniors should call (217) 782-0545 or (844) 528-8444 or email the
Illinois Department of Healthcare and Family Services for more information.
Pathways to Community Living
Seniors over age 60 who receive or are eligible to receive Medicaid may also qualify for the
Pathways program. To participate, seniors must reside in a nursing home or intermediate care facility for persons with developmental disabilities, have lived there for at least 90 days and wish to move into a personal residence or supportive living facility. Program services include:
- Personal assistance and financial support in making the transition to the community
- One year’s worth of guidance from a qualified transition coordinator including a care plan and assistance finding a home
- Help with transition costs and home improvements
Seniors interested in the Pathways program should complete the
online referral form or email
hfs.webmaster@illinois.gov.