DHS Family Community Resource Centers accept applications for Illinois Medicaid.
The Illinois Department of Healthcare and Family Services oversees government health care programs in Illinois, including Medicaid. The Medicaid program offers comprehensive medical coverage, to help pay for your doctor bills, hospital care or emergency services. You can choose from different types of Medicaid plans, managed by private insurance companies or hospitals. Your eligibility for Medicaid can depend on your income and you can apply for benefits at an office in your local area.
Eligibility for Medicaid Benefits
Medicaid offers coverage for low-income individuals and families, senior citizens, blind people and the disabled. To qualify for Medicaid in Illinois, you must hold residency in Illinois and citizenship in the United States and meet asset and income guidelines. Income can include your employment wages, Social Security benefits or alimony. Assets can include money in your checking and saving accounts, life insurance or stocks. If your assets or income exceeds the allowable limits, you may still meet the requirements for the Spenddown Program. The Spenddown Program allows you to receive Medicaid benefits, but you may have to pay for certain medical services.
Medical Services
Medicaid benefits offer comprehensive health care coverage. Benefits include doctor services, hospital care, laboratory tests, family planning, skilled nursing, medical transportation, hospice care, physical therapy and prescription drug coverage. Medicaid may also cover drug or alcohol treatment and psychiatric care. Benefits can pay for medical supplies, kidney dialysis, eye care and dental services.
Medicaid Plans
You can choose from two Medicaid plans in Illinois, fee-for-service or managed care. The fee-for-service plan allows you to receive services from the doctor of your choice. The doctor you choose can work at clinic or in a private practice, but must accept Medicaid patients. The fee-for-service plan also allows you to choose your hospital, but the hospital you choose must have an arrangement with the doctor you choose.
The managed care plan works with a network of hospitals, physicians and pharmacies. You must choose a primary care physician from the network of providers. The primary care physician serves as the coordinator for all of your health care needs, and can refer you to a specialist or arrange for medical equipment when needed. Managed care programs include prepaid health plans and health maintenance organizations. Private insurance companies administer HMO plans, which can include private and Medicaid participants. PHP plans, managed by medical schools and hospitals, only enroll Medicaid participants.
Applying for Benefits
The Illinois Department of Human Services handles Medicaid applications. You can apply for Medicaid at any DHS Family Community Resource Center. If you do not know the location of your local resource center, you can call 800-843-6154 for information. When applying in person, a caseworker will conduct an interview with you to complete the application. You can also request a copy of the application, which you can complete and return in person, by mail or by fax. The Illinois Healthcare Portal website also offers an online version of the Medicaid application, which you can download and submit in person at a DHS office, through the mail or by fax.
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