Proposed Medicaid Eligibility & Enrollment Changes

April 8, 2020

To expand access to coverage during the COVID-19 public health emergency, the Illinois Department of Healthcare and Family Services (HFS) has submitted formal requests to the Centers for Medicare & Medicaid Services (CMS) to modify the Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment processes under Section 1115(a) of the Social Security Act, emergency Medicaid and CHIP State Plan Amendments (SPAs), and other notifications. While the section 1115(a) waiver and SPAs require approval, certain actions may be implemented once the state has notified and obtained concurrence from CMS.

While HFS awaits federal approval for its proposed eligibility changes, HFS encourages individuals to submit medical assistance applications, answering all questions as completely as possible, even if applicants do not have all of the documentation required for the state to verify eligibility.

HFS also urges hospitals, physicians, and primary care providers treating uninsured patients in need of COVID-19 testing and treatment to assist these patients in submitting a Medicaid application, even if the provider is unsure as to whether the patient may be eligible. These applications should be submitted via ABE.illinois.gov. To expedite processing, please email the tracking number assigned to the application to HFS.Priority19@illinois.gov.

For additional information, please see an HFS Provider Notice and an IHA memo.