Medicaid Enrollment in Illinois

Who can get Medicaid in Illinois

ACA Adult (Medicaid expansion)

Adults ages 19–64 with household income at or below 138% of the federal poverty level (approximately $20,783/year for a single person, $28,208 for a household of 2 in 2024). This is the largest Medicaid category and the easiest to qualify for.

Family Health Plans (FamilyCare / All Kids)

Parents and children up to higher income thresholds. All Kids covers children in Illinois from low-income through middle-income households (up to 313% of FPL for income). Children qualify regardless of immigration status through the All Kids program — Illinois is unusual in extending state-funded coverage to undocumented children.

Moms & Babies

Pregnancy-related coverage for pregnant people up to 208% of FPL, regardless of immigration status.

Aid to the Aged, Blind, and Disabled (AABD)

For people 65+, legally blind, or disabled. Income and asset limits apply; these rules are stricter than ACA Adult.

Former Foster Care

Young adults up to age 26 who were in foster care at age 18 qualify automatically, regardless of income.

Immigration status and Medicaid

Immigration status affects which Medicaid category applies:

• U.S. citizens — eligible for all categories if income qualifies
• Lawful permanent residents (green card holders) — generally eligible after 5 years of qualified status, with exceptions for refugees, asylees, and children (no 5-year bar)
• Refugees, asylees, trafficking victims — eligible immediately
• DACA recipients — federal rules changed in 2024 to allow marketplace enrollment; Medicaid eligibility varies by state. Confirm current Illinois rules at time of application
• Undocumented adults — not eligible for full Medicaid, but eligible for Emergency Medical Services only, and for the Health Benefits for Immigrant Adults (HBIA) / Seniors (HBIS) programs in Illinois, which provide coverage for immigrants not eligible for federal Medicaid
• Undocumented children — eligible for state-funded All Kids
• Undocumented pregnant people — eligible for Moms & Babies

Immigration law and benefits eligibility interact in complex ways. Applying for benefits for your U.S.-citizen child does not affect your immigration status. Consult an immigration attorney or accredited representative before declining benefits for fear of immigration consequences — the public charge rule has changed multiple times and general information online is often outdated.

How to apply

1. Online (fastest): Apply at Illinois ABE. Create an account, fill out the application, upload supporting documents. Same application covers Medicaid, SNAP, TANF, and other programs.
2. In person: At your local IDHS Family Community Resource Center.
3. By phone: Call IDHS at 1-800-843-6154 (TTY 1-800-447-6404).
4. With help: Many community organizations, federally qualified health centers (FQHCs), and hospitals have certified application counselors who help free. Find one at ABE or contact your local FQHC.

Processing usually takes up to 45 days (or 90 days if disability determination is involved). Pregnancy applications and presumptive eligibility can be processed same-day at participating providers.

Documents to gather

• Identification (driver's license, state ID, passport, consular ID)
• Proof of income (pay stubs, tax returns, benefit letters)
• Proof of Illinois residency (utility bill, lease, mail)
• Social Security numbers for applicants who have them (non-applying household members do not need to provide)
• Immigration documents for applicants who need to establish qualified status
• Medical records if applying under disability category

Presumptive eligibility

Some providers — hospitals, FQHCs, Planned Parenthood — can make on-the-spot "presumptive eligibility" determinations for pregnant people and children. Coverage begins immediately based on self-attested information while the full application is processed. If the full application is later denied, the presumptive coverage already received is not clawed back.

What Medicaid covers

Illinois Medicaid covers doctor visits, hospital care, prescriptions (generally with no or low copays), lab work, mental health services, substance use treatment, dental care (for adults, limited services), vision care (for adults, limited services), maternity care, preventive services, family planning, and home-based long-term care through the Medicaid waiver programs.

Most Medicaid recipients are enrolled in HealthChoice Illinois — a managed-care plan. You choose a plan at enrollment; you can change plans during your annual open enrollment period or for cause at other times.

Renewal

Medicaid must be renewed annually. HFS mails a renewal notice to the address on file — keep your address current. If you do not respond, coverage will terminate. Missing the renewal is the leading cause of coverage gaps. The "unwinding" of continuous coverage after the 2023 public health emergency caused millions of people nationwide to lose coverage for procedural reasons — most of them were still eligible.

If you are denied or coverage is terminated

You have the right to appeal. Request a fair hearing within 60 days of the notice of action (or within 10 days to keep benefits continuing during the appeal). Legal Aid Chicago's Health and Disability Practice group and Illinois Legal Aid Online provide free help with Medicaid appeals.

Medicaid and marketplace interaction

If your household income goes above Medicaid limits but below marketplace subsidy limits (about 400% of FPL for most people), you may qualify for a subsidized plan on HealthCare.gov. Special enrollment periods apply when you lose Medicaid — you have 60 days to enroll.