Illinois Medicaid Office

Illinois Medicaid office (HFS)

Illinois delivers Medicaid through the Department of Healthcare and Family Services (HFS), which pays providers for more than three million Illinoisans every year. Two umbrella programs sit under HFS: Medical Assistance, authorized under Title XIX of the Social Security Act, and the separate Children's Health Insurance Program (Title XXI/SCHIP). The Department of Human Services (DHS) operates the field offices and runs the ABE benefits portal that handles intake for both.

How to reach HFS and DHS

• DHS Customer Helpline — for help applying, finding a Family Community Resource Center, or reporting an address, phone, or income change.
• ABE portal — abe.illinois.gov for new applications, Manage My Case self-service, and document uploads.
• Get Covered Illinois — at getcovered.illinois.gov, for Marketplace and Medicaid eligibility screening and to find in-person help.
• Illinois Office of Inspector General Medicaid Fraud Hotline — to report suspected fraud.
• HFS agency website — hfs.illinois.gov for program rules, brochures, and public notices.

HFS sets program policy and contracts with providers and managed-care plans. DHS Family Community Resource Centers (FCRCs) handle the in-person interview, document collection, and application processing for most households; the FCRC locator lives on dhs.state.il.us.

Who qualifies for Illinois Medicaid?

HFS sorts applicants by coverage group rather than by a single income table. Adults age 19 through 64 use the ACA Adults category at or below 138% of the federal poverty level. Children flow through the All Kids umbrella, which holds both a Medicaid layer (no premium) and a CHIP layer (Premium tiers with monthly premiums tied to family income). Older adults, people who are blind, and people with disabilities use the Aid to the Aged, Blind, or Disabled (AABD) Non-MAGI track.

Coverage categories

• ACA Adults — age 19–64 at or below 138% FPL (a monthly income of about $1,366 for one person or $1,845 for a couple per the HFS 2025 chart). MAGI budget; no asset test.
• FamilyCare and All Kids Assist — full Medicaid for parents and caretaker relatives up to 138% FPL and for children at or below 147% FPL, with no premium and no resource test.
• All Kids Share, Premium Level 1, Premium Level 2 — Illinois's CHIP tiers, covering children from 147% up to 318% FPL with monthly premiums and per-service copays that rise with income.
• Moms and Babies — full coverage for pregnant women up to 213% FPL plus babies up to age one when the mother was covered at birth.
• Former Foster Care — adults under age 26 who were on Medicaid when they left DCFS foster care at age 18 or later, eligible regardless of income.
• AABD Medical — Non-MAGI Medicaid for adults 65+, blind, or with a permanent disability, at or below 100% FPL with no more than $2,000 in non-exempt resources for one person.
• Coverage for Immigrant Seniors — for residents 65 and older not eligible for federal Medicaid because of immigration status; the benefit includes doctor and hospital care, behavioral health, dental and vision services, and prescription drugs with $0 premiums and $0 co-payments.
• Health Benefits for Workers with Disabilities (HBWD) — a Medicaid buy-in for workers with disabilities earning up to 350% FPL, with up to $25,000 in non-exempt resources and a small monthly premium.

Citizenship, residency, and SSN

Most adults must be U.S. citizens or be a lawful permanent resident who has held that status for at least five years; refugees, asylees, and several other special-status categories qualify immediately. Children under 19 and pregnant women can qualify regardless of citizenship or immigration status, and they don't need a Social Security number to apply. Applicants must live in Illinois.

Other targeted programs

HFS also runs narrower programs: the Illinois Breast and Cervical Cancer Program (IBCCP) for women who need treatment after a positive screening; Pay-In Spenddown for households whose income or assets exceed standard limits but who can meet a monthly spenddown; the State Hemophilia Program; the State Renal Dialysis Program; the Sexual Assault Survivors Emergency Treatment Program; Veterans Care for uninsured veterans under 65; and Medical Assistance for Asylum Applicants and Torture Victims, which provides up to 24 months of coverage for non-qualified-immigrant asylum seekers and certain torture victims.

Illinois Medicaid income limits

Illinois publishes income limits as a mix of FPL percentages and program-specific monthly dollar figures. The dollar amounts below come from current HFS pages and shift each January when the federal poverty figures update. Verify a specific number with HFS or a DHS Family Community Resource Center before relying on it for an eligibility decision.

MAGI categories

HFS Medical Benefits (AABD)

The Aid to the Aged, Blind, or Disabled track uses dollar income limits rather than FPL percentages. HFS publishes the chart below for the AABD medical category.

The AABD asset limit is $2,000 for a single applicant and $3,000 combined for a married couple. The home, personal belongings, certain resources used to earn income, life insurance with a total face value of $1,500 or less plus all term life, certain burial reserves, and one car (with conditions tied to work, medical use, or accessibility modifications) do not count toward that limit.

Workers with disabilities

HBWD raises the bar for people with disabilities who work: countable income up to 350% FPL and up to $25,000 in non-exempt resources, with retirement and medical savings accounts excluded. Enrollees pay a small monthly premium.

Medicare Cost Sharing

The Medicare Cost Sharing program (Illinois's Medicare Savings Program) pays Medicare Part B premiums for Qualified Medicare Beneficiaries (QMB) with incomes at or below 100% FPL and covers only the Part B premium for SLIB or QI enrollees with incomes between 100% and 135% FPL. Resources are limited to $7,280 for a single person and $10,930 for a couple.

How to apply for Illinois Medicaid

HFS lists four ways to apply: online through ABE, by phone, in person at a Family Community Resource Center, or on paper. The same ABE application also screens for SNAP (Help to Buy Food), Cash Assistance, and the Medicare Savings Program — check the boxes for every benefit you want a determination on.

Online: ABE

Apply at abe.illinois.gov. The portal asks you to create a secure account, saves your work between sessions ("Save and Exit"), and logs you out after 30 minutes of inactivity. A typical application takes 30 to 45 minutes to complete. After you submit, ABE assigns a T-number you can use to track the case — write it down. After approval, the same login becomes your Manage My Case account for renewals, document uploads, and change reporting.

By phone

Call the DHS Help Line to apply by phone. A representative collects the information and reads back the case number, which you should save.

In person at a Family Community Resource Center

DHS operates Family Community Resource Centers in every county. Use the FCRC locator at dhs.state.il.us to find the nearest one. Walk-in help is also available through hospitals, health centers, and community-based organizations whose staff are trained to file applications. To schedule an appointment for in-person help, call Get Covered Illinois.

On paper

You can download a paper application from dhs.state.il.us, complete it (on screen or by hand), sign it, and then mail, fax, or hand-deliver it to your local FCRC. Include as much information as you can — leave items blank rather than guess if you don't know an answer.

What to gather before you apply

• A mailing address (does not have to be your home — a friend, family member, or community organization address works if they agree to receive your mail)
• Full names and dates of birth for everyone in the household
• Social Security numbers for anyone who has one (children and pregnant women are not required to have an SSN to apply or qualify)
• Alien Registration Numbers for any non-citizens applying who have one
• Income for each household member, including spousal support (child support is not counted as income)
• Information on any current health insurance
• For applicants 65 or older: financial resource information (checking, savings, retirement balances)

What happens after you submit

HFS tries to verify each item electronically. If something cannot be verified that way, you'll receive a letter listing the documents to send in. Return them by the date on the letter or the application can be denied. Federal law gives the state up to 45 days to decide most applications and up to 90 days when the basis is disability. Retroactive coverage runs up to three months before the application month for qualifying medical bills.

What Illinois Medicaid covers

Illinois Medicaid pays for what HFS calls "necessary medical benefits" along with preventive care for children. Coverage is comprehensive for most enrollees and runs through participating providers — anyone licensed in Illinois who has signed up with HFS. A few HFS programs (the State Hemophilia Program, State Renal Dialysis Program, and Sexual Assault Survivors Emergency Treatment Program) cover only a narrow set of services tied to the program's purpose.

Core medical benefits

• Doctor visits, including primary, specialty, and well-child care
• Dental care
• Hospital care, including inpatient and emergency services
• Prescription drugs
• Mental health and substance use services
• Medical equipment and supplies, including durable medical equipment
• Immunizations for children
• Long-term care for AABD-eligible members

Dental

DentaQuest of Illinois manages the Medicaid dental provider network. Call DentaQuest to locate a participating dentist or confirm whether a specific dental service is covered before scheduling.

Non-emergency transportation

HFS authorizes non-emergency medical transportation for members who need help getting to a covered appointment. Prior approval is required — request it through the HFS transportation services line listed on the agency's contacts page.

Member supports outside of medical care

HFS-published contacts also connect members to the Illinois Department of Public Health AIDS Drug Assistance Program (ADAP), the WIC and Early Intervention office locator at DHS, the Tobacco Quitline for help quitting smoking, and the Lifeline Suicide Prevention 24/7 counselor line. The HFS contacts page lists current numbers and links for each.

AABD long-term care

HFS Medical Benefits covers long-term care for adults age 65 and older, people who are blind, and people with a permanent disability who meet the AABD financial limits. The benefit package covers nursing facility care plus the standard Medicaid medical services. To apply, send form HFS 2378h to a local Family Community Resource Center or apply online through ABE.

Other state Medicaid pages