Upcoming Changes to Medicaid

New federal Medicaid rules will change coverage and eligibility rules for some people. 

These changes do not affect everyone with Medicaid coverage. We will send you a direct notice if you need to take an action.

1. Beginning in 2027, federal law requires some adult Medicaid customers to comply with or be exempted from brand new work requirements. 
2. At the same time, redetermination periods will go down from 12-months to 6-months for these customers.

The new federal law affects the Affordable Care Act Medicaid eligibility group (“ACA Adults”), who are generally people ages 19-64, who don’t have dependent children under 18 at home, and who are not on Medicare. 

You can find out if you are an ACA Adult:

1. Look for your “medical group” on mail from the State including Notice of Decision, Redetermination paperwork, or processing of a change, or 
2. Log in to your Manage My Case account
   • Visit ABE.Illinois.gov and log in to your Manage My Case account. You can find notices from the past 12 months by selecting:
     • Case Summary → Benefit Details → Notices
3. Call HFS at 1-877-805-5312.

New applicants will be subject to the new work requirement if they apply after 5:00pm on December 31, 2026. 

If you are currently enrolled in Medicaid and are an ACA Adult, you will need to meet or be exempt from work requirements starting at your first redetermination date on or after January 1, 2027. Details about how to meet the requirement or who can be exempt are below.

All ACA Adults will also be moved to 6-month redetermination cycles, rather than 12-month redeterminations, starting after their first redetermination date in 2027.

What are Work Requirements?

Work requirements are a new condition of eligibility for Medicaid. This means that if you cannot meet or be exempted from work requirements you will not be able to get benefits as a new applicant or you will lose benefits that you currently have at redetermination. 

Generally, to meet the work requirement, you either need to have income that is higher than $580 per month, or you need to work, be in school, volunteer, or participate in a work program for at least 80 hours per month. 

There are also many ways to be exempted from the work requirement that are discussed below.

How to Meet Work Requirements

There are many ways to meet the work or activities requirements. Having monthly income of $580 or more means you have met the work requirement. 

Being a student at least half time (including high school, GED programs, college, or trade school) means you have met the work requirement. 

If you do not meet this income threshold or are not a student, you can comply by engaging in 80 hours of any of these activities or a combination of these activities during at least one month of your 6-month eligibility period:  

• Working (including unpaid or in-kind work, self-employment, and seasonal work)
• Volunteering

• Going to school less than half-time (including high school, GED programs, college, or trade school)

• Participating in a work program 

The state will use information we already have to verify your compliance with work requirements when we can. However, at your redetermination, you may be asked to provide proof that you complied with work requirements in any month since your last redetermination.  Remember, you can combine activities, but your hours must add up to 80 or more for the month you report. Be sure to keep proof of work or activity hours or proof of your exemption. 

Click on the links below to download our flyers for more information  

• General Changes to Medicaid – English Flyer (pdf)  

• General Changes to Medicaid – Spanish Flyer (pdf)

• Are pregnant.  

• Are in your 12-month postpartum period.  

• Are a veteran with a 100% disability rating.  

• Are an American Indian or Alaska Native.   

• Are a former foster youth who is under age 26.  

• Care for a young child or a dependent person with a disability.  

• Have a medical condition that prevents you from meeting the requirements.  

• Are receiving TANF benefits and meeting TANF work requirements. 

• Are meeting or are in the 3-month grace period for SNAP work requirements.

• Are participating in a drug or alcohol treatment program.  

• Are an inmate of a public institution (jail or prison) or were released within the last 3 months.

For more details and updates, check HFS’ HR 1 FAQs.

In 2027, the state will accept “self-attestation” from customers of exemptions to work requirements if we are unable to verify the exemptions through our data sources. Self-attestation requires you to promise that the information is true under penalty of perjury. If the state’s data sources provide conflicting information, we may request additional proof from you. 

Please note: even if you are exempt from work requirements, you will still need to renew your coverage every six months.

If we cannot determine that you have met or are exempt from the Medicaid work requirements, we will ask you for more information during your redetermination. You will have 30 days to provide this information.

Your benefits will be canceled at the end of your current eligibility period if you are not exempt and you have not met the Medicaid work requirements.  

If you do not meet and are not exempt from work requirements and your benefits are canceled, you may be able to get coverage through Get Covered Illinois but you will NOT be eligible for the advanced premium subsidies that help with premium costs.

• Are under 19 or over 64 years old.

• Are enrolled in or entitled to Medicare.

• Are enrolled in another Medicaid category, such as AABD, Moms & Babies, Family Care, or other programs.

As of October 1, 2026, some noncitizens will no longer qualify for federally funded Medicaid. 

Only the following noncitizens will continue to be eligible for Medicaid:

• Lawful permanent residents (LPRs or “green card” holders who have met the 5-year eligibility bar, OR are not subject to the 5-year eligibility bar, for example, refugees, asylees, and trafficking survivors who adjust to LPR from that status),

• Cuban-Haitian entrants, 

• Citizens of the Compact of Free-Associated States (COFA),

• Children under the age of 19 (who reside here lawfully), and

• Pregnant individuals (who reside here lawfully).

• People already enrolled in Health Benefits for Immigrant Seniors (HBIS) 

• People already enrolled in:

  • Illinois’ AATV Medical coverage
  • Illinois’ medical program for survivors of domestic violence
  • Illinois’ medical program for kidney/renal disease 

Download our flyer below for more information. 

• Noncitizen Fact Sheet – English (pdf) 

• Noncitizen Fact Sheet – Spanish (pdf)

• Create or log on to your Manage My Case account via abe.illinois.gov. You will be able to find out what medical group you are in to know if work requirements apply to you. You will also be able to use Manage My Case to check your redetermination date, review notices, and report income or address changes. By January 2027, you will also be able to request exemptions and upload work documents.

• Update your contact information. Make sure HFS has an address where mail always reaches you, otherwise you risk missing a notice and losing coverage. If you move, get a new phone number, change your email address or your immigration status changes, update that with the state right away. Visit abe.illinois.gov and click "Manage My Case," or fill out the Medicaid Address Change Form. 

• Watch your mail for letters from HFS. We will contact Medicaid customers directly before any change affects coverage. 

• If you get mail from the State of Illinois, open it right away. It may be about your Medicaid coverage.   

• Stay updated. Bookmark this page and come back often. We will be adding updates as new details from the federal government become available. 

Customer Fact Sheet 

HR1 Updates 

Frequently Asked Questions