Affordable Care Act

As part of the Affordable Care Act (ACA), uninsured Illinoisans have new options for health coverage either through the state’s Medicaid program or through the Federal Health Insurance Marketplace (the Marketplace). These options make it more affordable to get health coverage and meet the federal requirement that all individuals have health coverage starting in 2014.

Important Updates on 1095-B Forms for 2021: Because the federal government no longer requires individuals to have minimum essential health coverage, Illinois is not mailing 1095-Bs for the 2020 tax year to each household. HFS can mail 1095-B forms to customers upon request. A reminder that the 1095 -B form is NOT needed to file taxes and does NOT  go to the IRS. It is for informational purposed only. There are no tax penalties for being uninsured.

This guide​ contains answers to common 1095-B questions and instructions on where clients can go to request a correction or copy of their 1095-B form. It also contains external resources for more complicated questions. A sample form along with information about its contents is included at the end of the guide.​

The Internal Revenue Service is warning consumers about tax scams involving the Affordable Care Act and penalties imposed under the law on people who go without health insurance. In some cases, the agency said, unscrupulous tax preparers tell clients to pay the penalties directly to them, and they keep the money. Most people do not owe the payment at all. “However,” the I.R.S. said, “if you owe a payment, remember that it should be made only with your tax return or in response to a letter from the I.R.S. The payment should never be made directly to an individual or return preparer.”   Refer to the IRS website if you get a letter in the mail from the IRS.

For more information on applying for health coverage in Illinois, or to make an appointment for in-person help on any issues related to health coverage in Illinois, call the Get Covered Illinois (GCI) Helpdesk at 1-866-311-1119 or, visit GetCoveredIllinois.gov.

Monthly data on the number of clients who enrolled in Illinois Medicaid as a result of the ACA eligibility expansion.

• ACA Current Month Enrollment (pdf) (html)

Now, thanks to the ACA and IL Public Act 98-104 (pdf), more adults are eligible for Medicaid in Illinois and the public is able to apply for Medicaid through a new, online application called the Application for Benefits Eligibility (ABE).

Today, all Illinois residents between 19 and 64 years of age, who are U.S. citizens or who have legal status, and who have monthly income less than $1,366 for an individual or $1,845 for a couple, are eligible for Medicaid through the “ACA Adult” category. This means Illinois Medicaid now provides health coverage for low income individuals who are seniors, persons with disabilities, parents/caretakers of dependent children, “ACA adults,” pregnant women and children (under the All Kids program).

• Answers to Frequently Asked Questions – Applications for Medical Assistance (10/2014) (pdf)
• Answers to Frequently Asked Questions - Applications for Medical Assistance Spanish (2/2014) (pdf)
• Illinois All Kids Eligibility and Coverage Start Dates (2/2014) (pdf)
• Current Medicaid Income Eligibility Levels (pdf)

Illinois now has a  multi-benefit, web-based application system known as the Application for Benefits Eligibility (ABE). Through ABE, applicants can apply online for Medicaid, SNAP and Cash Assistance. ABE replaced the DHS web application and the All Kids Online Application. HFS has developed a Guide as an introduction to the new web portal. For community partners, including Illinois Assisters, there is a separate Guide that has the basic information on completing an application as well as instructions on how to register in ABE as a community partner.

• Introduction to ABE, recorded webinar (30 minutes)
• An Introduction for Community Partners, including certified Illinois Assisters (Navigators, In-Person Counselors and Certified Application Agents) (pdf)
• An introduction to the new web portal for Medicaid, SNAP and cash assistance (pdf)

•  Fact Sheet on Healthcare Reform Implementation Efforts in Illinois (pdf)

• Illinois Department of Insurance Warning About Affordable Care Act Related Fraud (pdf)

For those who are uninsured and do not qualify for Medicaid, the Illinois Health Insurance Marketplace (The Marketplace) is an online shopping website where you can compare health insurance plans side-by-side, and receive financial help from the government to help pay insurance costs. The next Open Enrollment Period for the Marketplace will be November 15, 2014 – February 15, 2015. After that date, only people who qualify for a Special Enrollment Period will be able to buy coverage. To see if you qualify to buy coverage on the Marketplace, or to find out more about the Federal Health Insurance Marketplace in Illinois, go to www.getcoveredillinois.gov

To learn more about the Affordable Care Act and the Health Insurance Marketplace, check out the following:

• Watch the video Health Insurance Changes Coming Your Way Under the Affordable Care Act to see what health insurance changes are coming under the Affordable Care Act

• Watch the New Spanish Cartoon: "Los YouToons Se Preparan Para Obamacare"

• Watch the indepth explanation of the Health Insurance Marketplace, this is a 45 minute training video.

• For an Overview of the Health Insurance Marketplace, see the Material in English and Spanish.

  • English Understanding the Health Insurance Marketplace (pdf)

  • English Understanding the Health Insurance Marketplace Presentation (pdf)

  • Video Training Understanding the Health Insurance Marketplace

  • Spanish Understanding the Health Insurance Marketplace (pdf)

  • Spanish Understanding the Health Insurance Marketplace Presentation (pdf)

• For information on the Marketplace Application Process and Marketplace Enrollment Process, visit the Centers for Medicare and Medicaid Services Website

• Video Determining Household for Medicaid and Premium Tax Credits

• Determining Household for Medicaid and Premium Tax Credits (pdf)

• Watch the Video Determining Household Income

• What counts as Income for Premium Tax Credits and Medicaid (pdf)

• Calculate how much financial help you could get on the Marketplace

• Webinar presentation by HFS regarding the Implementation of the Affordable Care Act (.wav)

• Get Covered Illinois & ABE: A presentation for LTC Facilities & Community Care Programs (pdf)