Health Benefits For Immigrant Seniors

Advancing its vision for healthcare equity, the State of Illinois in 2020 committed to providing medical coverage to seniors regardless of their immigration status. As part of its Mission, HFS developed the program to produce positive outcomes for our customers, address the social and structural determinants of health and foster the well-being of the Illinoisians we serve.    

Customers currently covered in the Health Benefits for Immigrant Seniors program have been covered under Fee-for-Service - administered by HFS.  As of January 1, 2024, many of those covered under HBIA will move to managed care.  Only those with private insurance (TPL) or eligible through spend-down, are excluded from managed care.

As of February 1, 2024, depending on the MCO a customer is enrolled with, hospitals and surgical centers may collect co-payments and cost sharing on some covered non-emergency services. Customers not enrolled in an MCO may be charged as well. Co-payments and cost sharing are what is paid out of own pocket for a covered health care service.

More information about copayments can be found here. 

Under HBIA/HBIS, co-payments and cost sharing can only be charged on the following services:

· Non-emergency Inpatient hospitalizations: $250 co-payment per stay.

· Non-emergency Hospital Outpatient Services or Ambulatory Surgical Treatment Center: 10% of what HFS would pay the provider. The amount you can be charged will vary depending on the service and the provider.

No co-payment or cost sharing can be charged for an emergency service needed to evaluate or stabilize an Emergency Medical Condition. An Emergency Medical Condition is a condition with symptoms that are severe and painful enough that a reasonable person would think they are life-threatening and need immediate medical care. Things like a severe asthma attack, symptoms of a heart attack, or a car accident with serious injuries, are just some examples.

Most services covered by the Health Benefits for Immigrant Adults and Seniors program will continue to be free to you. For example:

· Primary care visits

· Care at a Federally Qualified Health Center (FQHC)

· Vaccinations at a pharmacy or doctor’s office

· Prescription drugs

· Dental and vision services

· Prescription drugs

· Transportation services

Note, this list above is not a complete list, just examples. Always check with your provider about whether you will have any out-of-pocket costs.

Those currently covered on this program met 5 eligibility requirements:

1. Are 65 years old or older

2. Are an Illinois resident

3. An undocumented immigrant (including individuals in a Temporary Protected Status)

4. Have an annual 2022 annual income at or below $13,590 or a couple with annual income at or below $18,310*

5. Have assets below $17,500.

Reminder, do not submit applications for this program, enrollment is currently paused.

*** The Health Benefits for Immigrants Adults program covers adults ages 42-64.  It is also paused at this time.

If you have questions about how enrollment in this program would affect current or future requests to change your immigration status, please email Protecting Immigrant Families at pifillinois@povertylaw.org, or call the Immigrant Family Resource Program at 1-855-437-7669. They will help you find an organization to answer your questions.

Contact the Office of Welcoming Centers for Refugee and Immigrant Services, DHS Bureau of Refugee and Immigrant Services, phone (312) 793-7120, or email DHS.BRIS@illinois.gov