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Health Benefits For Immigrant Adults
Equity, Positive Outcomes, Well-Being
The Health Benefits for Immigrant Adults (HBIA) program, which currently serves eligible individuals aged 42 to 64, will be ending effective July 1, 2025. The last day of medical coverage through HBIA will be June 30, 2025. The Health Benefits for Immigrant Seniors (HBIS) program, which serves qualifying individuals aged 65 and over, will not be changing. Due to State Fiscal Year 2026 budgetary constraints, the state had to make the difficult decision to use the limited funding available to continue coverage for eligible noncitizens aged 65+ only.
Maintaining HBIS ensures that the most vulnerable individuals in these state-only programs, who are not eligible for Medicaid under federal law, maintain their healthcare coverage. HFS will continue to ensure that HBIS remains a source of high-quality healthcare coverage to those who are enrolled and eligible.
Notice of Public Hearing
The Illinois Department of Healthcare and Family Services (HFS) will hold a virtual public hearing on May 9, 2025, at 11 a.m., about the proposed rulemaking that would amend the Health Benefits for Immigrant Adults (HBIA) and Health Benefits for Immigrant Seniors programs (HBIS). The HBIA program serves individuals aged 42 to 64 who would otherwise be eligible for Medicaid if not for their immigration status. The HBIS program serves individuals aged 65 and older who would otherwise be eligible for Medicaid if not for their immigration status.
- The meeting will be held via WebEx.
- If you intend to virtually attend the hearing, please be sure to register by following this link: https://illinois.webex.com/weblink/register/r5a78290bb96199c28296e377f36ce5cb and completing the form by May 8, 2025, at 5 p.m.
- Translation services will be available, as needed.
- Any individual who would like to make a public comment may either speak during the virtual Public Hearing on the Proposed Rulemaking related to Health Benefits for Immigrant Adults and Seniors, or submit a written comment.
- If you would like to speak during the virtual hearing or submit a comment in writing, please email HFS.Rules@illinois.gov to state your intent to speak or send your written comment, by no later May 8, 2025, at 5:00 pm.
- Written comments will be read aloud during the hearing by HFS personnel.
If you experience any technical issues during the meeting, please let us know via the WebEx chat feature.
Please be advised that per 5 ILCS 100/5-40(b), Public Hearings "must be open to the public and recorded by stenographic or mechanical means", and such recordings are subject to the Freedom of Information Act. If you have any concerns about your personal privacy, please feel free to submit a written statement that can be read into the record under a pseudonym. Or if you prefer to read your statement on the record, you may wish to do so telephonically. Regardless of whether you provide written, telephonic, or video testimony, do not include personal information in your statement that you do not want to be in a public record.
What to Know
After June 30, 2025, current HBIA enrollees may have access to primary and preventative care at Federally Qualified Health Centers (FQHCs) and free and charitable clinics that serve uninsured and underinsured people regardless of their immigration status and ability to pay. More information and clinic locations are available online at https://www.illinoisfreeclinics.org/ and https://www.iphca.org/health-center-locator/.
Individuals who lose coverage will continue to be eligible for federally matchable emergency medical service coverage as needed to address emergency health care needs. Emergency Medical for Noncitizens is a federally matchable Medicaid eligibility group that provides time-limited coverage for emergency services to individuals who are not eligible for other Medicaid eligibility categories solely due to their immigration status.
A small number of the HBIA individuals may be eligible for coverage through the ACA Health Insurance Marketplace at getcovered.illinois.gov. Those individuals will receive a special second notice shortly after the initial April notice letting them know how they can enroll in a Marketplace plan. Additional information is available in HFS' Marketplace Transition Toolkit, including how affected individuals can connect with an assister in their zip code for assistance with their application. Undocumented noncitizens may be able to purchase private insurance directly from insurance companies.
Customer Notices
Letters were mailed to HBIA customers on April 1, 2025, providing them with 90 days' notice of loss of coverage. A special customer notice will be mailed mid-April to customers who may potentially be eligible for Marketplace coverage with additional information on how to enroll in a Marketplace plan. A final notice notifying customers of the upcoming coverage closure will be mailed on June 15, 2025.
Important Notice about Your Medical Benefits
April 1, 2025
Dear HBIA Customer,
This is a Special Notice to customers who are currently enrolled in the Health Benefits for Immigrant Adults (HBIA) program. HBIA is a part of Illinois Medicaid managed care, and you may receive your insurance through one of the following health plans: Aetna Better Health, Blue Cross Blue Shield Community Health Plan, County Care Health Plan, Meridian Healthplan, or Molina Healthcare. This program will be ending effective July 1, 2025. Your last day of medical coverage through HBIA will be June 30, 2025.
After June 30, 2025, HBIA individuals may have access to primary and preventative care at Federally Qualified Health Centers (FQHC) and free and charitable clinics that serve uninsured and underinsured people regardless of their immigration status and ability to pay. More information and clinic locations are available online at https://www.illinoisfreeclinics.org/ and https://www.iphca.org/health-center-locator/.
Individuals with a documented noncitizen status may be eligible for coverage through the Health Insurance Marketplace. Individuals who fall into this category will receive additional information on the health benefits available, eligibility criteria, and how to apply.
To find a list of community service agencies serving immigrants nearest you, visit this link: Support Services for Recently Arrived Migrants.
If you have questions about this letter, please call (1-877-805-5312 ).
Sincerely,
Illinois Department of Healthcare and Family Services
Health Benefits For Immigrant Adults FAQ
- I heard that the Health Benefits for Immigrant Adults (HBIA) program is being eliminated, is this true?
- When does the HBIA program end?
- When will HBIA customers be notified of the loss of coverage?
- What healthcare coverage alternatives exist for the people who are losing their HBIA coverage?
- If I need assistance in understanding this information in a language other than English, where can I go?
- If an individual reaches age 65 before the "Program End" date of June 30, 2025, will that individual automatically be rolled over to the HBIS?
- How do undocumented adults access the federally matchable emergency services?
- I don’t know who in my family has Medicaid through the HBIA program. How can I tell?
- Will coverage for Seniors remain the same?
- Does this change impact eligibility criteria for other Medicaid eligibility groups?
- How many people are in the HBIA/S Programs?
- How much does the HBIA program cost the state?
- How much does the HBIS program cost the state?
- What happens if the Illinois General Assembly is able to restore funding to the HBIA program?
- Are you going to cut HBIS if the budget requires it?
- Are you going to reopen new enrollment into HBIS for seniors?
- If the budget allows in the future, can HFS reopen the HBIA program?
- Does this require an administrative rule change?
The Governor’s introduced Fiscal Year 2026 budget proposes the elimination of the Health Benefits for Immigrant Adults (HBIA) program, which currently serves eligible individuals aged 42 to 64, in response to State budget constraints. The Illinois General Assembly will review and vote on the state’s budget by the end of May. The Health Benefits for Immigrant Seniors (HBIS) program, which serves eligible individuals aged 65 and over, will continue to operate.
The Health Benefits for Immigrant Adults (HBIA) program will be ending effective July 1, 2025. The last day of medical coverage through HBIA will be June 30, 2025.
HBIA enrollees will be notified about the loss of coverage via mail no later than April 1, 2025, which is 90 days in advance of when coverage will terminate on June 30, 2025. Providing 90 days’ notice is customary for care transitions, and the HealthChoice Illinois managed care contract includes a 90-day transition of care. A final closure notice will be mailed on June 15, in advance of the July 1 coverage termination date.
It’s important to note that all affected individuals will continue to remain eligible for federally matchable emergency services. Individuals who are currently enrolled in HBIA also may continue to have access to care through hospital financial assistance programs and primary and preventative care at Federally Qualified Health Centers (FQHC) and free and charitable clinics that serve uninsured and underinsured people regardless of their immigration status and ability to pay. More information and clinic locations are available online at https://www.illinoisfreeclinics.org and https://iphca.org/health-center-locator.
Undocumented noncitizens are also able to purchase private insurance directly from insurance companies.
Additional resources for newly arrived immigrants are available through the Immigrant Family Resource Program at 312-793-7120 or by visiting “Support Services for Recently Arrived Migrants” here. Support is also available through the Illinois Coalition for Immigrant and Refugee Rights’ (ICIRR) Family Support hotline at 855-435-7693.
Yes, if a current HBIA enrollee turns 65 before the final day of HBIA coverage on June 30, 2025, they will automatically be enrolled in the HBIS program, as long as they meet all of the other eligibility criteria for the program.
Emergency Medical for Noncitizens is a federally matchable Medicaid eligibility group that provides time-limited coverage for emergency services to individuals who are not eligible for other Medicaid eligibility categories solely due to their immigration status. The application pathways for Emergency Medical for Noncitizens are the same as other Medicaid coverage: online through ABE.illinois.gov, by calling the DHS ABE Call Center, or in person at a local DHS office. Hospitals may apply for coverage on behalf of a customer and Application Agents and Navigators can also support the application process.
Member services for your managed care plan can look up your membership. If you have other family members who you would like to request membership information for, they will need to be on the line to give their permission or call back themselves.
Yes, HFS’ proposed FY26 budget preserves the current level of services for seniors enrolled in the Health Benefits for Immigrant Seniors (HBIS) program. Eligibility requirements for Seniors will remain the same.
No, eligibility criteria for other Medicaid eligibility groups that provide coverage regardless of citizenship or immigration status, such as coverage for children for pregnant people and the 12-month postpartum period, has not changed.
As of the most recent February 2025 report, HBIA covers a total of 32,083 individuals aged 42 to 64. HBIS covers 8,931 individuals aged 65 and over.
In FY24, HFS spent a total of $487 million to administer the HBIA program. Combined HBIA/HBIS spending in FY24 was $682 million. Through December 2024, HFS has spent a total of $279 million to administer the HBIA/HBIS during FY25.
In FY24, HFS spent a total of $195 million to administer the HBIS program. Combined HBIA/HBIS spending in FY24 was $682 million. Through December 2024, HFS has spent a total of $279 million to administer the HBIA/HBIS during FY25. HFS’ FY26 budget includes $110 million of GRF to operate the HBIS program.
While HBIA enrollees will be notified of the loss of coverage by April 1, 2025, if the ILGA is able to restore funding to the program HBIA members will remain enrolled and HFS will issue a new notice to enrollees and providers.
HFS’ proposed FY26 budget preserves the HBIS program.
HFS’ FY26 budget proposal does not include reopening enrollment into the HBIS program.
HFS cannot predict when or if that would happen.
Yes, HFS filed administrative rules on March 21, 2025, that codify these changes.
Enrollment into the HBIA program is currently paused; do not submit new applications.
Covered Benefits
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 in the HBIA program met the following eligibility requirements:
At least 42 years old and not over age 64.
1. An undocumented immigrant (including individuals in a Temporary Protected Status)
2. A resident of Illinois.
3. Have an annual 2022 household income at or below $18,754 for one person; at or below $25,268 combined income for a household size of two. The income limit differs depending on the number of household members.
Reminder: Do not submit applications for this program, as enrollment is currently paused.
For those age 65+, the Health Benefits for Immigrant Seniors program was available, but is also currently paused. No new applications are being approved.
Public Charge
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.