Health Benefits for Immigrants

Health Benefits for Immigrant Seniors and Adults

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Equity, Positive Outcomes, Well-Being

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

As a result, Illinois currently covers Health Benefits for Immigrant Adults ages 42-64 (HBIA) and Health Benefits for Immigrant Seniors, ages 65 and over (HBIS)

Spring 2024 HBIA/HBIS program changes

In March 2024, HFS announced a series of changes related to the eligibility requirements for the Health Benefits for Immigrant Adults and Health Benefits for Immigrant Seniors (HBIA/HBIS) programs. The changes are:

• Effective May 1, 2024, HFS will close ineligible cases for any enrollee who is over income or who otherwise no longer meets the eligibility requirements. This automated process is also standard practice in the Medicaid program.
• Begin conducting redeterminations for HBIA and HBIS enrollees, following the same process Medicaid customers go through to annually verify their continued eligibility for coverage. HBIA and HBIS redeterminations will begin to be processed starting April 1. These renewals will incorporate notification and a public health emergency unwinding grace period for response. Anyone found ineligible for continued coverage or who does not respond to HFS when they are required to do so will lose coverage effective July 1. 
  
• Refer Legal Permanent Residents (LPRs), who qualify for other available health care coverage, to the alternative coverage they are eligible for.
  
  • LPRs who have been in the United States for over five years qualify for Medicaid coverage and will automatically transition to Medicaid in May if they otherwise meet eligibility requirements. Customers enrolled in a Medicaid managed care plan will remain enrolled in the same Medicaid managed care plan.
  • Legal Permanent Residents who have been in the United States for less than five years will be removed from the program and referred to the Affordable Care Act (ACA) Health Insurance Marketplace, which provides subsidies to noncitizens who are lawfully present in the country. HFS will encourage and assist affected HBIA/HBIS members with enrolling in an ACA Marketplace plan and is working with the Illinois Department of Insurance (IDOI) to ensure that Navigators and Assisters can help individuals with enrolling in coverage. 
    
• These individuals will qualify for Medicaid coverage if they meet the eligibility requirements once they have been in the country for five years.

Exciting News for customers in the HBIA and HBIS Programs. Between January 1 and April 1, 2024, many of you will enroll in one of the Medicaid Managed Care Organizations (MCO) through HealthChoice Illinois. This means you will get the extra benefits that MCOs offer, including care coordination. A care coordinator will help make sure you get the medical care and social services you need. Anyone can request a care coordinator if your MCO does not assign one to you.

If you do not receive an enrollment letter from HFS, your coverage will remain the same and you will not enroll into an MCO.

• Health Benefits For Immigrant Adults and Seniors: Frequently Asked Questions

HBIA/HBIS Fact Sheet

• English (pdf)

Co-payments for non-emergency procedures

Many HBIA and HBIS customers, whether enrolled in an MCO or not, may be charged copayments for certain non-emergency procedures and services. Your provider will tell you if you will be charged a co-pay, how much it will cost, and other details. Customers are not charged for anything considered an emergency.  Learn more here.

Public charge and status information

Enrollment in a health coverage program with a Managed Care Organization, such as Health Benefits for Immigrant Seniors (HBIS) and Health Benefit for Immigrant Adults (HBIA), is not counted in the public charge test. Enrollment in these programs will not affect your immigration status and immigration application. For more information about public charge, visit the Protecting Immigrant Families Illinois website or Keep Your Benefits Illinois website. You can also call ICIRR’s Family Support Hotline in English/ Spanish/ Korean/ Polish: 1-855-HELP-MY-FAMILY (1-855-435-7693).

Enrolling in an MCO

You will get a letter in the mail explaining what you need to do. You may also get a call from the Illinois Client Enrollment broker to help you pick a managed care plan. If you have private insurance too or have spenddown, you will not get a letter. You cannot enroll.

Enrollment letters will be mailed in four groups based on the following. You have until your due date to pick a plan or you will be assigned to the MCO on your letter.

Call the Client Enrollment Services line at 1-877-912-8880 (TTY 1-866-565-8576) if you didn’t get your letter or have any questions.

The first thing is to pick the MCO that is best for you by the due date in your letter. There will be a list of MCOs in your letter along with the deadline for picking your own plan and Primary Care Provider (PCP). The letter will also tell you what MCO and primary care provider you will be assigned to if you do not pick your own plan and when your MCO enrollment will start. If you like the MCO listed in your letter,

Ask your current doctors and other health care providers, including your pharmacy, what MCOs they accept. You can only go to providers in your MCO’s network, including pharmacies, so this is very important.

• To help you compare MCOs, go to https://enrollhfs.illinois.gov and click on “compare”. An online comparison chart is available too, and this can be translated into other languages.
• To help you choose, also look at the co-payment chart, extra benefits and prescription drug lists of each MCO.

If you want a different MCO than the one assigned in your letter, you can also choose your MCO on the website by setting up an account. You do not need a social security number, you just need your date of birth and your Recipient Identification Number (RIN) from your current Medical Card.

1. Once enrolled in the MCO, your MCO will send you a welcome packet in the mail with a member ID card. Look out for this packet in the mail. The MCO will also contact you over the telephone to ask you questions about your health, your current prescription drugs and doctors and talk to you about how they can help you meet your health needs.
2. If you are not happy with your MCO, you can make one plan change to a different MCO in the first 90 days.  After that, you will  stay in your MCO for one year. You may change your plan in one year during Open Enrollment or you can choose to remain with your current plan. This includes changing MCOs because you didn’t know about the co-pays.

MCOs have a 24-hour nurse helpline to answer your questions at any time of day. You should call the nurse helpline or your primary care provider for medical questions. Only go to the hospital Emergency Room if you have a medical emergency or if your provider or Helpline nurse tells you to. Your MCO can tell you what services are considered medical emergencies.

Call the MCO with any questions. MCOs must translate all materials into any language requested. MCOs must make translators available for phone so you written and verbal information in your primary language.

If you have a complaint (also called a grievance) or want to appeal a decision the MCO made about your care, you can do that within certain time periods. All of the information is on the MCO website and in the member handbook.

HFS expects MCOs and providers to treat everyone with respect and dignity in a culturally appropriate manner. If you do not feel you are getting that respect, you should file a grievance with the MCO. You can also contact ICIRR’s Family Support Network at 1-855-435-7693.

HFS is confident that HealthChoice Illinois Managed Care will provide our HBIA and HBIS customers the supports and services you need to the right care in the right place at the right time.