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A new federal law, HR 1, makes significant changes to Medicaid eligibility for many noncitizens. Some noncitizens may lose coverage starting October 1, 2026. 

Some noncitizens, including but not limited to refugees, asylees, humanitarian parolees, survivors of domestic violence or human trafficking, will no longer qualify for federally funded Medicaid. Individuals in these groups may still receive Emergency Medicaid, but not regular, full-scope benefits.

The following groups will remain eligible:

• Naturalized Citizens

• Lawful permanent residents who have met or are exempt from the five-year eligibility bar 

• Certain Cuban and Haitan entrants

• COFA migrants (from Marshall Islands, Micronesia or Palau)

• Children under 19 years old and pregnant people

• Individuals enrolled in a state-funded program, including Medical Benefits for Asylum Applicants and Torture Victims (AATV); Victims of Trafficking, Torture or Other Serious Crimes (VTTC); and Health Benefits for Immigrant Seniors (HBIS). 

These changes are required under federal law and are not changes initiated by the State of Illinois.

HFS urges customers to update their contact information and immigration status on file with the state right away, to ensure critical notices reach them timely, and to ensure their continued Medicaid eligibility is assessed based on up-to-date information. In early July 2026, HFS mailed a notice to all Illinois households that have a noncitizen resident, to raise awareness of the upcoming eligibility changes. Some households that received this notice may not be impacted by the eligibility change. HFS will mail an additional notice in August 2026 to all customers who are directly affected by the HR 1 noncitizen changes. Customers should watch their mail for important notices from HFS.

The July notice that was mailed to households with noncitizen residents included the following information:

Important Notice about Your Medical Benefits 

Federal Law Changes May Affect You and Your Family 

July 06, 2026 

Dear Customer,  

Federal law changes will end Medicaid eligibility for many noncitizens starting October 1, 2026. 

What to do: 

Update Your Address and Immigration Status So We Can Keep You Informed About Benefits Changes that May Impact You 

1. Check that we have your correct home address, phone number, and e-mail.  

2. For anyone receiving benefits, make sure we have their current immigration status, and provide any documentation of updates. 

You can review and update your information through: 

• ABE Manage My Case: https://abe.illinois.gov/access/, 

• By going to your local Family and Community Resource Center,  

• By calling the All Kids Unit toll-free at 1-877-805-5312 (TTY: 1-877-204-1012), or 

• If you need help navigating this change, contact an Immigrant Resource Program partner at 1-855-435-7693. 

Please provide any updates or changes as soon as possible. 

What is changing: 

Beginning October 1, 2026, ONLY the following noncitizens will keep their Medicaid coverage: 

1. Lawful Permanent Residents (LPRs or “green card” holders) who: • Have met the 5-year eligibility bar, OR  

* Are not subject to the five-year eligibility bar (for instance, refugees, asylees, and trafficking survivors who adjust to LPR from that status) 

2. Cuban/Haitian entrants 

3. Compacts of Free Association (COFA) migrants 

4. Children under the age of 19 (All Kids) and pregnant individuals (Moms & Babies)  

5. People who have 40 qualifying quarters of work in the U.S. or who are a veteran or active-duty military and their spouses. 

6. People already enrolled in the Health Benefits for Immigrant Seniors (HBIS) 

7. People enrolled in: • AATV Medical coverage 

• Illinois’s medical program for survivors of domestic violence  

• Illinois’s medical program kidney/renal disease 

Under the new federal rules, if you are not in one of these groups, your Medicaid coverage will end on September 30, 2026. 

Individuals whose Medicaid coverage ends may be able to get primary and preventative care in other places. Federally Qualified Health Centers (FQHC) and free and charitable clinics serve uninsured and underinsured people regardless of their immigration status and ability to pay. More information and clinic locations are available online at www.illinoisfreeclinics.org and https://www.iphca.org/health-center-locator/.  

For information about your rights and responsibilities, you can call the Immigrant Family Resource Program at 1-855-435-7693 or visit “Support Services for Recently Arrived Migrants” here to find a list of community service agencies serving immigrants nearest you. 

If you have questions about this letter, please call the All Kids Unit toll-free at 1-877-805-5312 (TTY: 1-877-204-1012).

Organizations and providers who serve impacted individuals are encouraged to utilize the messages in the HFS HR 1 NonCitizen Toolkit when communicating with customers about these federal changes. Additional resources are available on HFS’ Federal Resource Center.

Advancing its vision for healthcare equity, the State of Illinois in 2020 committed to providing medical coverage to seniors regardless of their immigration status. Illinois currently provides this coverage through the Health Benefits for Immigrant Seniors program (HBIS), which serves eligible individuals aged 65 and over. Individuals enrolled in a state-funded program, like HBIS, are not affected by the HR 1 federal changes detailed above.

2024 HBIS program changes

In March 2024, HFS announced a series of changes related to the eligibility requirements for the Health Benefits for Immigrant Seniors (HBIS) program.

Coverage Renewals: HFS conducts yearly redeterminations for HBIS enrollees, following the same process Medicaid customers go through to annually verify their continued eligibility for coverage. 

You may submit your redetermination using any one of the following options:

1.    Complete the electronic version of the redetermination online in ABE Manage My Case at abe.Illinois.gov; or

2.    Complete your Medical redetermination over the phone by calling 1-800-843-6154/1-866-324-5553 TTY; or

3.    Fill out and sign the form and send it to us with any necessary verifications to: 

a.    Mail to P.O. Box 19138, Springfield, IL 62763; or 
b.   Fax the completed form and verifications to 1-844-736-3563; or 
4.    If you want to complete your redetermination in person, call 1-800-843-6154/1-866-324-5553 TTY to find help near you or visit a Family and Community Resource Center (FCRC) closest to your home. You can find out where the nearest FCRC is by visiting this link. 

For more information about your rights and responsibilities regarding the redetermination process, you can also call the Immigrant Family Resource Program at 312-793-7120 to find a list of community service agencies serving immigrants nearest you.

The earlier we receive your redetermination, the earlier we can determine your eligibility to continue receiving medical benefits.

Once we receive your form, we will determine your eligibility and send you another notice explaining our decision. 

Health Benefits for Immigrant Seniors: Frequently Asked Questions

Co-payments for non-emergency procedures

Many 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), 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).

HBIS Managed Care

Medicaid Managed Care Organizations (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.