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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 August 2026, HFS mailed a notice to noncitizen customers who are expected to be affected by the upcoming eligibility changes that take effect Oct. 1, 2026. HFS will mail an additional notice in September 2026. Customers should watch their mail for important notices from HFS.

A July 2026 notice was mailed to households with noncitizen residents. An August 2026 notice that was mailed to households with noncitizen residents who may be impacted by the HR 1 eligibility changes included the following information:

08/10/2026 

Important Change to Your Medicaid Coverage

Illinois has reviewed the noncitizen status we have on file for you, and based on that status, you will NOT qualify for full Medicaid benefits starting October 1, 2026, because of a new federal law. 

This means your current Medicaid health plan will end September 30, 2026. 

Why is this happening? 

Federal law has changed to say that only certain noncitizen statuses can get full Medicaid coverage. Illinois is required to follow this new federal law. Your noncitizen status listed in our system is not one of the types that can receive full Medicaid after October 1, 2026. 

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 already enrolled in Health Benefits for Immigrant Seniors (HBIS) 

6. People enrolled in: 

• Illinois’s AATV Medical coverage 

• Illinois’s medical program for survivors of domestic violence 

• Illinois’s medical program for kidney/renal disease 

If your noncitizen status or personal circumstances have changed recently — for example, if you became a lawful permanent resident or you are pregnant — please report this right away so that we can see if you are eligible for other healthcare coverage. You can send updated documents by: 

• Visiting your local IDHS office 

• Uploading documents through ABE Manage My Case: https://abe.illinois.gov/access/ 

• Calling the ABE Customer Call Center at 1-800-843-6154 (TTY: 1-877-734-7429)  

• Calling the All Kids Unit at 1-877-805-5312 (TTY: 1-877-204-1012) 

• Contacting IDHS at 1-800-843-6154 (TTY: 1-877-734-7429) 

You may still qualify for Emergency Medicaid. This program only pays for care during a serious medical emergency. Emergency Medicaid does not cover regular doctor visits, prescriptions, or ongoing treatment. 

You may be able to get primary and preventive care at Federally Qualified Health Centers (FQHC) and free and charitable clinics which serve uninsured and underinsured people regardless of their noncitizen status and ability to pay. More information and clinic locations are available online at IAFCC and Health Center Locator - IPHCA. 

For information about your rights and responsibilities, you can call the Illinois Coalition for Immigrant and Refugee Rights (ICIRR) hotline and ask to be connected to an Immigrant Family Resource Program (IFRP) partner at 1-855-435-7693 or visit “Support Services for Recently Arrived Migrants” at IDHS: Illinois Support Services & Community Resources 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). 

Sincerely,  

Illinois Department of Healthcare and Family Services

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

Questions about public charge can be emailed to pifillinois@legalcouncil.org or please visit the Protecting Immigrant Families Illinois (PIF-IL) coalition’s website.

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.