Health Benefits For Immigrant Adults

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.

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.

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.

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.

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.