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Elizabeth M. Whitehorn, Director

State Chronic Renal Disease Program Frequently Asked Questions

1. What is the State Chronic Renal Disease Program?

The Illinois State Chronic Renal Disease Program assists patients suffering from chronic renal diseases who require lifesaving care and treatment, but do not qualify for Medicaid or All Kids or cannot meet spenddown. The program was established by statute in 1967 and is administered by the Department of Healthcare and Famliy Services.

2. Who is eligible for the State Chronic Renal Disease Program?

Illinois residents who have been diagnosed as having chronic renal disease, defined as that stage of renal impairment which is irreversible and requires a regular course of dialysis to maintain life, may apply. Patients must meet income qualifications and be a U. S. citizen or meet certain immigration requirements.

3. What factors affect eligibility?

Factors that affect eligibility include earned income, family size, payments made for other insurance (including Medicare), other medical expenses, transportation costs and necessary employment expenses.

4. What is the cost of the program?

The services provided under the State Chronic Renal Disease Program are available at little or no cost, depending on how the patient qualifies. In some cases the patient may be required to pay a participant fee, if their family income exceeds the standard.

5. What if there is other insurance coverage?

The State Chronic Renal Disease Program will only pay for covered services after all other payment sources, including Medicare, private insurance, or any other health insurance, have determined and paid their part. If there are expenses remaining after other payment sources have paid, a patient may still be eligible under the program.

6. What services are covered?

Services include dialysis treatments received in a dialysis treatment center, dialysis treatments received in the hospital outpatient setting and home dialysis treatments.

Which MCOs are charging copayments/coinsurance and which are not?

CountyCare, an MCO serving customers in Cook County, has waived all copayments and coinsurance. This means hospitals or surgical centers will not charge CountyCare members any out-of-pocket costs. 

The remaining four MCOs and HFS (Fee-for-Service) have not waived copayments or coinsurance, which means that hospitals or surgical centers can charge members enrolled in those plans cost-sharing in the form of allowable copayments and coinsurance. It is the responsibility of the provider to collect any copay or coinsurance, not the MCO. A provider may elect not to charge cost-sharing for a medical service. Ask the provider prior to receiving the medical service whether they will charge any cost-sharing.

 

7. How do you apply for the program?

Applications are available at the Medicare approved dialysis facility where the dialysis services are provided. The social worker or financial counselor at the facility will help complete the application and answer any questions. All information you provide will remain confidential and will not be used for any other purpose other than to determine eligibility for the program.

8. How to learn more about the program

Contact:

Illinois Department of Healthcare and Family Services
Bureau of Comprehensive Health Services
State Chronic Renal Disease Program-Program Coordinator
607 East Adams Street, 7th Floor
Springfield, IL 62701
Telephone: 217-785-2867
Telefax: 217-558-1317