Eligibility

Not be eligible for the state’s regular medical program for those with disabilities - the applicant cannot be eligible for a regular non-spenddown medical card. The applicant who is eligible for a regular non-spenddown medical card will be referred to apply at a local DHS office since this would allow the applicant to receive a medical card without paying monthly premiums.

Be a resident - The applicant must be considered a resident of the state of Illinois. There is no minimum length of time for the person to have lived in Illinois.

Be a citizen or an eligible non-citizen - The applicant must be a citizen of the United States or an immigrant legally admitted for permanent residence. Immigrants admitted after August 21, 1996, are ineligible for the first five years after entry into the U.S.

Be age eligible - The applicant must be at least 16 years of age and under age 65.

Have a disability - The applicant must meet the Social Security Administration definition of disability. The applicant’s disability can be proven through receipt of Social Security Disability Insurance or SSI benefits or a determination by the state’s Client Assessment Unit.

Be employed - The applicant must be employed or self-employed and provide proof of payment of payroll taxes through FICA, IMRF, or the equivalent. If the applicant is not currently employed, they must provide proof that employment will begin within 60 days.

Provide a Social Security number - The applicant must provide the Social Security Number or proof of an application for a number.

Report other health insurance - The applicant must provide information about other health insurance coverage.

Provide known information about responsible relatives - If the applicant is married and not living with the spouse or if the applicant is a child under 18, the applicant will be asked information about the legally responsible relative.

Have countable assets of $25,000 or less - The applicant must provide information about the assets owned such as bank accounts, savings accounts, motor vehicles, property, stocks, bonds, etc. The value of the participant’s home and one motor vehicle is exempt. Applicants age 55 or older should understand that an estate claim is placed on real property but is only effective at their death.

Have countable income equal to or less than 350% of the Federal Poverty Level for the family size - the applicant must provide proof of all income for the applicant and the applicant’s spouse living in the home. SSI is not counted. The applicant will have to provide proof of the unearned income of their children under 18 if the applicant chooses to include them in counting the family size. Countable income is determined after allowing earned income deductions and expenses.

• HBWD Premium Chart (pdf)

Provide proof of earned income Expenses - deductions from earned income for lunches, child care, transportation, uniforms and special tools may be allowed if the applicant provides proof.

Pay monthly Premiums - The applicant must pay a monthly premium before the medical card is issued. Payments are due by the 20th of the month. Failure to pay the premium will result in cancellation of coverage.