HFS Family Planning Program

Two Programs:

Family Planning Presumptive Eligibility (FPPE) provides immediate, temporary, medical coverage for reproductive health and family planning related services to all eligible Illinois residents.

HFS Family Planning Program provides ongoing medical coverage for reproductive health and family planning related services to all eligible Illinois residents.

HFS Family Planning Program

The HFS Family Planning program offers coverage for reproductive health and related services to men and women who do not otherwise qualify for Medicaid. Information about eligibility, coverage and other details will be available soon.

Requirements for both programs include:

• Illinois residency
• Individual, NOT family monthly income that meets the program requirements, $3500 in 2023. To find income each year, check the Department of Human Services Program Standards page.
• Not currently pregnant **
• NOT enrolled in standard Medicaid or other full coverage state medical program

** If you are pregnant you may qualify for one of our Programs for Pregnant Women.

What if I have private insurance?

Individuals with private health insurance, through an employer, a relative, or other source, may still be eligible for the FP Program if they meet other eligibility requirements.

What is covered under the Family Planning Program?

Some of the family planning services include:

· An annual preventative exam

·All FDA-approved methods of contraception

·Permanent methods of birth control, such as tubal ligation or vasectomy

·Cervical cancer screening

·Screening mammograms

·Other testing, treatment, and vaccines for reproductive health

·Transportation for family planning visits

Extended list of covered services

Family Planning Presumptive Eligibility

To enroll in Family Planning Presumptive Eligibility, you must go to an FP provider. The FP provider will decide if you can get FPPE. You must tell the provider your individual gross monthly income. If you are not pregnant, live in Illinois, and meet the income requirements, you can get FPPE. You do not need to provide proof when you meet with the provider, your statement of residency, income, and non-pregnancy are adequate to apply.

If approved coverage will begin on the day the FP Provider completes your submission and will last until the end of the next month. For example, if your information is submitted on July 10^th, coverage will begin that day and extend until August 30^th, unless an application has been submitted for ongoing Medicaid coverage. If you apply for full Medicaid or ongoing Family Planning Program coverage, your FPPE coverage will be extended until a final decision is made on your application. If you don’t end up qualifying for ongoing HFS Family Planning Program coverage, you will NOT be penalized or billed for using FPPE coverage.

You do not have to be a citizen or a legal immigrant to get FPPE. You do not have to have a Social Security number to get FPPE. To find a FP Provider go to our FPPE Search page and enter your zip code.

HFS Family Planning Program

In addition to above listed program requirements, ongoing FP Program coverage requires that the applicant be a U.S. citizen or other covered immigrant group.

The same services and prescriptions are covered under Family Planning PE and ongoing FP Program coverage. FP Program coverage will last for one year. After one year you will receive a renewal request to the address included in your application or, if you have an Application for Benefits Eligibility (ABE) Manage My Case (MMC) account and you requested electronic notification, you will receive the renewal in your MMC account.

You can apply for Family Planning Program coverage in a variety of ways. You can apply:

·Online: Go to abe.illinois.gov and click Apply for Benefits

·By Phone: Call the ABE Customer Call Center at 1-800-843-6154

·With the assistance of your Provider, or

·With the assistance of an HFS Application Agent.

·By Paper: Complete a paper application and mail it to the HFS All Kids Unit:

Illinois Department of Healthcare and Family Services
P.O. Box 19122
Springfield, IL 62794-9122

· Send or fax to a DHS Family Community Resource Center if applying for other benefits in addition to medical.

If applying at ABE.Illinois.gov  you will click on the Apply for Benefits button in the middle of the page to start your application

Opting in: If you wish to be considered for the Family Planning Program if you do not qualify for full Medicaid, when completing the application, click on “Yes” for both, Apply for Healthcare Coverage and Apply for Family Planning Program.

Stand-alone: If you wish to apply for the Family Planning Program only, click “Yes” on  Apply for Family Planning Program and "No" on Apply for Healthcare Coverage. 

When does Family Planning Program coverage begin?

Coverage start date for FP Program depends on whether you requested back-dated coverage when submitting your application. Customers may request up to three months of backdated coverage. If not requesting backdated coverage, coverage will begin on the first day of the month in which you were approved. For example, if an application was submitted on July 29^th, if you are approved your coverage will begin on July 1^st.

For Providers

Providers interested in the program should visit the Medicaid Presumptive Eligibility and Family Planning Presumptive Eligibility Providers page, which includes training materials.

410 ILCS 50/3.4 Rights of Women; Pregnancy and Childbirth

• 410 ILCS 50/3.4 Rights of Women; Pregnancy and Childbirth (pdf)