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IPHA

Three Steps Illinois Medicaid Participants Should Take NOW


For the first time since the COVID-19 global pandemic began in 2020, Illinois is redetermining Medicaid participants’ eligibility to participate in the program that provides health insurance coverage for more than 3 million people. HelpGuideThrive recommends the following three tips to stay on top of your insurance coverage and make sure you are renewed.


Get up-to-date on COVID-19 vaccination.


Keeping with the Centers for Disease Control and Prevention’s recommendations for COVID-19 vaccination is the best way to prevent severe infection. Since a Public Health Emergency was declared in spring 2020, costs for COVID-19 vaccination and at-home testing kits have been covered by the Federal government. The declaration expired in May, therefore its more important now than ever to ensure you have and maintain your health coverage. The Illinois Public Health Association and Illinois Primary Health Care Association renew their call for residents to schedule COVID-19 vaccination appointments as soon as possible to help maintain healthy communities.


Know your Medicaid renewal date.


Current Illinois Medicaid enrollees should log in to the State of Illinois’ Manage My Case at ABE.illinois.gov to check their redetermination date.

The Illinois Dept. of Healthcare and Family Services (HFS), which administers the state’s Medicaid program, has resumed redetermining Medicaid eligibility and will make one of two determinations for each member account between now and July 2024:

  • Automatic Renewal: Some Medicaid participants will not be required to submit documentation verifying their eligibility for enrollment based certain qualifying factors. HFS uses reliable data sources to determine when a Medicaid participant is eligible for enrollment without providing any addition information. In these cases, known as “Ex Parte Redetermination,” the participant will receive an official notice from the State of Illinois stating their Medicaid coverage will continue.

  • Eligibility Verification Required: In most cases, Illinois Medicaid participants will be prompted to submit income verification documents, such as pay stubs or tax records. These help the program’s eligibility verification teams to formally determine if an applicant meets the criteria as prescribed by state and Federal laws. HFS and the Illinois Dept. of Human Services (DHS) will make these determinations in phases over the next year. Those who are asked to verify their eligibility are encouraged to do so in a timely manner to make sure there is not a gap in their medical coverage.

Residents who already know their renewal date can submit the required eligibility verification materials during their renewal period online at abe.illinois.gov or by calling +1 800 843 6154.


Illinois Medicaid participants who need help to identify their renewal date can call 1 800 843 6154, go on line to GetCoveredIllinois.gov. click on Get Free Help to make an appointment with an assister or visit a community health center, .Many of these facilities also have access to Medicaid enrollment resources, including health insurance navigators. A directory of FQHCs in Illinois is available online at findahealthcenter.hrsa.gov.


Verify the address associated with your Medicaid account.


Official notices from the State of Illinois about Medicaid coverage are sent via U.S. mail to the mailing address the participant included in their application. Any Medicaid participant who has moved since they enrolled in the program is strongly encouraged to visit abe.illinois.gov to verify the contact information associated with their account is accurate. Undeliverable mail or failing to respond to official notices by the prescribed date may result in a coverage termination.

The bottom line: With these changes coming to Medicaid renewal, it is imperative participants are aware of their insurance information to continue receiving care. Follow these guidelines to keep your health and that of your family your top priority.

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