Wednesday, June 29, 2022: In Spring 2020, Get Care Illinois and Healthy Illinois started a program called Health Benefits for Immigrant Seniors (HBIS). HBIS assists immigrant seniors, ages 65+, living in Illinois to receive Medicaid-like healthcare. HBIS provides affordable, comprehensive health coverage to low-income seniors age 65 years old and older, including seniors who are undocumented.
Eligibility: In order to qualify, for the HBIS program, individuals must meet the 5 requirements below:
- Be age 65 or over;
- Not eligible for Medicare or traditional Medicaid because of immigration status. For instance, immigrants eligible for the HBIS program include:
- Individuals who are undocumented (including individuals who have temporary protected status (TPS) and
- Legal permanent residents (LPR, aka. green card holders) who have had their green card for less than five years. NOTE: A social security number is not required in order to enroll in the HBIS program. Applicants must indicate that they are a citizen or a non-citizen in the application.
- Live in Illinois; ABE will attempt to verify Illinois residency through electronic matches or by documents already provided before requesting the applicant or individual to provide proof (such as ownership of a house, a rental lease, utility bills, document issued by the Mexican consular or other foreign consulate showing an Illinois address, etc.). Full list: https://www.dhs.state.il.us/page.aspx?item=13236
- Have assets below $2,000 for an individual or assets under $3,000 for two people (Currently waived during COVID-19 Public Health Emergency (PHE));
- Have a household income that is at or below 100% FPL (see chart).
|
Family Size |
100% FPL Income |
|---|---|
|
1 |
$1,133 per month |
|
2 |
$1,526 per month |
|
3 |
$1,919 per month |
|
4 |
$2,313 per month |
If the individual's income is over the 100% FPL limit but has medical expenses, the applicant can use them to spenddown their income. Once spenddown is met, clients will remain in met status until after the Public Health Emergency (PHE) ends. For more information about Spenddown see: https://www.illinois.gov/hfs/info/Brochures%20and%20Forms/Brochures/Pages/HFS591SP.aspx.
The HBIS program follows the same income budgeting guidance as is used for the AABD (Aid to Aged Blind and Disabled) older adult population. The HBIS program’s income eligibility uses non-MAGI budgeting (based on relationship rules and NOT tax filing status) so that means that a Household includes:
- Applicant
- Spouse living in home
- Children under 19 living in home
For mixed-status households where the senior lives with an adult child who claims their senior parent on their taxes: Since HBIS is a non-MAGI program, the dependent tax status of the senior parent is not considered as part of the household nor is their son or daughter’s income considered as countable income. When the senior applies for HBIS, they should apply for themself and include their own income (and if it is zero income then list $0) and income of their spouse (if any) only.
Cost to Enrollee: There are $0 premiums and $0 co-payments.
Benefits and Services: Seniors enrolled in the HBIS Program will receive medical benefits similar to those offered under the Seniors and Persons with Disabilities program (formerly Aid to the Aged, Blind and Disabled).
Covered Services Include:
|
Doctor and hospital care |
Mental health and substance use disorder services |
|
Lab tests |
Home health |
|
Rehabilitative services such as speech, physical and occupational therapy |
Medically necessary services (including rehabilitation services) are covered in a hospital or outpatient setting |
|
Dental services, including Diagnostic, Preventive, Restorative, Endodontics, Periodontics, Prosthodontics, Oral and Maxillofacial Surgery, and Adjunctive General Services. List of dental benefits for adults as found in the Dental Office Reference Manual (DORM): https://www.illinois.gov/hfs/SiteCollectionDocuments/42117DORM.pdf |
Other medically necessary as follow-up to a medical procedure - for instance, services needed post-hospitalization in order to recover (e.g., home health, oxygen, short term rehab after hospital etc.) Kidney Transplants are covered. Note: transplants always need to meet medical necessity criteria and have prior approval through HFS. Source: https://www.dhs.state.il.us/page.aspx?Item=18133 |
|
Transportation Services |
Vision Services |
|
Durable Medical Equipment |
Prescription drugs |
Excluded Benefits and Services from the HBIS program as of 4/14/22:
- Care in any type of Nursing Facility, including short term rehabilitation;
- Home and Community-Based waiver Services;
- Intermediate Care Facility for Persons with Developmental Disabilities (ICF/DD) services;
- Specialized Mental Health Rehabilitation facility (SMHRF) services;
- Medically Complex for the Developmentally Disabled facility (MC/DD) services;
- Funeral and burial expenses;
- Services that are indefinitely provided and require a Determination Of Need assessment like waiver services (like homemaker services or adult day services) or living indefinitely in a facility.
Enroll in Program: Enrollment in the HBIS program is OPEN at all times during the year; to apply contact Heartland Health Services Outreach and Enrollment team at 309-680-7632.
Resources on HBIS Program:
Get Care Illinois page in English, Spanish, Chinese, Arabic and Polish: https://getcareillinois.org/need-health-coverage/medicaid/immigrant-over-65/
