04/18/2024
Abstract
- Well being Advantages for Immigrant Adults (HBIA) is for people ages 42 by way of 64. Earnings eligibility is set through the use of Modified Adjusted Gross Earnings (MAGI) budgeting.
- Be aware: New enrollment within the Well being Advantages for Immigrant Adults (HBIA) program was paused efficient July 1, 2023.
- Well being Advantages for Immigrant Seniors (HBIS) is for people ages 65 and older. This program follows the present AABD neighborhood eligibility standards.
- Be aware: New enrollment within the Well being Advantages for Immigrant Seniors (HBIS) program was paused efficient November 6, 2023, at 5 p.m.
- HBIA/HBIS covers noncitizen adults and seniors, ages 42 and older, in any other case ineligible for some other medical advantages.
- Medical backdating of three months previous to the month of software is on the market.
- HBIA/HBIS medical advantages are state funded.
- Efficient Might 1, 2024, Lawful Everlasting Residents should not eligible for Well being Advantages for Immigrant Adults/Seniors.
- Well being Advantages for Immigrant Adults/Seniors (HBIA/HBIS)
- Eligibility
- Well being Advantages for Immigrant Adults (HBIA)
- People eligible for HBIA
- People not eligible for HBIA
- Well being Advantages for Immigrant Seniors (HBIS)
- People eligible for HBIS
- People not eligible for HBIS
- Utility Course of
- Well being Advantages for Immigrant Adults (HBIA)
- Well being Advantages for Immigrant Seniors (HBIS)
- Emergency Medical for Noncitizens
- Well being Advantages for Immigrant Adults (HBIA)
- Case Change/Redetermination Course of
- Well being Advantages for Immigrant Adults (HBIA)
- Well being Advantages for Immigrant Seniors (HBIS)
- Profit Protection
- Lined Providers: Examples of Lined Providers
- Excluded Providers
- Co-payments and Price Sharing
- Built-in Eligibility System (IES)/MANG P
- Well being Advantages for Immigrant Adults (HBIA)
- Well being Advantages for Immigrant Seniors (HBIS)
- Handbook Revisions
Well being Advantages for Immigrant Adults/Seniors (HBIA/HBIS)
Efficient 12/01/2020, pursuant to 305 ILCS 5/12-4.35(a-5), Illinois Division of Healthcare and Household Providers (HFS) made medical advantages like these provided below Help to the Aged, Blind or Disabled (AABD) out there to noncitizens aged 65 and over who don’t meet immigration standing for Medicaid. This totally state-funded particular program is named Well being Advantages for Immigrant Seniors (HBIS). New enrollment for the HBIS program was suspended for purposes dated after November 6, 2023, at 5 p.m. as a consequence of having met an enrollment cap.
As of 5/1/2022, Illinois Division of Healthcare and Household Providers (HFS) expanded protection out there to noncitizen adults with the enactment of Well being Advantages for Immigrant Adults (HBIA) out there to noncitizens ages 55 by way of 64 years previous who should not in any other case eligible for medical protection within the state of Illinois.
On 07/01/2022, pursuant to 305 ILCS 5/12-4.35(a-7), Well being Advantages for Immigrant Adults was expanded to start at age 42 for many who should not in any other case eligible for medical protection within the state of Illinois. This enlargement permits for Well being Advantages for Immigrant Adults (HBIA) to cowl ages 42 by way of 64. New enrollment for the HBIA program is suspended for purposes dated 7/1/2023 and later pursuant to a June 16, 2023, public discover, Well being Advantages for Immigrant Adults (HBIA) and Well being Advantages for Immigrant Seniors (HBIS) Emergency Rulemaking and HBIA Short-term Enrollment Pause.
Eligibility
Well being Advantages for Immigrant Adults (HBIA)
This program follows MAGI eligibility budgeting. A person could also be eligible for this program offered all the next standards are met:
- Applicant is just not a U.S. citizen;
- Applicant has a noncitizen standing that doesn’t meet the standards for Medicaid. (See PM 03-01-00: Citizen/USCIS (U.S. Citizenship and Immigration Providers) Standing);
- Applicant is a resident of Illinois;
- Applicant is between the ages of 42 by way of 64 years previous. Self-attestation is suitable if the shopper’s age can’t be verified electronically; and
- Applicant’s revenue is at or beneath 138% FPL. (See PM 08-03-00: MAGI Budgeting for extra particulars on MAGI Budgeting).
- An inmate of a public establishment could also be eligible in line with MAGI guidelines.
People eligible for HBIA
People not eligible for HBIA
- Applicant is eligible for Medicaid.
- Efficient Might 1, 2024, candidates who’re Lawful Everlasting Residents (LPR/inexperienced card holder).
- Be aware: Lawful Everlasting Residents assembly the 5-year ready interval could also be eligible for Medicaid. Lawful Everlasting Residents below 5 years could also be eligible for federally funded Market protection.
Well being Advantages for Immigrant Seniors (HBIS)
This program follows the present AABD neighborhood eligibility standards. A person could also be eligible for this program offered all the next standards are met. (See PM 08-02-00: Help to the Aged, Blind and Disabled for extra particulars on AABD Budgeting):
People eligible for HBIS
People not eligible for HBIS
- An inmate of a public establishment in line with AABD guidelines.
- Applicant is eligible for Medicaid.
- Efficient Might 1, 2024, candidates who’re Lawful Everlasting Residents (LPR/inexperienced card holder).
- Be aware: Lawful Everlasting Residents over 5 years could also be eligible for Medicaid. Lawful Everlasting Residents below 5 years could also be eligible for Federally Facilitated Market protection.
Utility Course of
Candidates have to be residents of Illinois and decided to not be eligible for different out there medical advantages as a consequence of not assembly the citizen/immigration standards as denoted in PM 03-01-00: Citizen/USCIS (U.S. Citizenship and Immigration Providers) Standing.
- Be aware: When an applicant with a SSN and/or an Alien Registration Quantity entered on the Non-Citizen Particulars display screen is denoted as “Undocumented,” IES will show a message alerting the employee that denoting the person as undocumented is inconsistent with the applicant having an SSN and/or an Alien Registration Quantity.
Well being Advantages for Immigrant Adults (HBIA)
- Be aware: New enrollment within the Well being Advantages for Immigrant Adults (HBIA) program was paused efficient July 1, 2023, and stays paused presently.
HBIA circumstances are processed equally to ACA and Household Well being Plan Instances. An applicant’s eligibility for one of many federally funded Medical Applications have to be reviewed as a part of their eligibility willpower.
People could receive backdated medical protection for as much as three months previous to the month of software until the person doesn’t meet all eligibility necessities for a number of backdated months.
Well being Advantages for Immigrant Seniors (HBIS)
- Be aware: New enrollment within the Well being Advantages for Immigrant Seniors (HBIS) program was paused efficient shut of enterprise November 6, 2023, and stays paused presently.
HBIS circumstances are processed equally to AABD circumstances. An applicant’s eligibility for one of many federally funded medical applications have to be reviewed as a part of their eligibility willpower.
People could receive backdated medical protection for as much as three months previous to the month of software until the person doesn’t meet all eligibility necessities for a number of backdated months.
Emergency Medical for Noncitizens
A noncitizen decided eligible for both HBIA or HBIS might also qualify for emergency medical if the person wants or has acquired emergency medical providers through the month of software or through the 3 months previous to the month of software. Each medical applications will be on the identical case.
When finishing an software in ABE (Utility for Advantages Eligibility), the applicant should reply the query, “Is that this individual a U.S. citizen?” If answered “No”, ABE will ask, “Is that this a request for emergency medical for a noncitizen.” If “Sure”, a request for emergency medical for a noncitizen might be processed in IES.
To create an software for emergency medical the employee should navigate to the “Questions” web page within the Particular person Info part and choose “Sure” to the “Particular Medicaid Approvals” query.
Detailed insurance policies and procedures must be reviewed at: MR #18.05: Emergency Medical Protection for Noncitizens Not Assembly Immigration Standing and PM/WAG 06-05-00 Emergency Medical for Noncitizens Who Do Not Meet the Federal Qualifying Medicaid Standards.
Case Change/Redetermination Course of
Eligibility might be redetermined yearly and at any time when a change is reported.
Noncitizens decided eligible for State funded medical, will need to have their standing reviewed at every redetermination for doable change of their immigration standing.
Clients reporting a change in immigration standing or turning 65 years previous must be thought of for the suitable program.
- Instance: Mr. Heinz has HBIA however is popping 65 this month. His eligibility to transition to HBIS must be reviewed at redetermination.
When an replace or redetermination is accomplished, circumstances have to be reviewed to make sure clients are being positioned within the appropriate program(s) and to examine if the shopper is eligible for one of many federally funded medical applications.
Well being Advantages for Immigrant Adults (HBIA)
HBIA circumstances are maintained and renewed the identical as ACA and Household Well being Plan circumstances. Consult with PM 19-02-02 for processing ACA/Household Well being Plan redeterminations.
- Instance:
Elena, 45 years previous, got here to the U.S. in 1/1/xx on a H1B visa as a brief worker of an IT agency in NY. Elena is eligible for HBIA.
Nonetheless, she was compelled to work in a sweatshop. After 2 years, Elena acquired help from native authorized and volunteer companies and Elena was granted a Sufferer of Trafficking standing and acquired a Certification Letter from the Workplace of Refugee Resettlement (ORR). The “certification date” on the letter was 6/15/xx.
6/15/xx is the date Elena grew to become a professional alien and met immigration standing necessities for federally funded help, due to this fact Elena must be reviewed to transition from HBIA to Medicaid.
Well being Advantages for Immigrant Seniors (HBIS)
HBIS circumstances are maintained and renewed the identical as AABD circumstances. Consult with PM 19-02-03 for added particulars on processing AABD redeterminations.
- Instance:
Maggie got here to the U.S. in 1/1/xx as a scholar on the age of 66 years previous. She stayed within the U.S. after her visa expired. Underneath her scholar visa and after it expired Maggie was eligible for HBIS.
Maggie utilized for asylum with USCIS on 3/1/xx, due to this fact Maggie is now eligible for AATV or VTTC. Maggie must be reviewed to transition from HBIS to AATV or VTTC. A number of years later Maggie acquired a USCIS resolution granting her asylum. The USCIS letter acknowledged her asylum approval date was 8/26/xx.
8/26/xx is the date Maggie grew to become a professional alien and met immigration standing eligibility requirement for federally funded help, due to this fact Maggie must be reviewed to transition from AATV or VTTC to Medicaid.
Profit Protection
The well being profit applications present complete healthcare protection with co-payments and price sharing for sure providers.
Lined well being care providers shall be the identical as lined providers for adults as described in AABD and MAGI applications besides the excluded providers listed beneath.
Lined Providers: Examples of Lined Providers
- Physician, hospital care, lab checks
- Rehabilitative providers reminiscent of bodily and occupational remedy
- Psychological well being contains psychiatry, psychology, or providers offered by a neighborhood psychological well being heart
- Substance use dysfunction providers
- Some dental providers
- Eye care providers
- Pharmaceuticals
Excluded Providers
- Lengthy-term care providers
- Funeral and burial bills
- Residence and community-based waiver providers
- Different providers not lined below AABD as listed in PM 20-03-04-c: Providers Not Lined
Co-payments and Price Sharing
- Inpatient hospitalizations: $250 co-pay
- Hospital or Ambulatory Surgical Remedy Middle outpatient providers: 10% of the Division fee
Built-in Eligibility System (IES)/MANG P
An indicator and MANG P code was created to establish people authorized below the HBIA and HBIS applications. People authorized below HBIA and HBIS will be recognized by an indicator and particular MANG P code.
Well being Advantages for Immigrant Adults (HBIA)
In IES a particular indicator “(A)” was added to the present ACA Grownup and Household Well being Plan Sorts of Help (TOA) inside eligibility abstract to establish the person as HBIA.
This system can be denoted with a “Sure” subsequent to “State Non-Citizen Program” within the EDG Info part of the chosen EDG abstract.
In MMIS the MANG P code is NI:
Well being Advantages for Immigrant Seniors (HBIS)
In IES a particular indicator “(A)” was added to the present AABD Kind of Help (TOA) inside eligibility abstract to establish the person as HBIS.
This system can be denoted with a “Sure” subsequent to “State Non-Citizen Program” within the EDG Info part of the chosen EDG abstract.
In MMIS the MANG P codes is 6I:
Handbook Revisions
[signed copy on file]
Dulce M. Quintero
Secretary-Designate, Illinois Division of Human Providers
Elizabeth M. Whitehorn
Director, Illinois Division of Healthcare and Household Providers