The Department of Healthcare and Family Services (Department) provides access to health
insurance for approximately 2.2 million Illinoisans. Illinoisans receiving healthcare through the Department's program include 1.3 million children, 509,000 parents, 150,000 seniors, and 240,000 persons with disabilities.

The Department administers these programs under the provisions of the Illinois Public Aid Code (305 ILCS 5/5 et seq.) the Illinois Children's Health Insurance Program Act (215 ILCS 106/1 et seq.) and Titles XIX and XXI of the Social Security Act. Through its role as the designated Medicaid single state agency, the Department works with several other agencies that manage important portions of the program—the Departments of Public Health; Human Services; Children and Family Services; Revenue; the Department on Aging; the State Board of Education and hundreds of local school districts; and the University of Illinois at Chicago.

The Medical programs are funded jointly by the state and federal governments and, in certain instances, local governments. In fiscal year 2007, the Department spent in excess of eight billion dollars on health benefits provided to over two million individuals over the course of the year. A monthly average of 2.2 million individuals were served by 53,153 providers of medical services, including 32,854 physicians, 2,718 pharmacies, 311 home health agencies, 261 hospitals and 746 nursing facilities.

Medical Programs

The Department covers children, parents or relatives caring for children, pregnant women, seniors, blind persons and persons with disabilities. To be eligible, individuals must also be Illinois residents and U.S. citizens or qualified immigrants. (Immigrants who are not permanent legal residents may be covered for emergency medical care only, and are never eligible for transplantation services.) They must also meet income and asset requirements. Income and asset limits vary by group. Major groups are described below in these brief descriptions of our programs:

Family Health Plans

All Kids covers children in families with income up to 200 percent of poverty, regardless of other insurance coverage. Children in families above 200 percent of the federal poverty level (FPL) must be uninsured to qualify. All Kids includes four plans with varying cost sharing based on income: All Kids Assist, All Kids Share, All Kids Premium and All Kids Rebate. Federal matching funds are available under Title XIX, Medicaid, and Title XXI, State Children's Health Insurance Program, to finance health benefits for children.

FamilyCare covers parents or caretaker relatives of children with income up to 185 percent of the FPL regardless of assets. Federal matching funds are available under Title XIX, Medicaid, and Title XXI, Children's Health Insurance Program through the FamilyCare waiver, for this group. The Department increased the income standard of this program to 185 percent of the poverty level in January 2006.

All Kids Moms and Babies covers pregnant women and their infants up to 200 percent of the FPL regardless of assets. This program receives federal match under Medicaid.

Aid to Aged Blind and Disabled (AABD) Medical covers individuals with income up to 100 percent of the FPL and no more than $2,000 of non-exempt assets (one person) who are seniors, blind persons and persons with disabilities. Federal matching funds are available under Medicaid for these benefits.

DCFS - Children whose care is subsidized by the Department of Children and Family Services (DCFS) are provided coverage under Title IV-E (Child Welfare) of the Social Security Act as well as children served by DCFS through its subsidized guardianship and adoption assistance programs.

Health Benefits for Workers with Disabilities covers persons with disabilities who work and have earnings up to 200 percent of the FPL who buy-in to Medicaid by paying a small monthly premium. Eligible people may have up to $10,000 in non-exempt assets. Federal matching funds are available under Medicaid for these benefits.

Illinois Healthy Women Program is a special Medicaid waiver program that provides women's reproductive healthcare to those losing their Medicaid eligibility. Women are offered access to this program, which covers contraceptives, mammograms, pap tests, sexually transmitted disease screening and treatment, HIV testing and referral, and folic acid to promote better births. Federal matching funds are available for most services at the 90 percent enhanced rate for family planning.

Health Benefits for Persons with Breast or Cervical Cancer covers women who are screened through the Illinois Breast and Cervical Cancer Program, which is operated by the Department of Public Health, and found to need treatment. Federal matching funds, at the enhanced rate of 65 percent, are available under Medicaid for these benefits.

State Renal Dialysis Program covers the cost of renal dialysis services for eligible persons who have chronic renal failure and are not eligible for coverage under Medicaid. These benefits are financed entirely with state funds.

State Hemophilia Program provides assistance to eligible patients to obtain antihemophilic factor, annual comprehensive visits and other outpatient medical expenses related to the disease. As part of the FamilyCare waiver, the state receives federal matching funds for some of the individuals enrolled in this program.

State Sexual Assault Survivors Emergency Treatment Program pays emergency outpatient medical expenses for survivors of sexual assault. These benefits are financed entirely with state funds.

Medicare Cost Sharing covers the cost of Medicare Part B premiums, coinsurance, and deductibles for Qualified Medicare Beneficiaries with incomes up to 100 percent of the FPL. It covers the cost of Medicare Part B premiums only for persons with incomes up to 135 percent of the FPL only if they are Specified Low- Income Medicare Beneficiaries or Qualified Individuals. Assets are limited to $4,000 for a single person and $6,000 for a couple. The federal government shares in the cost of this coverage.

Illinois Cares RX Program (formerly SeniorCare and Circuit Breaker Pharmaceutical Assistance) provides comprehensive prescription coverage to seniors who are not eligible for Medicaid but who have income up to 200 percent of the FPL, regardless of assets.

With the exception of All Kids Rebate, persons who qualify in the first seven groups above are covered for a comprehensive array of health services. Services for the other groups vary by program.