Medicaid for Disabled Adults in Illinois

Walking Through the Process

Step 1- Pursue SSI (if eligible)

If the individual is 18 years or older and meets the eligibility requirements for SSI through the Social Security Administration, consider applying for SSI first.  An individual who is approved for SSI is automatically approved for Medicaid, so working through SSI first can save both time and energy.  

If the individual is not eligible or does not plan to apply for SSI, move to Step 2.  

If the individual is younger than 19 years and needs medical insurance, they may apply for All Kids Children’s Health Insurance Program (CHIP) and information about that program can be found HERE.

Step 2- Take Pre-Test

There is an online ‘ABE Screener’ that allows people to anonymously enter information to check to see what benefits they might be eligible to receive.  If the individual is considering applying for Cash Assistance or SNAP Benefits (aka Food Stamps) in addition to Medicaid, then this might be a handy tool to work through before completing the application.  

Cash assistance is an additional form of funding and varies greatly based on a variety of circumstances.  SNAP Benefits, also known as LINK or Food Stamps, is a benefit that supports individuals in covering the cost of certain goods and food.   

The ABE Screener takes about 10 minutes to complete and is a helpful preview into the type of questions asked and level of detail needed for the Medicaid application.   The ABE Screener is NOT the actual application and information won’t transfer over, but it’s a good way to do a ‘test run’ of what the online initial application will look and feel like. 

If there is any question whether the individual would pass Medicaid eligibility, completing the ABE Screener would be a worthwhile tool to use. 

Step 3- Set Up ABE Account

An ABE Account is the name of the account in Illinois through which an individual would apply to receive Medicaid benefits.  ABE stands for ‘Application for Benefits Eligibility’ and is simply the name of the website where the application is found.   ABE Accounts do allow individuals to start the application and come back to submit it at a later date, therefore it does not need to be completed in its entirety in a single sitting.   

Individuals can also complete a paper application or call the Illinois Department of Human Services Helpline. Contact information for both of these options can be found HERE. 

If individuals choose to complete the Medicaid application through the ABE website, they will need to start by creating an account.  Individuals will need to identify a username and password and select and answer secret questions for added security.  Passwords must include- capital letters, lowercase letters, numbers, and special characters (! @ # $ % & *).   Record sensitive information, including the username, password, and secret question responses as the individual will need to access their online account if approved for Medicaid benefits.  

Step 4- Complete Application

Answering the application questions can feel the most overwhelming and time consuming, so working through or reviewing the paper application will give the individual a clear idea of what the online application will be like.   If viewing or completing the paper application on a computer, download the file and open in Adobe.  The paper application can’t be viewed or completed in browsers like Chrome or Safari because it has fillable boxes and isn’t compatible in a web browser.  

Keep in mind that the more documentation included in the application the easier (and faster) a caseworker will be able to determine if the individual is approved or denied.  If the online application question or language is confusing, click the ? mark next to the question for more detail.  

If all the materials are gathered and ready, expect the online application to take between 30-60 minutes.  Find a list of information to have ready HERE (Checklist download coming soon!). 

One of the first questions asked is regarding what benefits the individual wants to apply for and the remaining questions will be based on how this question is answered.  So, if the individual is applying only for Medicaid, and not SNAP or Cash Assistance, then just choose that option and continue to the next step. 

If the individual has medical bills from the past 3 months that they would like covered if they are approved for Medicaid then they should mark that they want  3 months backward coverage.  

Some question highlights:

•There is the option to request future communications in other languages.   While all forms come in English and most in Spanish, other languages can be requested.  If the individual needs an alternate language, consider requesting forms in English and having the form interpreted and explained by someone the individual knows or an interpreting agency.  

•One of the first sets of questions will be to identify a Head of Household.   This part of the application is designed to create an understanding of the individual’s living situation for the caseworker who is determining whether to approve or deny Medicaid. If the Head of Household is not applying for benefits, they still need to be listed in the application to create the whole picture of the individual, their situation, and needs.  Everyone who is listed in the home will later be given a label to see how they are all related (parent, sibling, family, other, etc.).  There will also be a question to indicate whether each person listed is applying for benefits, like Medicaid, so only those who want to apply for benefits will be considered.  

•The individual will need a Social Security Number (SSN) or ITIN or can show proof they are actively applying for a SSN.   An application can be submitted without a SSN listed, but will need to be provided later.  

•Individuals will need to verify their identity, and this may be done electronically if applying online.  If the individual isn’t able to be verified online (which is common), they will need to print, complete, sign, and send in a form.  More information about that process HERE.

•For questions with ‘mental disability’ wording, this includes intellectual, cognitive, and developmental disabilities.  

•If the individual is still in school (middle school, high school, transition, or post-secondary training/college), there is a question to indicate student status. 

•There is a question regarding the individual’s finances, specifically balances in different accounts and liquid access (like Special Needs Trusts), so have that information handy.  

•The individual will have a choice between ACA (American Care Act), AABD (Aid to Aged Blind and Disabled), or No Preference health insurance options.  

•Both ACA and AABD are Medicaid programs.  

•ACA Medicaid is based on income, so when an individual’s earnings exceed the maximum income, then they may no longer be eligible. 

•AABD Medicaid is based on disability, so if an individual’s earnings exceed the maximum income, there are programs that can keep them eligible because of their disability. 

•If the individual is employed, they will need to have the business’s EIN number.   The individual should request that number from their manager.  If the individual has insurance coverage through their job, mark YES on the application.   This will not automatically deny them of Medicaid if they meet other eligibility requirements.  

•If applying after being awarded SSI benefits, click ‘YES’ for the question about receiving benefits in the last 3 months. 

•The online application will be summarized after each section and before the individual submits to check for errors and will be converted to a printable version once it’s submitted. 

Step 5- After Submitting

Once an application has been submitted, the next page will allow the individual to upload relevant documents.  Select the person’s name who the document supports and the appropriate category for the supporting documents and electronically upload.   

Supporting documents may include pay stubs from a job, proof of living expenses, SSI Benefit Statement letter, and the like.  

Remember, the more documentation included in the application the easier (and faster) a caseworker will be able to determine if the individual is approved or denied.  

If scanning paper documents with an iPhone, use the Notes app to scan as a PDF.  Directions for this can be found HERE.  

If the individual was unable to prove their identity, they may need to take additional steps after submitting.   Information about this process can be found HERE (see under ‘Requesting Manual State Identity Proofing to Access Manage My Case) and the form can be found HERE and should be completed after submitting if the individual was unable to verify their identity through ABE.  

A few notes about the form:

•Include the case number you received after submitting the application through the ABE account on the bottom of the first page. 

•The top question on the second page references the Developmental Disability Waiver, this refers to the PUNS waitlist for the Home and Community Based Services Medicaid Waiver and should be marked YES if the individual has already been pulled off the PUNS waitlist. 

•Include proof of one item from Column A OR two items from Column B.  If scanning a document, directions for scanning as a PDF using an iPhone can be found HERE. 

Step 6- Answer the Phone! 

After submitting the application, be ready to answer a phone call to set up an in-person interview or to complete a phone interview.  If submitting during business hours, the individual could receive a phone call within minutes of submitting the application.    If the individual doesn’t have a phone number and their application includes the number of a family member who isn’t with them when they submit the application, alert the family member to answer incoming calls.   Individuals will be contacted within 14 days after applying for an interview.  

An interview is not necessary for Medicaid but is necessary for SNAP Benefits and an in-person interview is required for Cash Assistance.  

A state caseworker will likely call for the interview and they are looking to verify the information on the application and gather additional information that may be missing from the application.   Remember, the more documentation included in the application, the easier (and faster) a caseworker will be able to determine if the individual is approved or denied. 

Step 7- Track Progress Online for Approval 

After submitting, individuals can track the progress of their application through the determination process by referencing the Manage My Case section of the ABE website. 

Individuals should hear within 60 days whether they were approved or denied for Medicaid coverage.  If approved, the individual will be provided information about coverage for the 3 months prior (if initially indicated on the application) and coverage moving forward. SSI recipients will be approved for Medicaid health insurance coverage, but must go through the enrollment process.  

Individuals can compare the plans by using this website HERE, scroll down a bit, click HealthChoice Illinois, select County, and click box to compare.  

For more information about medical services available, call Health Care Benefits Helpline: (866) 468-7543.  If denied, information about an appeal will be included in the letter.  

Step 8- Yearly Renew/Redetermination and Life Events

If the individual was approved for Medicaid benefits, they will need to renew their benefits on a yearly basis.   Renewals may also be called Redetermination because each year an individual’s information is reviewed to confirm they still qualify for Medicaid benefits.  Letters will be sent to the individual with steps on how to renew for another year and individuals should complete necessary steps within 30 days of receiving the letter, so they don’t lose health benefits.   Renewal steps can be completed through the Manage My Case section of the ABE website. 

Failing to follow the steps in those letters by the deadline may cause the individual to lose their Medicaid coverage.   If the individual responds to a denial letter (received after not responding to the initial letter within 30 days) within 60 days, then their benefits may be reactivated.  

Update the individual’s ABE profile when there is a change in life, income, or living situation within 10 days as they may qualify for additional benefits.  Updating the ABE account with these changes supports automatic renewal because IL uses an electronic system for verification of eligibility, so it’s time well spent.