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Here are answers to some questions
you might have about Medicaid.

Download the Medicaid Eligibility Changes FAQ

• What is Medicaid?

  Medicaid is a public health insurance program that is jointly administered by the federal and state governments, helping people with limited income access affordable health care services, including doctors’ visits, hospital care, vision, dental and prescription coverage.

  Medicaid covers a wide range of people, including children, pregnant individuals, working adults, individuals with limited incomes, older adults including those who are also eligible for Medicare (dual eligibles), and people with disabilities.

  Approximately 1 in 5 people in the U.S. are covered by Medicaid, including 3.4 million Illinoisans.

  In Illinois, Medicaid may also be known as HealthChoice Illinois, medical card, or the managed care organization that the individual is enrolled in (Aetna Better Health, Blue Cross Community Health Plans, CountyCare Health Plan, MeridianHealth, Molina Healthcare, or YouthCare).

  Medicaid in Illinois is administered by the Illinois Department of Healthcare and Family Services.

• What changes are being made to Medicaid eligibility?

  The federal government has made some significant changes to Medicaid eligibility that all states must implement, including the following.

  • Proof from some enrollees that they work, volunteer or attend an education or training program (work requirements), starting January 2027
  • More frequent Medicaid renewals (redetermination) for some enrollees, starting January 2027
  • A narrower definition of the immigrants who are eligible for Medicaid, starting October 2026

• Who do the new requirements apply to?

  Starting in January 2027, some enrollees will have to submit proof that they work, volunteer or attend an education or training program. They will also need to renew their Medicaid coverage twice a year (every six months), instead of once a year (every 12 months).  

  The new requirements will apply to enrollees who:

  • Are between the ages of 19 and 64
  • Do not have a dependent child age 13 or younger living with them

  These enrollees are also known as Affordable Care Act adults, or “ACA adults”.

  Exemptions for work requirements may be available for individuals with certain health conditions or disabilities, or who were recently released from jail or prison. Even if an ACA adult is exempt from work requirements, they will still be required to complete redetermination every six months.

  The new requirements will not apply to:

  • Children under age 19
  • Adults ages 65 and older
  • Parents or guardians with a dependent child age 13 or younger living with them
  • Pregnant people or people who have given birth within the last 12 months
  • People with a disability or serious health condition
  • Caretakers for an individual with a disability
  • Foster youth or former foster youth under age 26
  • Individuals complying with work requirements for food assistance programs like the Supplemental Nutrition Assistance Program (SNAP)
  • Veterans with total disability ratings

• What activities count towards work requirements?

  Individuals subject to work requirements can satisfy them in multiple ways:

  • Employment: A minimum of 80 hours of work per month or a monthly pre-tax (gross) income of at least $580 per month (different rules for seasonal workers)
  • Enrollment in an educational program: At least half-time enrollment in higher education or a career or technical education program
  • Work program participation: Participation in a work program for a minimum of 80 hours per month
  • Community service: A minimum of 80 hours of community service per month

   

  More details about how a person can submit information about their hours will be shared by HFS this fall. 

• Which groups of immigrant enrollees will no longer qualify for Medicaid?

  Currently, some non-citizens can still access Medicaid as “qualified immigrants.” Starting October 2026, the definition of qualified immigrant will change to exclude refugees, people seeking asylum (Temporary Protected Status) and victims of domestic violence and trafficking (Violence Against Women Act applicants and T visa holders).

  These immigrant groups will still be eligible for Medicaid:

  • People with legal permission to live in the U.S. (green card holders) after they have lived here for five years
  • Cuban and Haitian immigrants
  • Compact of Free Association migrants and citizens of the Freely Associated States (like Micronesia, Marshall Islands and Palau) who have legal permission to live in the U.S.
  • Pregnant people and children under age 18 who are not U.S. citizens

• How can enrollees stay informed ahead of changes to Medicaid?

  All Medicaid enrollees should make sure their contact information is up to date with HFS, their health plan and their primary care doctor.

  For instructions on how to update your contact information with HFS, visit hfs.illinois.gov/medicalclients/addresschange.html, log-in to abe.illinois.gov, or call 1-877-805-5312.

  HFS will inform individuals of any changes to their eligibility or new requirements they must follow to keep their coverage.

• When will more details be available?

  The federal government is expected to give states instruction on how to implement these changes in June 2026.

  Details on steps that enrollees may need to take to keep their Medicaid coverage will likely be shared in August or September 2026.

• How do enrollees complete redetermination?

  Redetermination is a review of an enrollee’s eligibility for Medicaid. It is how HFS determines if someone is still eligible for coverage.

  Enrollees will receive paperwork in the mail when it is time to complete redetermination. That’s why it is so important for HFS to have an enrollee’s current mailing address on file.

  The redetermination paperwork must be completed and mailed back to the state or the enrollee could lose their Medicaid coverage. 

  Redetermination can also be completed online by going to ABE Manage My Case at abe.illinois.gov.

• How can someone create an ABE Manage My Case account?

  The Illinois Application for Benefits Eligibility (ABE) Manage My Case portal allows users to manage their Medicaid enrollment, update their contact information and more.

  All users of the ABE portal are required to create an ILogin account with State of Illinois and an ABE profile. To register, the user must have an email address.

  To create an ILogin Account, visit: iloginhelp.illinois.gov

  To access the ABE portal or create an ABE profile, visit: abe.illinois.gov

  On the ABE Manage My Case portal, enrollees can:

  • Apply for benefits or renew benefits
  • Update their contact or household information
  • Sign up for electronic or text notification
  • File and manage appeals
  • Review notices about their case

   

  For technical support about using the ABE portal, visit dhs.state.il.us/page.aspx?item=98456 or call the ABE customer call center 800-843-6154.

• How is Medicaid eligibility currently determined?

  Medicaid eligibility is based on several financial and non-financial factors like household income, family size, Illinois residency and immigration status. In Illinois, most people with income up to 138% of the federal poverty level (FPL) are eligible to receive benefits. 

  Household Size	138% of FPL (monthly)	138% of FPL (annually)
  1	$1,835.42	$22,025
  2	$2,448.58	$29,863
  3	$3,141.83	$37,702

  Children and pregnant individuals qualify for Medicaid at higher household income levels. Some adults qualify at lower income levels and need to meet asset tests.

  Eligibility is determined by the Illinois Department of Healthcare and Family Services (HFS).

  More information is available on HFS’s website: hfs.illinois.gov/medicalclients/medicalprograms.html

• Can people still apply for Medicaid?

  Yes! People can still apply for Medicaid health coverage or renew their existing health coverage if they are still eligible.

  For more information about applying for Medicaid:

  • Visit the HFS website: Applying for Medicaid
  • Log in at IL ABE
  • Call 1-800-843-6154

• What happens if someone loses their Medicaid coverage?

  Losing Medicaid coverage does not prevent an enrollee from applying again. An individual might reapply after a change in life circumstances, such as a change in income, becoming pregnant or developing a health condition.

  For more information about applying for Medicaid:

  • Visit the HFS website: Applying for Medicaid
  • Log in at IL ABE
  • Call 1-800-843-6154