How to Apply: Medicaid in Illinois

A how to guide on how to apply for Medicaid in Illinois

Illinois Medicaid is free or low-cost health coverage. It is run by the Illinois Department of Healthcare and Family Services (HFS). It pays for doctor visits, hospital stays, prescriptions, mental health care, and more.

A new federal law (H.R. 1) adds work requirements for some adults on Medicaid. Most people who have this coverage will also have to renew every 6 months instead of once a year. Read the work requirement sections below to see if this applies to you.

Check if you can get Illinois Medicaid

You must live in Illinois. You must also meet the income limit for your group. Illinois has different Medicaid groups:

• ACA Adults: ages 19 to 64, no related child under 18 living with you, and not on Medicare. This is the group with the new work requirements.
• FamilyCare (parents and caretaker relatives): adults raising a child under 18 who lives with them.
• All Kids: children under 19.
• Moms & Babies: pregnant people, and for 12 months after the pregnancy ends.
• AABD Medical: people 65 or older, blind, or with a disability. There is also an asset limit of $17,500.

2026 monthly income limits (before taxes)

People in household

ACA Adults and FamilyCare (138% FPL)

Moms & Babies (213% FPL)

All Kids (up to 318% FPL)

AABD Medical (100% FPL)

1

$1,835

—

$4,229

$1,330

2

$2,488

$3,841

$5,734

$1,803

3

$3,141

$4,849

$7,239

$2,276

4

$3,795

$5,857

$8,745

$2,750

5

$4,448

$6,865

$10,250

$3,223

6

$5,101

$7,873

$11,755

$3,696

A pregnant person counts as 2 or more people (the unborn baby counts). Families near the top of the All Kids range may pay small monthly premiums or co-pays.

Immigration status matters. Starting October 1, 2026, many non-citizens can no longer get full federal Medicaid. Green card holders who have met the 5-year wait (or are exempt from it), Cuban/Haitian entrants, and COFA migrants can still qualify. Children under 19 and pregnant people are still covered. Emergency Medicaid is still available.

Not sure if you qualify? HFS says the best thing to do is apply. There is no penalty for applying.

Gather required documents and information

The application is easier if you have this ready:

• A mailing address. It does not have to be your home. You can use a friend, family member, or community group that agrees to hold your mail.
• Names and dates of birth for everyone in your household.
• Social Security numbers for everyone applying who has one. Children and pregnant people do not need one to apply.
• Alien Registration Numbers (A-numbers) for anyone applying who is not a U.S. citizen.
• Income information for everyone in your household, like pay stubs. Spousal support counts as income. Child support does not.
• Health insurance information if anyone already has coverage.
• Bank and retirement account balances, only if you are applying because you are 65 or older.

The state will try to check your information electronically first. If it cannot, you will get a letter asking for documents. Send them by the date on the letter, or your application may be denied.

Starting in 2027, ACA Adults may also need proof that they meet the work requirement or an exemption (see below).

Apply

There are four ways to apply:

• Online at abe.illinois.gov. This is the best way to keep track of what you sent. It takes about 30 to 45 minutes. Write down your T-number (tracking number) when you submit. You can apply for SNAP and cash assistance on the same application.
• By phone: call the IDHS Help Line at 1-800-843-6154. Ask for your case number at the end.
• In person at a Family Community Resource Center (FCRC). Find one with the IDHS Office Locator. For an in-person helper, call Get Covered Illinois at 1-866-311-1119.
• On paper:download the application. Fill in what you can, sign it, and bring, mail, or fax it to your local FCRC.

Important timing: If you are an ACA Adult, an application started and submitted by 5:00 p.m. Central on December 31, 2026 is reviewed under today's rules. Applications after that must meet the new work requirement.

After You Apply: What to Expect

• A caseworker reviews your application. If they need more information, you will get a letter listing the documents to send and a deadline.
• Check your status by phone, not by applying again. Applying twice causes delays. Call 1-800-843-6154, say the program, then say "case status." Have your T-number ready.
• If you are approved, you get an approval letter with your start date. Within 10 days you get a second letter with your Recipient ID Number (RIN). That letter is your HFS Medical Card. Bring it and a photo ID to every appointment. Keep it even if your coverage ends.
• Coverage for past bills. You can ask for coverage of medical bills from before you applied. Starting January 2027, this goes back 2 months instead of 3.
• If you are denied for missing papers, you have 60 days to send them and have your application reopened.
• If you are denied for income that is too high, your application is sent to the health insurance Marketplace, where you may get help paying for a plan.
• You can appeal any decision within 60 days of the date on the letter.
• Keep your address, phone, and email up to date at abe.illinois.gov or by calling 1-877-805-5312. Most H.R. 1 notices come by mail. Create a Manage My Case account at ABE so you can report information online.

New Work Requirements Starting January 1, 2027

A federal law passed in July 2025 (H.R. 1, Section 71119) requires some adults to work, study, or volunteer to keep Medicaid. Illinois must follow this law.

Who it applies to: ACA Adults only. You are an ACA Adult if you are 19 to 64, have no related child under 18 living with you, and are not on Medicare. Your mailed notices and the "Benefit Details" tab in Manage My Case will say "ACA" if this is your group.

How to meet it. Each month you need to count, you must do one of these:

1. Earn $580 or more in the month (80 hours × $7.25 federal minimum wage).
2. Work 80 hours or more. This includes full-time, part-time, self-employment, seasonal work, and unpaid work like an internship.
3. Volunteer 80 hours or more with a structured program that helps the community.
4. Take part in a work program 80 hours or more. See snapworkrequirements.illinois.gov for programs like Job Ready IL.
5. Go to school at least half-time (high school, GED, college, or trade school), as defined by your school.
6. Seasonal workers: average $580 or more per month over the last 6 months.

You can mix activities to reach 80 hours. Example: 50 hours of work + 30 hours of volunteering = 80 hours. In some households, another person's income can count toward the $580.

When you have to meet it

• New applicants (applying after 5:00 p.m. on December 31, 2026): you must have met the requirement in the month before you apply. Example: apply in April 2027, meet it in March 2027. If you have an exemption, you can show it in the month you apply.
• People already enrolled: it starts at your first renewal in 2027. The first group renews in March 2027.
• How often: in Illinois you only need to meet it (or be exempt) for 1 month in each eligibility period.
• Renewals every 6 months: after your first 2027 renewal, ACA Adults renew every 6 months instead of every 12.

How you prove it

• HFS will check its own data first, like payroll records. If it can confirm you, you do nothing.
• If not, you get a notice with your renewal form. You have 30 days to respond. You keep coverage during those 30 days.
• In late 2026, ABE will add a screener: "Check to see if I meet SNAP & Medicaid Work Requirements." HFS will also release a Manage My Work Requirement form. You can mail it to Central Scanning Unit, P.O. Box 19138, Springfield, IL 62794, fax it to 1-844-736-3563, or bring it to your FCRC. HFS says it will announce when these are ready.

If you do not meet it or prove an exemption, your coverage ends at the end of your eligibility period. You can appeal within 60 days. You may be able to buy a plan through Get Covered Illinois, but HFS says you will not get premium tax credits to help pay for it.

Exemptions: ACA Adults who do not have to meet the work requirement

You are exempt if you are:

• A former foster youth under age 26
• Pregnant, or getting postpartum coverage through Moms & Babies
• American Indian or Alaska Native, an Urban Indian, a California Indian, a member of a recognized tribe, or eligible for care through the Indian Health Service
• A parent, guardian, caretaker relative, or family caregiver (paid or unpaid) of a child under 14, or of a person with a disability
• A veteran with a 100% VA disability rating
• Medically frail, meaning you:

• Are blind or disabled under Social Security rules
• Have a substance use (drug or alcohol) condition
• Have a serious mental health condition
• Have a physical, intellectual, or developmental disability that makes daily activities hard
• Have a serious or complex medical condition that needs regular treatment

Short-term hardship exemptions

• Living in a county with a federal disaster declaration or high unemployment. HFS decides this and tells you.
• Being an inpatient in a hospital, rehab facility, intermediate care facility for people with intellectual disabilities, or psychiatric hospital. You must ask for this one.
• Traveling outside your community for a long time for care you cannot get locally for a serious medical condition. You must ask for this one.

Good to know about SNAP: If you are exempt from SNAP work rules, that does not automatically exempt you from Medicaid work rules. You still need a Medicaid exemption or qualifying activity.

HFS says federal guidance on the medically frail exemption is still coming.

Exclusions: People the work requirement never applies to

The work requirement does not apply at all to:

• People 18 or younger, or 65 and older
• Anyone in a Medicaid group other than ACA Adults, like All Kids, Moms & Babies, FamilyCare, and AABD
• People who have, or are entitled to, Medicare Part A or Part B
• People with partial coverage only, like the Family Planning Program or a spenddown

You do not need to report these. HFS already has this in your case file.

Other H.R. 1 changes to know

Change

Who it affects

Starts

Fewer non-citizens qualify for full Medicaid

Many lawfully present immigrants; see list above

October 1, 2026

Renew every 6 months

ACA Adults only

First renewal in 2027

Past-bill coverage cut from 3 months to 2

All Illinois Medicaid customers

January 2027

Work requirement

ACA Adults only

January 1, 2027

In mixed households, each person keeps their own schedule. Example: one person on AABD renews yearly while an ACA Adult in the same home renews every 6 months.

Helpful numbers

• IDHS Help Line (apply, case status, card): 1-800-843-6154
• HFS Health Benefits Hotline (update contact info): 1-877-805-5312
• Get Covered Illinois (in-person help, Marketplace): 1-866-311-1119
• Appeals: 1-800-435-0774

If you have any additional questions, you can email Mirza support, support@heymirza.com. We are happy to help in any way we can.

Last updated October 15, 2026