Ill. Admin. Code tit. 89, § 120.11 - Eligibility for Pregnant Women and Children
a) Pregnant Women Eligible
1) Eligibility for medical assistance exists
for a pregnant woman of any age who meets the following eligibility
requirements:
A) cooperation in establishing
eligibility as described in Section
120.308;
B) residency as described in Section
120.311; and
C) whose countable monthly income is at or
below 200% of FPL as determined pursuant to Section
120.64.
2) Beginning on the last day of the
pregnancy, the pregnant woman shall be eligible to receive medical assistance
for 60 days. The 60 day medical assistance continues through the last day of
the calendar month in which the 60 day period ends. The 60 day medical coverage
period shall be provided for all women determined eligible for medical
assistance under subsection (a)(1), including women who are no longer pregnant
at the time of application, but were pregnant at any time during the three
calendar months preceding the month in which the application was received. A
woman who meets the requirements of this Section is eligible regardless of
whether the pregnancy ended as a result of birth, miscarriage or abortion and
regardless of whether she signed an adoption agreement.
3) When a pregnant woman is determined
eligible for medical assistance under subsection (a)(1), income changes
occurring after the eligibility determination are not considered through the 60
day postpartum period following the last day of pregnancy.
b) Children Under Age 19
1) Eligibility for medical assistance exists
for children under age 19 who meet the following eligibility requirements:
A) cooperation in establishing eligibility as
described in Section 120.308;
B)
citizenship/alienage status as described in Section
120.310;
C) residency as described in Section 120.311;
and
D) whose countable monthly
income is at or below 313% of FPL as determined pursuant to Section
120.64.
2) Children
under age 19 shall be eligible to receive medical assistance under subsection
(b)(1) for a period of time as determined in Section
120.400.
3) When the Department becomes aware of the
birth of a child or children to a woman determined eligible under subsection
(a)(1) while she was eligible, the child or children shall be deemed to have
applied and been found eligible for medical assistance under subsection (b)(1),
without written request. The child or children shall be eligible to receive
medical assistance for a period of time as determined in Section
120.400.
Notes
Amended at 38 Ill. Reg. 5967, effective February 26, 2014
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