Covered Benefits

As of February 1, 2024, depending on the MCO a customer is enrolled with, hospitals and surgical centers may collect co-payments and cost sharing on some covered non-emergency services. Customers not enrolled in an MCO may be charged as well. Co-payments and cost sharing are what is paid out of own pocket for a covered health care service.

More information about copayments.

Under HBIA/HBIS, co-payments and cost sharing can only be charged on the following services: · Non-emergency Inpatient hospitalizations: $250 co-payment per stay. · Non-emergency Hospital Outpatient Services or Ambulatory Surgical Treatment Center: 10% of what HFS would pay the provider. The amount you can be charged will vary depending on the service and the provider. No co-payment or cost sharing can be charged for an emergency service needed to evaluate or stabilize an Emergency Medical Condition. An Emergency Medical Condition is a condition with symptoms that are severe and painful enough that a reasonable person would think they are life-threatening and need immediate medical care. Things like a severe asthma attack, symptoms of a heart attack, or a car accident with serious injuries, are just some examples. Most services covered by the Health Benefits for Immigrant Adults and Seniors program will continue to be free to you. For example: · Primary care visits · Care at a Federally Qualified Health Center (FQHC) · Vaccinations at a pharmacy or doctor’s office · Prescription drugs · Dental and vision services · Prescription drugs · Transportation services Note, this list above is not a complete list, just examples. Always check with your provider about whether you will have any out-of-pocket costs.

Those currently in the HBIA program met the following eligibility requirements:

At least 42 years old and not over age 64.

1 . An undocumented immigrant (including individuals in a Temporary Protected Status)

2. A resident of Illinois.

3. Have an annual 2022 household income at or below $18,754 for one person; at or below $25,268 combined income for a household size of two. The income limit differs depending on the number of household members.

Reminder: Do not submit applications for this program, as enrollment is currently paused.

For those age 65+, the Health Benefits for Immigrant Seniors program was available, but is also currently paused. No new applications are being approved.