What Are the Requirements to Be Eligible for a Family Medicaid Card in Illinois?

Illinois offers medical insurance coverage for low-income families who are United States citizens or legal residents and live in Illinois. Three levels of coverage are offered for parents or caretakers of children in Illinois. The three options are called FamilyCare Assist, FamilyCare Share, and FamilyCare Premium Level 1. Each of these plans offers the same benefits, however they have different costs.

FamilyCare Assist

• Eligibility is based on the the income level and size of the household. This program is designed to assist families who earn a monthly income but might not be able to afford health insurance through their employer. Larger families can earn more monthly income and be eligible for this program than a smaller family. A family of two may be eligible if its income is below $1,615 per month; a family of three with income less than $2,029; a family of four ($2,444); a family of five ($2,858); and a family of six ($3,273) also may be eligible. This insurance program is administered through the Illinois Department of Health, which is funded by both federal and state funds.

FamilyCare Share

• Much like FamilyCare assist, FamilyCare Share is designed for low-income families, however this program is designed for families that carry health insurance through their employer or may purchase it privately. FamilyCare Share will assist in copays and out-of-pocket expenses that may be incurred for services not covered by a primary medical plan. Eligibility is based on the the income level and size of the household. Eligibility is based on both minimum and maximum income for a family size as determined by the Illinois Department of Health. A family of two with income between $1,616 and $1,821 per month may be eligible; a family of three (between $2,030 and $2,289); four (between $2,445 and $2,756); five (between $2,859 and $3,224); and six (between $3,274 and $3,691) also may be eligible. There is no monthly premium associated with this coverage.

FamilyCare Premium Level 1

• FamilyCare Premium level will have to pay a monthly premium based on the number of people in the household. This program is designed to assist households with higher income, with medical-related costs such as copays and out-of-pocket expenses. A household of two would be charged $25 per month; household of three, $30; household of four, $35; and a household of five, $40. Eligibility is based on the income level and size of the household. A family of two with income between $1,822 and $2,246 per month may be eligible. A family of three (between $2,290 and $2,823), four (between $2,757 and $3,399), five (between $3,225 and $3,976), and six (between $3,692 and $4,553) also may be eligible. .

Copays

• Payment for services is similar for all three plans stated above. Copays for a medical doctor visit are $2 per visit. Preferred prescriptions, those that do not need a prior authorization are free for generics and $3 for name-brand medication. There is no fee or copay for visiting the emergency room. Hospital stays cost $3 per day that a covered recipient is admitted. American Indians and Native Alaskans are exempt from premiums or copays.