Illinois Administrative Code
Title 89 - SOCIAL SERVICES
Part 118 - SPECIAL ELIGIBILITY GROUPS
Subpart I - HEALTH BENEFITS FOR IMMIGRANT ADULTS
Section 118.815 - Eligibility Exclusions and Terminations
Universal Citation: 89 IL Admin Code ยง 118.815
Current through Register Vol. 48, No. 38, September 20, 2024
a) Coverage of medical services under this Subpart for inmates of public institutions shall be consistent with 89 Ill. Adm. Code 120.318 and other applicable law.
b) An individual's coverage under the Program shall be terminated if the individual:
1) No longer qualifies as an Illinois
resident;
2) Becomes eligible for
medical assistance under the Public Aid Code that receives federal financial
participation;
3) Fails to report
to the Department changes that affect eligibility for the Program;
4) Asks the Department to terminate the
coverage;
5) Is no longer eligible
based on any other applicable State or federal law or regulation;
6) Failed to provide eligibility information
that was truthful and accurate to the best of the individual's knowledge and
belief and that affected the individual's eligibility;
7) Was incorrectly determined eligible;
or
8) Fails to complete the
redetermination of eligibility within the required timeframes or provide proof
of on-going eligibility.
c) Following termination of an individual's coverage under the Program, the following action is required before the individual can be re-enrolled:
1) A new
application is completed and submitted, or an existing application or case is
reopened, and the individual is determined otherwise eligible; and
2) The individual cooperates with the
Department to meet the prescribed timeframes regarding a determination of
eligibility found in
305 ILCS
5/11-5.1(a)(2) and 89 Ill. Adm. Code
120.308(h).
d) If the Department determines the individual's exclusion or termination was in error, the individual can be re-enrolled.
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