Ill. Admin. Code tit. 89 § 118.715

Current through Register Vol. 49, No. 2, January 10, 2025

Section 118.715 - Eligibility Exclusions and Terminations

a) An individual shall not be determined eligible for Health Benefits for Immigrant Seniors if the individual is an inmate of a public institution.

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;

8) Fails to complete the redetermination of eligibility within the required timeframes or provide proof of on-going eligibility; or

9) Becomes an inmate of a public institution.

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.

Ill. Admin. Code tit. 89, § 118.715

Added at 44 Ill. Reg. 19684, effective 12/11/2020