ENTITLEMENT PROGRAMS:

An Overview for Mental Health Consumers and Their Families

Compiled March 2004 by:

Tammy Pesenti

Assistant Executive Director

NAMI of Greater Chicago

1536 West Chicago Avenue, Chicago, IL 60622

Phone: 312.563.0445

Website: www.namigc.org

Pages

Social Security (SSI, SSDI, The Ticket to Work 3

and Self-Sufficiency Program)

Medicare 8

Medicaid for Adults 12

The Qualified Medicare Beneficiary Program (QMB) 16

Medicaid for Children/KidCare 17

Comprehensive Health Insurance Plan (CHIP) 23

Temporary Assistance for Needy Families (TANF) 28

Transitional Assistance, Family and Children Assistance, 30

and Earnfare

Aid to the Aged, Blind or Disabled (AABD) 34

General Assistance 36

Food Stamps 39

Access Numbers and Internet Resources 41

Social Security Disability Benefits (SSDI)

and Supplemental Security Income (SSI)

What Is It? Social Security is an insurance program that provides income to workers who become "disabled" (or who retire), and to their dependents and survivors. SSI is a needs-based program that provides a basic income for people with disabilities who meet specific low-income guidelines.

Where to Apply? The Social Security Administration local office in your area, or by calling toll-free 1-800-772-1213.

Who May Be Eligible? Social Security: workers who become "disabled" (or who are at least 62 years old), and their spouses, and dependents of workers who are "disabled" (or retired or deceased). SSI: People of any age who are needy and are blind or "disabled" (or who are at least 65 years old).

The Differences Between SSDI and SSI

The Social Security Administration
The Social Security Administration (SSA) is a federal government agency that administers benefits for people with disabilities. Although SSA also runs programs for people of retirement age, the focus of this section is on people with disabilities.

People with disabilities may be eligible under either the "Social Security Disability Insurance" (SSDI) program, or the "Supplemental Security Income" (SSI) program. When you apply for benefits, the Social Security Administration will inform you whether your benefits will come from SSI, SSDI or both.

Social Security Disability Insurance (SSDI) is an Insurance Program
Most workers pay into Social Security while they are working. To become eligible for SSDI disability benefits, you must have worked for a minimum length of time before claiming benefits. The amount of time depends on your age at the time you become "disabled." If you become "disabled" before reaching age 22, you may be able to receive SSDI benefits based on the earnings record of your parent, stepparent, or adoptive parent, if they receive Social Security disability or retirement benefits or if they are deceased.

The amount of SSDI benefits you receive is based on the amount of your contributions. If you became "disabled" before age 22 and are receiving benefits based on the earnings record of a parent, stepparent, or adoptive parent, your SSDI benefit will be one half of their benefit amount.

If you are found eligible for SSDI, you may be entitled to a retroactive benefit. In general, you are entitled to receive benefits going back to the first month following the end of a "waiting period."

The waiting period is the 5 month period starting with the first month in which you were both insured for disability and "disabled." However, the waiting period can start no earlier than the 17th month before the month you apply, no matter how long you were "disabled" before then.

Supplemental Security Income (SSI) is a Financial Aid, or "Needs Based" Program
You can receive SSI benefits even if you have never been employed and regardless of your age when you become "disabled." However, the amount of benefits you can receive under SSI usually is less than what you can receive if you qualify for SSDI.

If you are eligible for SSI, you also may be entitled to receive a retroactive benefit. In general, you are entitled to receive benefits going back to the first full month following the month in which you filed your application for SSI.

Income and Asset Limits for SSI
Income Limits. Because SSI is a needs-based program, your benefits may be reduced or you may not be eligible at all if you have other sources of income. Social Security considers many types of resources to be "income."

"Income" includes the following things, among others:

Money that you earn from employment;
Pensions, alimony, and interest;
Food, clothing, or shelter that is given to you on a regular basis;
An amount of money that Social Security assumes is given to you by your parent (if you are a minor child) or by your spouse if they live with you and have their own income.

In general, Social Security does not count the first $65 per month in earned income and the first $20 per month of unearned income. They also do not count certain types of income, such as the value of food stamps, energy assistance, Pell grants or other federally funded student assistance programs, and federally subsidized housing assistance.

Asset Limits. You may have no more than $2,000 in assets ($3,000 in the case of a married couple where both receive SSI). Social Security does not count some types of property in determining whether you meet the asset limit. These assets are considered "exempt." Exempt assets include:

The home in which you live;
Your household goods and personal effects (to the extent that their equity value is less than $2,000);
The value of your car or truck, if it is necessary for medical care, employment, or essential daily activities for you or any household member, or if the car is modified for a person with disabilities. If the car is not totally excluded for one of the above reasons, then one car may be excluded to the extent that its market value is under $4,500. Social Security counts the market value in excess of $4,500 toward the asset limit. They also count the equity value of any additional cars toward the asset limit.

Income and Asset Limits for SSDI
There are no asset limits under the SSDI program. There also are no limits under the SSDI program on the amount of unearned income you may receive. However, employment earnings can affect eligibility for SSDI.

Disability Requirements

Who is Considered "Disabled" for SSI or SSDI benefits?
To receive disability benefits under either program, you must meet the Social Security Administration's definition of "disability."

The term "disability" under Social Security law means that you are unable to work because of a physical or mental impairment which has lasted or is expected to last for at least 12 months, or is expected to result in death.

Proving Disability for Adults
In deciding whether you have a disability, SSA uses a five-step analysis:

Step One: If you are working and performing substantial gainful activity, then you are considered able to work and therefore not "disabled." If your average monthly earnings are over $800 per month, you are probably not eligible. If you are not earning significant income, proceed to step two.

Step Two: You must have a "severe impairment." This means that you must have a medical problem which significantly limits your physical or mental ability to perform basic work activities. If you have a severe impairment, proceed to step three.

Step Three: Social Security has determined that certain medical conditions are automatically disabling. Social Security describes these conditions in a part of their regulations called the "Listing of Impairments." To be considered "disabled" under the Listings, you need to have the required type of medical proof and the indicated level of severity for your particular illness.

If you have impairments that are similar but not identical to those included in the Listings, or if you have a combination of illnesses, SSA will consider you "disabled" if your condition is considered to be "comparable" to those included in the listings, and is of equal severity.

If your condition does not meet or equal one of the conditions in the Listings, proceed to step four.

Step Four: If you are physically and mentally able to return to a job that you have held within the last fifteen years, then SSA considers you "not disabled." If you cannot perform any of your past jobs, proceed to step five.

Step Five: If you cannot perform your past work, then Social Security decides whether you are able to perform other types of work.

At step five, SSA will consider your physical limitations, your age, education, the type of work skills you have acquired, and any mental limitations on work activities.

Proving Disability for Children's SSI Disability Benefits
As with adults, Social Security has a process for determining whether a child has a disability and whether that child is eligible for benefits. But, the evaluation process for children is different from the evaluation process for adults. In deciding whether your child has a disability, SSA uses a three-step analysis:

Step One: If your child is working and performing substantial gainful activity, then SSA considers the child to be "not disabled." SSA considers the child to be performing substantial gainful activity if the child is earning at least $800 per month. If your child is not earning at that level, proceed to step two.

Step Two: Your child must have a "severe impairment." This means that your child must have a medical problem which causes more than minimal problems with respect to the child's ability to perform basic physical or mental activities. If your child has a severe impairment, proceed to step three.

Step Three: As with adults, SSA has determined that certain medical conditions are automatically disabling for children. These conditions are set forth in a part of the Social Security regulations called the "Listing of Impairments for Children." The Listings indicate the type of medical proof needed and the level of severity required for a particular illness to be considered disabling. SSA considers your child to have a disability if the child has an impairment of the severity indicated in the Listing.

SSA can also find children to be "disabled" if their impairments are "medically equal" in severity to a listed impairment.

The term "medically equal" means that your child's medical findings are equal in severity and have lasted as long as those in the Listing of Impairments for Children.

If your child's condition does not meet or medically equal one of the conditions in the Listings, SSA can find the child to be eligible if the child's condition is "functionally equal to the listings."

The term "functionally equal" means that the child's impairment or combination of impairments causes "marked and severe" limitations in the child's level of functioning.

Applying for Disability Benefits
You should apply for benefits at your local Social Security Administration office. To locate that office and for other information, you can call Social Security toll free at 1-800-772-1213.

When you apply for disability benefits, you will be asked to explain why you have a disability. You also will be asked to name the doctors, hospitals and other medical providers who have treated you. SSA will contact them to obtain your medical records to confirm how serious your impairments are.

If you have not received medical care recently or your records do not contain the necessary information, SSA may pay to send you to a doctor for a "consultative examination."

Following this review of your medical records, SSA will then send you a notice telling you whether or not they find that you are "disabled." The notice will explain whether or not you will receive benefits, and if so, in what amount.

If you disagree with the decision made by Social Security, you can appeal.

“The Ticket to Work and Self-Sufficiency Program”

The SSA implemented “Ticket to Work and Self-Sufficiency Program” in 2001. The Ticket to Work Program provides Social Security disability beneficiaries and disabled or blind Supplemental Security Income beneficiaries with expanded access to employment services, vocational rehabilitation services, or other support services. This program will enable these beneficiaries to obtain, regain or maintain employment and to reduce their dependency on cash assistance. Under this program, SSA will pay the providers of those services, called employment networks (ENs), after the beneficiaries achieve certain levels of work and earnings.

Most Social Security and Supplemental Income (SSI) disability beneficiaries will receive a “ticket” they may use to obtain vocational rehabilitation, employment or other support services from an approved provider of their choice to help them go to work and achieve their employment goals. This program is voluntary.

Expanded Availability of Health Care Services

Starting October 1, 2000, the law expanded Medicaid and Medicare coverage to more people with disabilities who work.

States may provide Medicaid coverage to more people who are still working. States also may permit working individuals with income above 250 percent of the federal poverty level to purchase Medicaid coverage. This provision creates an experiment in which medical assistance will be provided to workers with impairments who are not yet too disabled to work. In addition, a Medicaid infrastructure Grant program is available to support State efforts to increase employment options for people with disabilities. To find out if these provisions are available in your state, call the State Medicaid office or check the State Chart of Work Incentives Activity at http://www.ssa.gov/work/Beneficiaries/activity.html. This law also expands Medicare coverage to people with disabilities who work. It extends Part A premium-free coverage for at least four and a half years beyond the current limit (39 months) for most Social Security disability beneficiaries who work. This is a minimum for eight and a half years for most Social Security disability beneficiaries who work.

Expedited Reinstatement of Benefits

Effective January 1, 2001, when a person’s Social Security or SSI disability benefits have ended because of earnings from work, he or she would be able to request reinstatement of benefits, including Medicare and Medicaid, if applicable, without filing a new application. Beneficiaries must be unable to work because of their medical condition. They must file the request for reinstatement with Social Security within 60 months from the month their benefits are terminated. In addition, they may receive temporary benefits- as well as Medicare or Medicaid- for up to six months while their case is being reviewed. If they are found not disabled, these benefits would not be considered an overpayment.

Deferral of Medical Disability Reviews

Effective January 1, 2001, an individual who is “using a ticket” will not be subject to regularly scheduled continuing disability medical reviews. However, benefits can still be terminated if earnings are above the limits. Effective January 1, 2002, Social Security disability beneficiaries who have been receiving benefits for at least 24 months will not be medically reviewed solely because of work activity. However, regularly scheduled medical reviews can still be performed and, again, benefits terminated if earnings are above the limits.

For More Information

If you have questions about the Ticket to Work program, you should call the Ticket Program Manager, MAXIMUS Inc., at 1-866-968-7842 (TTY 1-866-833-2967). For information about other work incentives, you should also visit www.socialsecurity.gov/work. You also may request a copy of the work incentives publication, Working While Disabled: How We Can Help, by calling 1-800-772-1213 (TTY 1-800-325-0778).

Overpayment of Benefits

It is fairly common for SSI and SSDI recipients to receive a notice that they have received benefits to which they were not entitled. This is called an "overpayment." Usually, SSA will require you to pay back any overpaid benefits, and they will reduce your current benefits until the money is paid back. Overpayments commonly occur when recipients acquire new sources of income and their benefits are not promptly reduced. Overpayments can also occur when SSA is not promptly informed of changes in living arrangements, marital status, or employment changes.

If you receive a notice of overpayment, you have the right to appeal. You should file an appeal if you believe that SSA is wrong in saying that you received an overpayment, or if you believe that the amount of the overpayment is less than they allege. You must file an appeal in writing within 65 days of the date of the notice of overpayment.

Even if you agree that you received an overpayment, you can ask that you not be required to pay the money back. This is called a "Request for Waiver of Recovery of Overpayment," commonly called a "waiver." You may request a waiver at any time, by completing a written form available at your local SSA office.

In order to qualify for a waiver, you must prove that you were not responsible for causing the overpayment. In other words, you must show that you did your best to properly report all necessary information to SSA, and that you did not accept benefits that you knew you were not entitled to receive. In addition, you must also show that it would be unfair to make you pay back the money, either because you cannot afford to do so, or because you have taken certain actions thinking that you were entitled to the overpaid benefits.

You should clearly explain your side of the story when you file a request for a waiver. Staff at the SSA office can help you complete the form. You are entitled to file an appeal if your request for a waiver is denied.

Where to Go for More Information

Other Information
To apply for benefits or to file an appeal, contact your local Social Security office, or call (800) 772-1213(v) or (800) 335-0778 (TTY) for information and assistance.

The Social Security Administration website can be found at http://www.ssa.gov

Medicare

What It Is: Medicare is a national health insurance program created by the Social Security Act for people with disabilities and the elderly.

Where To Apply: The Social Security Administration.

Who May Be Eligible: People who are age 65 or older, people of any age who Social Security says are "disabled," and people with kidney failure.

The Medicare Program in General

Medicare is a federal health insurance program for people with disabilities and the elderly. The Medicare program pays a portion of hospital and other medical bills. There are three parts to Medicare.

Medicare Part A (hospital insurance):

This covers inpatient hospital care, skilled nursing home care, hospice care, and some home health care.

Medicare Part B (medical insurance):

This covers doctors, outpatient hospital services, and various other medical services not covered under Part A.

Medicare Part C:

Also known as Medicare + Choice, it adds a variety of health care choices, such as Health Maintenance Organizations (HMOs), preferred provider organizations, medical savings accounts, and private fee-for-service. These are not available everywhere.

Medicare is not a comprehensive insurance program. There are many medical costs, which are not covered by Medicare.

Who is Eligible for Medicare?

You are eligible if you are in any of the following categories of individuals:

· You are age 65 or older, and you are eligible to receive Social Security Retirement, Survivor's benefits, or Railroad Retirement Board Benefits.

· You are under age 65 and you are entitled to receive Social Security Disability benefits or Railroad Retirement Board disability benefits, and have been entitled to those disability benefits for at least 24 consecutive months.

· You are under age 65, you have kidney disease requiring dialysis or kidney transplant, and you are insured for Social Security benefits, or you are the spouse or dependent child of someone who is insured for Social Security benefits.

What does Medicare Cost?

If you have contributed to the Social Security or Railroad Retirement plans long enough, Part A (hospital insurance) costs you nothing. If you have not contributed long enough to get Part A for free, you may still participate in Medicare Part A by paying a large monthly premium.

To receive Part B (medical insurance), you must pay a monthly premium which is deducted from your monthly Social Security check. Even if you have not worked long enough to get Part A for free, you may receive Part B benefits by paying the monthly premium.

How to Apply for Medicare

Automatic Enrollment

If you are already receiving Social Security Retirement or Railroad Retirement benefits before reaching age 65, you do not need to apply for Medicare. You will be automatically enrolled in both Part A and Part B upon reaching age 65.

If SSA determines that you are disabled, you will automatically be enrolled in both Part A and part B beginning with the 25th month that you are eligible for Social Security disability insurance (SSDI) benefits.

NOTE
If you do not want Part B benefits, you must notify Social Security in writing to prevent the premiums from being deducted from your benefits.

Services Covered By Medicare

Services Covered Under Part A

You do not need to file a claim for coverage of a Medicare Part A covered service. Instead, the provider submits the claim. You will then receive a Benefits Notice explaining how much was paid and the amount you are responsible for paying.

Services covered under Part A include:

Pre-Approval of Certain Medical Care
IDPA requires pre-approval of many types of non-routine medical care. Pre-approval also is required for many types of medical equipment and assistive technology devices, and many prescription drugs.

The doctor or other healthcare provider who is recommending the proposed treatment or device must submit information about why the treatment or device is medically necessary in order to receive payment.

The "Spend Down" Process

If your income or assets are above the limits, you will have what is called a "spend-down." A spend-down is similar to a deductible under an insurance policy. If you have a spend-down, you will be eligible for Medicaid coverage and you will receive a medical card only after you meet the spend-down amount. The amount of the spend-down will vary, depending on how much your income or assets exceed the limits.

You meet the spend-down amount by incurring (not necessarily paying) medical bills in the amount of your spend-down. This means that as soon as you have medical bills in the amount of the spend-down, you have met your spend-down, even though you may not yet be able to pay all of those bills.

It is very important, therefore, that you keep copies of all medical bills, prescription receipts, and records of other medical expenses. When you accumulate enough bills to meet your spend-down, submit copies of the bills to your caseworker in the local Public Aid office. The program will then process the bills so that you can receive a medical card.

Types of Expenses That Can Be Used to Meet the Spend-Down
You can use a number of expenses to meet your spend-down. They include the following:

· Physician and hospital services;

· Medications;

· Cost of travel to obtain medical care (when Medicaid is not directly paying for travel);

· Medicare and other medical insurance premiums, deductibles or other insurance co-payments;

· Some dental expenses, many in-home care services, and over-the-counter medicines when prescribed by a physician.

To meet your spend-down, you can use a bill for medical services or medications purchased within the past six months. In some cases, you can use a bill which is older than six months if the bill is re-issued and you are still obligated to pay it (provided that you were eligible for Medicaid at the time the bill was incurred). However, you may not use the bill more than once to meet your spend-down.

If you have not met your spend-down for three consecutive months, IDPA will send you a notice stating that your case has been canceled. However, you may reapply for Medicaid when you have sufficient bills to meet the spend-down.

How to Apply for Medicaid
You may file an application at your county Illinois Department of Human Services office. Medicaid coverage of incurred medical bills can be granted retroactively, up to 3 full months before the date that you apply, as long as you met the eligibility criteria during that period. This is called "backdating" of eligibility. You should specifically request back-dating if you have any unpaid medical bills from the 3 month period before your application.

What to Do If You Are Denied Medicaid or Medicaid Coverage

Common Problems
A person who already receives Social Security or SSI benefits based on their disability automatically meet the disability criteria for Medicaid eligibility. All other applicants who seek Medicaid coverage on the basis of disability are required to prove that they are "disabled."

The State denies many applications on the basis that the applicant is found to be "not disabled." It is very important that you provide your caseworker with all available medical evidence to document the presence of a disabling condition. If you do not have any current medical evidence and cannot afford to pay to see a doctor, IDPA must pay for a medical examination. Often, it is necessary to file an appeal and obtain legal representation to establish that you are "disabled" and eligible for Medicaid.

Even if you are found eligible for Medicaid participation, Medicaid may deny coverage of a medical service or medical equipment. Common reasons for denial include:

· Failure to obtain pre-approval;

· The treatment or equipment is not medically necessary;

· There are more cost effective alternatives;

· The medical service or item is not a Medicaid covered service.

Appeal Procedures
If your application for Medicaid is denied, or if Public Aid refuses to cover a medical service or item, you are entitled to file an appeal. You must file the appeal within 60 days of the date of the denial notice. The appeal can be filed at your local IDHS office, or by calling 1-800-435-0774 (TTY: 312-793-2697 or 800-526-0857).

Where to Go for More Information

Phone Numbers
For information about your eligibility status if you are a Medicaid participant, or for help in finding medical providers participating in Medicaid, call the Client Health Benefits Hotline at (800) 226-0768, TTY: (877) 204-1012.

For information about the location of your nearest IDHS office or for other information, call the IDHS-Bureau of Customer Inquiry and Assistance at (800) 252-8635(v); (800) 447-6404(TTY).

Medicaid Coverage of Medicare Premiums and Deductibles:
The Qualified Medicare Beneficiary (QMB) Program

What It Is: Under the Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLIMB) and Qualified Individual-1 programs, Medicaid can help with Medicare premiums, co-payments and deductibles.

Where to Apply: The Illinois Department of Human Services

Who May Be Eligible: Low-income Medicare participants who are residents of Illinois.

Help in Paying Medicare Premiums, Co-payments and Deductibles
Participants in the Medicare program must pay monthly premiums, co-insurance and deductibles. These out-of-pocket costs can be considerable. Under the QMB program, Medicaid will cover all Medicare premiums, deductibles and co-insurance amounts. Under the SLIMB and Qualified Individuals-1 programs, Medicaid will cover only your Medicare Part B premium.

If you are eligible for the QMB program, you will receive a "Mediplan card" from the Illinois Department of Public Aid (IDPA). You can present this card to your doctor or other medical provider so that they may bill IDPA. In order to obtain QMB coverage of a bill, you must receive treatment or services from a medical provider who accepts Medicare assignment and also participates in the Medicaid program.

Who is Eligible?

Qualified Medicare Beneficiary (QMB) Program
Under the QMB program, all Medicare premiums, deductibles and co-insurance amounts are covered.

To be eligible for this program, you must:

· Be enrolled in Medicare Part A;

· Have monthly income of below 100% of the federal poverty level; and

· Have assets of $4000 or less for one person, or $6000 or less for a couple.

Specified Low Income Medicare Beneficiary (SLIMB) and Qualified Individuals-1 (QI-1) Programs
Under the SLIMB and QI-1 programs, only your Medicare Part B premium is covered.

To be eligible for SLIMB, you must:

· Be enrolled in Medicare Part A;

· Have monthly income of between 100% and 120% of the federal poverty level;

· Have assets of $4000 or less for one person, or $6000 or less for a couple.

The requirements for the QI-1 program are the same except that your monthly income must be at or below 135% of the federal poverty level, and you cannot be eligible for Medicaid (a person who is eligible for Medicaid only after meeting a spenddown is not considered eligible for Medicaid).

Other Eligibility Rules
Citizenship. You must be an Illinois resident, and you must be a U.S. citizen or be within one of the permitted classes of non-citizens, as set forth in the section on Medicaid for Adults.

Income and Assets. The QMB and SLIMB programs each have their own income limits (see above). The program does not count the first $25 of income (other than SSI income) for each person who is a household member.

Each program also has certain asset limits. Certain assets are exempt (not counted), similar to the assets which are exempt under the regular Medicaid rules, such as your home, furniture, and one car.

How to Apply
You file an application with your local Illinois Department of Human Services (IDHS) office.

Under the QMB program, your QMB benefits will begin the first day of the month following the approval of your application. Under the SLIMB program, if you specifically request, your benefits can be effective up to three months before the month of application.

Under both programs, the State department will redetermine your continuing eligibility once every 12 months.

KidCare and Medicaid for Children

What It Is: A program that pays for medical care for low and moderate income children.

Where to Apply: The Illinois Department of Human Services (www.dhs.state.il.us/ ), County Public Health Departments, and other places.

Who May Be Eligible: Children who are residents of Illinois with a household income of up to 185% of the federal poverty level.

KidCare and Medicaid
The group of Illinois programs which provide health benefits to low and moderate income children is called "KidCare." These plans are administered by the Illinois Department of Public Aid (IDPA).

Who is Eligible?

Income

KidCare Assist: Any Illinois resident child under age 19, whose family income is below 133% of the federal poverty level will be eligible for KidCare Assist.

KidCare Share, Premium and Rebate: These plans cover children under age 19 who are Illinois residents with a family income between 133% and 185% of the federal poverty level.

KidCare Moms and Babies: This plan covers pregnant women and infants up to age one if the household has an income level up to 200% of the federal poverty level.

Children in a family which receives cash assistance under the Temporary Assistance for Needy Families (TANF) welfare program are always eligible for Kidcare. Also, any child with a disability who receives Supplementary Security Income (SSI) benefits may be eligible for Kidcare.

Medicaid Spend-Down
If your household income is over 185% of the federal poverty level, your child will be eligible for KidCare Assist but there will be a spend-down. A "spend-down" is similar to a deductible under an insurance policy. If you have a spend-down, your child will be eligible for coverage and you will receive a medical card, but only after you meet the "spend-down amount."

You meet the spend-down amount by incurring (not necessarily paying) medical bills for your child's care in a specified amount. As soon as you have medical bills in the amount of the "spend-down," you are eligible for KidCare coverage. This is true even though you may not be able to pay all of those bills, as yet. It is very important, therefore, that you keep copies of all medical bills, prescription receipts, and records of other medical expenses for the child. When you accumulate enough bills to meet your spend-down, submit copies of the bills to your caseworker in the local IDHS office. The program will then process the bills so that you can receive a medical card.

Assets
There are no asset limitations for children participating in KidCare.

Citizenship
To be eligible, your child must be a U.S. citizen, or be within one of several categories of non-citizens.

A child who is ineligible for KidCare Assist due to citizenship but who meets the financial eligibility criteria is eligible for medical assistance that is required for the treatment of an emergency medical condition.

How to Apply
Applications may be filed at your county Illinois Department of Human Services Public Aid office. Many county Health Departments and Women, Infants and Children (WIC) sites also are able to provide applications and assist in filing an application.

You can call (800) 226-0768 (TTY: (877) 204-1012) to receive an application that you complete at home and mail to KidCare. This number can also provide you with the name of an agency in your area that can help you apply for KidCare. To download an application from the Internet, go to www.kidcareillinois.com/html/kidcare.

Coverage Before the Date You Apply

KidCare Assist and KidCare Moms and Babies: Coverage for incurred medical bills can be granted retroactively up to 3 full months before the date that you apply, if you met the income eligibility criteria during that period. This is called "backdating" of eligibility. You should specifically request backdating if you have any unpaid medical bills from the 3 month period before your application.

KidCare Share and Premium: Under these plans, coverage can be granted retroactively up to 2 weeks before the date that you submit your application. This is true only if you met the eligibility criteria during that period.

In order to obtain prior coverage, you must make a specific request for each child for whom you want retroactive coverage. You must make your request for retroactive coverage no later than 6 months from the date that your child was first covered under the KidCare program. When your application is approved, you will receive a notice explaining when coverage begins and how to request prior coverage.

What Services Are Covered?

This section describes the services that are covered under the KidCare Assist, KidCare Share, KidCare Premium, and KidCare Moms and Babies plans. Under the KidCare Rebate plan, the child is enrolled in a private or employer sponsored health care plan available to their parent, and the terms of coverage are dictated by that plan.

Healthy Kids Program
One aspect of the KidCare plans is the Healthy Kids Program. This program provides Medicaid coverage for preventive medical care. Under the Healthy Kids program, Medicaid will cover:

· Periodic health, hearing, vision and dental screening services;

· Immunizations;

· Diagnostic laboratory tests; and

· Assistance in locating a doctor, dentist, optometrist or other medical provider, assistance in obtaining an appointment and in arranging transportation for medical needs.

Medically Necessary Care
KidCare for children must cover all "medically necessary" care needed to treat, heal, compensate for or correct a medical condition. This includes the following:

Health Insurance Premium Payment (HIPP) Program
This program is available to both children and adults who are eligible for either the KidCare Assist or KidCare Moms and Babies plans or Medicaid for adults. This program is intended to reduce Medicaid costs by using private health insurance which is available to a participant. It is for persons who meet the following conditions:

· The person has a medical condition which is expected to be very expensive to treat; and

· There is a group or individual health plan available to the person which would cover the costs of treating the medical condition; and

· IDPA determines that the cost of paying for person's treatment is more than 2 times the amount of the premiums to enroll the child in the health insurance plan.

In these cases, if you are otherwise eligible, IDPA will allow you to enroll or re-enroll in the group or individual plan. IDPA will then pay the premiums, co-payments, and deductibles required by the plan.

When the health plan covers other family members besides the person with the high-cost medical condition, only the share of the premium needed to cover the person with the high-cost condition will be paid by HIPP, unless the terms of the policy require coverage of other household members. In this case, premium payments for a non-eligible family member may be made if necessary to enroll the HIPP participant, but deductibles and co-insurance will not be paid for the non-eligible family members.

If the person enrolled requires medical care or equipment which is not covered by the private insurance plan, the care or equipment will be covered by KidCare or Medicaid, provided that the service is otherwise covered by KidCare or Medicaid.

If IDPA does not permit you to participate in the HIPP program or terminates your participation, you will have the right to appeal this determination.

Pre-Approval of Coverage
As indicated above, pre-approval is required for many forms of treatment and for most medical equipment. In order to obtain pre-approval, the doctor or other medical provider must submit a written request which documents the medical necessity of the requested service or item.

In most cases, IDPA must make a decision within 21 days of receiving the request, although a shorter or longer time frame may apply to some items. If IDPA fails to act on a request for prior approval within the permitted time, they must approve the requested service or item.

If it is not possible to obtain prior approval due to an emergency, you may submit a request for approval up to 90 days after the service or item is provided.

Special Rules Concerning the KidCare Share, Kid Care Premium, and KidCare Rebate

Programs/Groups Excluded from KidCare
Children who are inmates of a correctional facility, and children who are patients in a state operated mental health facility on the date they apply are not eligible to participate in the KidCare Share, Premium and Rebate programs. Children who are eligible to be enrolled in an Illinois state employee health insurance program are not eligible for KidCare Share, KidCare Premium, or KidCare Rebate.

Children who were covered under any other health insurance plan within 3 months before the date of application for KidCare are ineligible for KidCare Share or KidCare Premium. There is an exception where the loss of that health insurance was involuntary (such as due to loss of a job or loss of income needed to pay the premium).

Note: This exclusion of children who were enrolled in another health plan does not apply to children applying to participate in the KidCare Assist and KidCare Rebate plans, discussed below.

The KidCare Plans
There are several different health insurance plans under the KidCare program. A child will be eligible for the KidCare Assist plan if their household income is at or below 133% of the federal poverty level. Under KidCare Assist, there are no premiums or co-payments required. The plans for families with higher incomes require some payments by the family. The plan you will have depends on your income level and whether you have an employer-provided insurance program available to you.

Plan 1: "KidCare Share." This Plan covers children with family income between 133% and 150% of the federal poverty level. Under this program, there are no premiums to pay. There is a $2 co-pay for prescription drugs, doctor office visits (except check-up/immunization visits), and for non-emergency use of emergency room services. The maximum family cost for co-payments is capped at $100 per year.

Plan 2: "KidCare Premium." This Plan covers children with family income levels between 150% and 185% of the federal poverty level. Under this program, there is a monthly premium charged to the family. The premium is $15 for one child, $25 for two children, and $30 for three or more children.

Premiums are due on the first day of each month, although a grace period through the end of the month is allowed. KidCare participation will be terminated if the premium is not paid by the end of the grace period.

In addition, there are co-payments. There is a $5 co-pay for prescription drugs ($3 for generic drugs), $5 for doctor office visits (except check-up/immunization visits), and $25 for non-emergency use of emergency room services. The maximum family cost for co-payments is capped at $100 per year.

Under both the KidCare Share and Premium Plans, you must keep your receipts to document the amount of co-payments you have paid. Upon reaching the $100 annual co-payment cap, you submit your receipts to IDPA. After that, your monthly KidCare card will state that your co-payment cap has been satisfied.

Plan 3: "KidCare Rebate." This Plan covers families with household income above 133% and at or below 185% of the federal poverty level. This plan is available to families who have a private or employer sponsored medical insurance plan available which requires the family to pay a premium to enroll the child. Under this plan, the KidCare program will make a monthly payment directly to you to reimburse you for the premium payment you make.

The amount of the monthly rebate paid to you will be based on the monthly premium that you must pay to enroll your child in the employer health plan. However, the rebate amount is capped at a certain amount. The maximum monthly rebate is $75 per child. This amount may be revised annually.

You will be required to pay any deductibles, co-payments or other costs not covered under the terms of the private or employer sponsored health insurance plan.

In order for you to be eligible to participate in the KidCare Rebate program, the medical insurance plan must provide comprehensive major medical coverage including coverage of physician and inpatient hospital services.

Changing KidCare Plans
If there is a reduction in your income so that you should qualify for a different KidCare plan with lower co-pays or with no premium, you should immediately notify IDPA. You do not need to report an increase in your household income before the time of your child's annual renewal.

If you participate in the KidCare Rebate program and you lose your coverage under the private or employer sponsored health insurance plan, you must immediately notify IDPA. Your child will then be enrolled in the proper KidCare plan. You must repay any KidCare Rebate payments that you received for a period that your child was not covered by the private or employer sponsored medical insurance plan.

Termination of KidCare Benefits
Your child's coverage under any of the KidCare plans may be terminated upon any of the following events:

· Your child ceases to be an Illinois resident or becomes age 19.

· Your child becomes an inmate at a correctional institution.

· You fail to pay your monthly premiums by the end of the coverage month under the KidCare Premium program.

· You fail to notify IDPA of non-financial changes that affect your child's eligibility (such as a change in state of residence, or your child begins living with a different family).

· Your child becomes covered by another comprehensive health insurance plan.

· IDPA determines that you knowingly supplied false information on your application.

If your KidCare participation is terminated, you can become covered again. To do so, you will be required to file a new application and pay any premiums that you owed under your prior period of coverage. If you received any rebate payments to which you were not entitled under the KidCare Rebate program, these must be repaid before you can reapply.

What to Do If You Are Denied KidCare or Denied Coverage of Needed Medical Care

Common Problems
Despite the broad range of medical services that are required to be covered, you may encounter problems in obtaining coverage. This is especially true for children with serious disabilities who require extensive or unusual forms of treatment.

Some common problem areas:

1. Treatment is not "medically necessary." IDPA may deny coverage on the basis that the treatment is not necessary. You should know that decisions about appropriate care must be made on a case-by-case basis. Your treating physician's opinion is entitled to great weight.

2. Service limits. Rules may place limits on how often a particular service can be obtained.

3. Cost Limits. State rules provide that the most cost-effective manner of treatment must be used. IDPA may deny a proposed form of treatment if there is a less expensive alternative that meets the child's medical needs.

4. Out-of-state Services. KidCare usually covers medical treatment provided only in Illinois. However, if a medically necessary treatment is available only at an out of state institution, IDPA must provide coverage.

5. Services not on the list of covered services. IDPA may deny coverage if a particular medical service or item is not included on certain lists of covered services. KidCare must cover all medically necessary services for eligible children, regardless of whether the needed service is on the list of covered services.

What to Do If You Are Being Billed for KidCare Covered Services
Occasionally you may receive a bill from a doctor or other medical provider for services that you believe should have been covered by KidCare. IDPA has established a procedure for investigating and resolving disputed bills.

Appeal Procedures

Right to an Appeal

You are entitled to file an appeal if any of the following things occur:

· Your initial application is denied.

· You are denied continued participation at the time of your annual redetermination.

· Your participation is terminated due to alleged non-payment of the premium or for any other reason.

· You believe that you are being charged the incorrect amount for premiums or co-payments.

· KidCare denies coverage of a medical service or item due to failure to obtain pre-approval.

· KidCare denies coverage of a medical service or item which you believe to be medically necessary.

When you file an appeal, it should be in writing. It also is permissible to make the appeal by calling the toll-free number established by IDPA for making appeals. You must file the appeal within 60 days of the date of the notice of the action which you are appealing. You can appeal by filing at your local IDHS office, or by calling 1-800-435-0774 (TTY: 312-793-2697 or 800-526-0857).

Where to Go for More Information

Phone Numbers
For information about KidCare, call the KidCare Hotline at (800) 226-0768; TTY: (877) 204-1012.

State of Illinois Comprehensive Health Insurance Plan

What Is It? The Illinois Comprehensive Health Insurance Plan (CHIP) is a state program for Illinois residents who are unable to obtain private health insurance coverage. CHIP is not a welfare or entitlement program. You must pay premiums to participate in the plan.

Applicants for CHIP can be denied or put on a waiting list if the State fails to appropriate enough money to allow all eligible applicants to participate.

What Is Its Purpose? To provide health insurance coverage to Illinois residents who otherwise would not have it due to a pre-existing condition or because premiums are too expensive or because they are otherwise uninsurable.

Who Can Benefit? Illinois residents who are unable to obtain private health insurance.

Who is Eligible? In order to be eligible, you must be an Illinois resident, and you must be a U.S. citizen or an alien lawfully permitted for permanent residence.

You also must meet one of the following criteria:

•You have applied for and been denied individual health insurance due to a "pre-existing condition;"
•You have a health insurance policy, or have been offered a policy which offers coverage similar to CHIP, but the premium is more expensive than the CHIP premium;
•You have one of the 31 "presumptive eligibility conditions;" or
•You are a "federally eligible individual." These terms are explained below.

Presumptive Eligibility Conditions
You can qualify for CHIP if you have a presumptive eligibility condition. A person having certain medical conditions is presumed to be uninsurable. Such a person can apply for CHIP without first receiving a rejection letter for health reasons from an insurance company.

In such cases, applicants for CHIP may instead submit a letter from their attending physician identifying the medical conditions for which they are being treated.

Federally Eligible Individuals
A federal law, called the Health Insurance Portability and Accountability Act (HIPAA), requires each state to create a plan permitting people to obtain health insurance coverage without any exclusions for a "pre-existing condition." Such people must previously have been covered under another insurance plan.

Illinois has chosen to allow these people, called federally eligible individuals, to participate in the CHIP program. To be considered a federally eligible individual, you must satisfy all of the following criteria:

•You must have accrued a total of 18 or more months of prior "creditable coverage" (see explanation below). Also, you must have no more than a 62 day break between periods of creditable coverage;
•Your most recent creditable coverage must have been provided under a group health plan, governmental plan or church plan;
•You must not be eligible for group health coverage, Medicare or Medicaid, and must not have any other health insurance coverage;
•Your most recent coverage must not have been terminated due to nonpayment of premium or fraud; and, if offered continuation of coverage under federal COBRA requirements or state continuation laws, you must have elected and exhausted such continuation coverage.

Creditable Coverage
As indicated above, one of the criteria for being a federally eligible individual is that you have accrued 18 or more months of prior creditable coverage. What this means is that you must have been previously covered under some type of health insurance plan. Coverage under any of the following types of plans will count:

· A group health plan;

· Part A or B of Medicare;

· Medicaid;

· CHAMPUS;

· A medical care program of the Indian Health Service or tribal organizations;

· A state health benefits risk pool, such as CHIP;

· The federal employees health benefits program;

· A public health plan; (a plan established or maintained by a State, county, or other political subdivision of a State that provides health insurance coverage to individuals)

· A health benefit plan under the Peace Corps Act; or

· A church plan.

Who is Not Eligible for CHIP?
You are not eligible to participate in CHIP if any of the following are true:

•You are eligible for Medicaid;
•You were previously covered under a CHIP plan and you voluntarily terminated your CHIP coverage less than 12 months ago;
•You are a resident of a public institution;
•You have received a personal injury settlement or judgment, and you currently have over $100,000 in funds from the settlement or judgment;
•You fail to pay your CHIP premium;
•You are eligible or become eligible for coverage under a health insurance plan that provides coverage that is as good as or better than the CHIP plan for the same or lesser cost.

Types of Insurance Plans Available Under CHIP

Five kinds of plans are available to eligible persons under CHIP. They are:

Plan 1. This is the standard plan. It is like a traditional comprehensive major medical indemnity plan for persons who are not eligible for Medicare.

Plan 2. This is for persons who are eligible for Medicare and have primary coverage under both Medicare Parts A and B.

Plan 3. This is an optional Hospital Preferred Provider Organization (Hospital PPO) plan which is designed to be more affordable than the Standard CHIP Plan 1. This plan is available to anyone who is eligible for Plan 1. The premiums are lower but persons enrolled in Plan 3 must use a hospital that is in the CHIP network of PPO hospitals if they wish to receive maximum benefits.

Plan 4. This is the standard plan for federally eligible individuals and is the same as Plan 1 except there is no exclusion for preexisting conditions.

Plan 5. This is the optional hospital PPO plan for federally eligible individuals. It is the same as Plan 3 except there is no exclusion for preexisting conditions.

Four deductible options are available under each of these five plans: $500, $1,000, $1,500, or $2,500. A family annual deductible of 2 times the annual deductible is available if two or more members of the same family are covered under a single CHIP policy.

The maximum amount CHIP will pay in benefits for any covered person in his or her lifetime under any of the benefit plans offered by CHIP is $1,000,000 for all sicknesses and injuries combined.

Types of Medical Care Covered Under the CHIP Plans
To be covered, care must be medically necessary and be prescribed by a physician. The covered services include:

· Hospital care;

· Doctor bills;

· Prescription drugs;

· Up to 120 days per year of skilled nursing services in a facility;

· Up to 270 home health visits per year;

· Orthoses and protheses;

· Durable medical equipment, other than eyeglasses or hearing aids;

· X-rays and lab tests;

· Physical, speech and occupational therapy;

· Ambulance transportation.

CHIP plans do not cover the following:

· Private hospital room charges;

· Dental care;

· Glasses, contact lenses, or hearing aids;

· Routine examinations and tests;

· Charges for experimental treatment;

· Infertility treatments.

Cost of the CHIP Premiums
You must pay a premium to participate in the CHIP program. By law, the premium is set at 135% of the average cost that it would take to obtain comparable coverage from the 5 largest insurance companies doing business in Illinois.

The amount of your premium depends on whether you choose to participate in a CHIP PPO plan or in a traditional plan. Your premium amount also depends on such factors as your age, gender, and area of the state in which you reside. The amount of the premium also depends on how large of a deductible you select.

The average CHIP participant pays an annual premium of $3800.

Pre-existing Conditions
Charges for expenses incurred in connection with a "pre-existing" medical condition are not covered during the first 6 months of coverage under a CHIP plan.

There are two exceptions, where pre-existing conditions are immediately covered:

· You are a federally eligible individual, as defined above; or

· You are eligible for the "pre-existing condition Waiver Program."

To be eligible for the pre-existing condition Waiver Program, all of the following must be true:
•Your pre-existing condition was previously covered under a health plan, and
•Your coverage under that plan was involuntarily terminated, and
•You are not eligible for continuation coverage under the previous health plan, or some other law, and
•You apply for CHIP coverage within 30 days of the termination of the prior health plan.

If you are eligible for immediate coverage of a pre-existing condition under the Waiver Program, you also must pay a premium surcharge of an additional 10% during the first 60 months.

How Long Does CHIP Coverage Last?
Your CHIP coverage will end immediately if you stop living in Illinois, or upon your death, or on the date that you ask for your coverage to end. If you are asked to supply eligibility information and you fail to respond, your coverage may end 30 days after the request.

How to Apply for CHIP

You can apply for CHIP directly to the address shown below. Parents or legal guardians of the person may apply on behalf of dependents or other legally incompetent individuals. The parent or guardian will be required to supply a copy of the guardianship court order or power of attorney papers. Applications and information can be obtained from:

Office of the Board of Directors
Comprehensive Health Insurance Plan
400 West Monroe Street, Suite 202
Springfield, Illinois 62704-1823
1-217-782-6333 (voice)
1-217-782-6410 (TTY), or

Blue Cross Blue Shield of Illinois,
Toll Free Number: 1-800-367-6410(v)
1-800-545-2455 (TTY)

Applications by Federally Eligible Individuals for CHIP Coverage
If you are a federally eligible individual and you are about to exhaust your COBRA or state continuation rights under your previous health plan, you should contact the CHIP Board Office to obtain a CHIP application. You must complete and submit this application as far in advance as possible of the date of expiration of your continuation coverage under your previous health plan. Also, you must be careful not to exercise any rights to convert from a group to an individual policy, because doing so will make you ineligible for CHIP.

What to Do If Your CHIP Application or Claim is Denied

The Appeal Process

You are entitled to file an appeal, called a grievance, if your application to participate in the CHIP program is denied. If you are already a CHIP participant, you are entitled to file a grievance if a claim for coverage is fully or partially denied, or claim is not processed within a reasonable time.

Your grievance must be in writing. It should explain the reasons for your disagreement. The grievance should be filed with the Grievance Committee of the CHIP Board of Directors at the address given above. The CHIP Board of Directors will then issue a final written decision.

Where to Go for More Information

You may obtain further information about the CHIP program at the Illinois Department of Insurance web site at http://www.chip.state.il.us/chip.htm.

Temporary Assistance to Needy Families (TANF)

TANF provides temporary financial help for families. TANF can help you pay for food, housing, electricity and other utility expenses, and other non-medical expenses. TANF can also help you get the skills needed to get steady jobs. TANF offers classes and programs to help improve your education and work-related skills. The goal of TANF is to help you become financially independent.

Who can get benefits through TANF?

In general, a person can get benefits through TANF if he or she is a U.S. citizen and:

· Is a pregnant woman with 0 or more children.

· Is the husband of a pregnant woman and lives with his wife.

· Has a child under age 19 and lives with the child. If the child is 18, the child must be a full-time high school student in order to qualify for TANF.

· Lives in Illinois. Even if a person is homeless, he or she may qualify for TANF.

· Can show that there is a plan for making money and that the plan is being followed.

Some non-citizens are also eligible for TANF. A complete listing of these groups can be found at the DHS Community Operations office where applications are done, see below.

What can I get from TANF?

These are services that are offered from TANF:

· Cash assistance for basic needs like food, clothes, and housing.

· Transitional services to help you become financially independent. TANF has partnerships and programs to help you improve your education and work skills so that you are able to get jobs and serve your community. Services provided by TANF include classes to help you improve your education, classes and programs that help you improve your skills to get jobs (http://www.dhs.state.il.us/ts/et/fsetjp.asp) and classes to help you learn basic English language skills. Other TANF services are child care (http://www.dhs.state.il.us/ts/ccfs/ccd/), job placement (http://www.dhs.state.il.us/et/tanfjp.asp), and job training (http://www.dhs.state.il.us/ts/et/tanfwfp.asp).

· TANF also helps people with issues like drug and alcohol abuse, mental health, and domestic violence. Through TANF, you can find services to help you with these issues.

If I get TANF, can I still get medical help and food stamps?

Yes. Even if you get TANF, you can still get food stamps and medical assistance.

If you get TANF and also qualify for food stamps, DHS will also give you food stamp benefits. See section on Food Stamps. Through the TANF program, you can work off the cost of your food stamps and make extra money through a program called Earnfare. See section on Earnfare to learn more.

You can get medical help through Illinois' Department of Human Services (DHS). If you get TANF, you can also get a MediPlan Card through DHS that will cover most of your medical needs.

How does TANF work?

You will get cash and food stamps through the Illinois Link Program. Illinois Link allows you to use a plastic card, like a bank card, at grocery stores and ATM machines. You can use your Link card to take money out of your TANF cash account. You can also use the Link card to buy food by using the money from your food stamps benefit account to pay for food at the grocery store.

If you do not want your benefits to be kept in a Link account, you can have your TANF benefits deposited directly into your own bank account.

If you use child care through TANF, your child care provider will be paid directly by DHS. You do not have to use your TANF benefits to pay for child care.

If you show your MediPlan Card to your doctor, your doctor will bill the State of Illinois for your visit. You do not have to make any payment to your doctor.

How do I apply?

You can apply for TANF at the local DHS Community Operations office. In Chicago, the DHS Community Operations office you should visit to apply is at 70 E 21st St, Chicago, IL 60616-1782. The office's phone number is: (312) 793-7500. If you do not live in Chicago, go to http://www.dhs.state.il.us/OfficeLocator/ to find your local DHS Community Operations office.

What else should I know about TANF?

No family with an adult over age 18 can get TANF benefits for over two years without working or participating in one of the following activities. Approved work activities include:

· paid or unpaid work

· providing community services

· volunteering

· going to school

· getting drug or alcohol abuse treatment

· participating in mental health activities

· participation in domestic violence counseling

· participating in other activities that help move the family toward goals and financial independence

Families in which the adults are over 60 years old, there is only one parent who is caring for an infant child, or families in which only children get TANF benefits do not have to meet these work requirements.

Most adults may only receive benefits for a total of 60 months during their lifetime. There are some exceptions to this, but it is important to keep in mind that TANF is a service that is limited.

Transitional Assistance, Family and Children Assistance, and Earnfare

Who is eligible for Transitional Assistance (TA)?

To be eligible for TA, a person may not be eligible for TANF, AABD, SSI, Social Security, Unemployment Insurance, or any other kind of public benefit. In addition, they must be very poor and fit into one of seven categories of persons that IDHS calls "not employable." If they do not fit into one of these categories, they are deemed "employable," and they are not eligible for any form of cash or medical assistance. They are still eligible for food stamps though.

Who is considered "not employable" for purposes of TA?

There are seven "not employable" categories:

1. Disabled, as determined by the Department, with SSI application pending.
A person is eligible under this category if he has applied for SSI disability benefits and is found by IDHS to meet the SSI disability standards. This determination is based upon medical evidence. The client has to get his doctor, or some doctor, to fill out IDHS disability forms, which a caseworker will provide to the client. Alternatively, the client can submit "medical records." Hospital records or clinical records or a detailed letter from the treating doctor documenting the client's impairments (not just listing the diagnoses) are advisable. If the client cannot get the forms filled out because he cannot pay a doctor to do it, he should tell his caseworker. The caseworker will then set up an appointment for the client at a hospital for filling out the forms (IDHS has contracted with some hospitals to provide this service).

The client must also submit proof that his SSI application is pending with the Social Security Administration.

When clients receive TA in this SSI-related category, they get the $100 cash benefit, plus the following:

A. They are exempt from any mandate to participate in employment searches and other workfare-type activities.

B. They are entitled to Medicaid-type medical coverage, which is much more comprehensive than the medical coverage provided to other TA recipients.

C. They receive a referral to an advocate to help them with their SSI application at the first stage of the social security appeals process (called "reconsideration"). The advocates are at the SSI Advocacy Project, which is run on contract with IDHS by the Legal Assistance Foundation of Chicago.

D. They are eligible to have IDHS pay for a psychological examination and testing to help document their SSI application, but only if IDHS has not previously paid for a psychological examination for them.

When applying for TA, the recipient must sign an agreement to reimburse IDHS for the aid paid during the pendency of the SSI application, to the extent that SSI benefits are paid for any of those months. Social Security then sends the retroactive SSI check to IDHS, which reimburses itself for the aid and sends the balance to the recipient.

2. Age 55 or over and without gross earnings totaling $2,000 in the past year and also without earnings of at least $200 a month in seven of those months

3. Needed at home to provide full-time care for a medical reason for another person residing with the recipient

4. Homeless as a result of court-ordered building evacuation (not eviction), domestic violence, fire, or natural disaster within the previous six months.
Eligibility runs for six months from the date of application (not the date of the loss of residence). The person must be in a shelter or on the street. Temporarily staying with relatives or friends does not constitute homelessness for these purposes.

5. Under 20 and a full-time high school or vocational school student or training program participant.

6. Required to take medication to control diabetes, hypertension or seizure disorders.

7. Temporarily unable to work due to a medically documented illness or incapacity.

What procedures does IDHS use for TA determinations?

IDHS should not deny a TA application without going through all of the categories

What about medical coverage?

Anyone who receives a TA (other than in the SSI-related category) or State Family and Children Assistance (SFCA) cash grant also receives GA medical coverage (a medical card) automatically. The children in the SFCA unit are entitled to Medicaid coverage; the adults get GA medical coverage. GA medical coverage is substantially less comprehensive than Medicaid, principally because it does not include any hospital-based services. Persons not eligible for TA because they are "employable," including Earnfare participants, receive no medical coverage at all.

Who is eligible for State Family and Children Assistance (SFCA)?

Families containing children are eligible for SFCA if they are not eligible for TANF. Generally, this means that very few families will be eligible for SFCA, because most families are now eligible for TANF. Children who live with a legal guardian are not eligible for TANF, but they are eligible for SFCA (although the legal guardian cannot receive benefits for herself).

Who is eligible for Earnfare?

"Employable" adults who receive Food Stamps are eligible for Earnfare. Also, other individuals may be ordered into Earnfare by a court because they have not been paying child support due to lack of employment. Earnfare is not a typical welfare program. It is not an "entitlement," so nobody has any enforceable right to receive Earnfare. An eligible person who applies for Earnfare, or a court-ordered applicant, will be placed into an Earnfare slot if one is available.

How does a client get into the Earnfare program?

The client can apply at IDHS's local offices. IDHS also contracts with a number of community organizations to run Earnfare programs. IDHS has a list of these. Generally, the client can access these Earnfare programs directly at the site.

The client technically is volunteering for the Earnfare component of the Food Stamps Employment and Training program. IDHS will inform him/her about the program and then perform an assessment of the client's skills and experience. The client will then be given a choice of the Earnfare assignments for which he/she is qualified, or, if there are no available assignments, he/she will be put onto a waiting list.

What are the cash benefits for these programs?

A. TA pays $100.00 per month.

B. SFCA pays the same payments as the same-sized TANF families. Countable income (which is not determined the same way as under the TANF program) is subtracted to arrive at the actual payment.

C. Earnfare does not pay any set benefit amount. A person in the Earnfare program goes to work for an employer. He/she must first work enough hours at the minimum wage rate to "pay off" his/her food stamps. Then he/she may work additional hours at the minimum wage to earn cash, but there is a maximum of 80 total hours per month. Also, a person may be in the Earnfare program only six months out of any twelve month period. Earnfare will also provide transportation expenses during the six months of participation, as well as for two more months to facilitate a job search. There is also a clothing allowance of up to $100 per year, if the caseworker agrees that the client needs clothes for the work assignment.

What are the financial factors of eligibility for TA and SFCA?

This is how the client proves he/she is "needy" enough to be eligible for TA or SFCA, and how IDHS establishes the actual payment amount. There are two categories of financial factors: assets and income.

A. Assets: Assets are the cash or property the client owns. Money received in a given month is generally income, but any of it left over in the next month is considered an asset. Some assets are exempt or not counted. These include clothing, other ordinary personal possessions and household furnishings; real estate used as the principal place of residence; a car of any value.

If a person's non-exempt assets exceed $2000, the person is ineligible for TA. A family’s SFCA asset limit is $3000 for two people, plus $50 for each additional person.

B. Income: "Countable" income attributable to a given month is subtracted from the standard payment level to arrive at the actual payment level. Some types of income are exempt, or not countable: in-kind (non-monetary) contributions or gifts, such as food and shelter; payments made to third parties for the benefit of the recipient (e.g., payment of rent directly to a landlord); loans from persons not legally responsible for the recipient (a spouse or a parent of a child under 18 or under 21 if living in the parent's home is "responsible" for the recipient); some JTPA, VISTA and foster care payments; educational loans and grants paid directly to the school; and others (none of which are very common). In-kind payments and payments to third parties and loans can be key strategies to prevent or resolve homelessness, because they can add necessary buying power to the recipient without reducing the TA or SFCA benefit payment or endangering medical coverage. This is the best way to target contributions from, for example, family or friends.

When a client has earned income, there are deductions made from the gross prior to counting the earnings against the payment level:

-- Essential expenses of self-employment;

-- $90 standard deduction;

-- Up to $175.00 of out of pocket child care expenses for each child, $200.00 if the child is under 2 years old;

-- The first $50.00 per month earned by a child under 18 who is a full time student in elementary or high school ($150.00 maximum per family);

-- For TA cases, for three consecutive months each 12-month period, a further deduction of approximately $350

Countable earned and unearned income is added together and deducted from the standard payment level to arrive at the actual payment, if any.

C. Lump sums. When a recipient receives a non-recurring lump sum payment (e.g., personal injury settlement, lottery winnings, large cash gift), IDHS does a special calculation. The amount of the lump sum that exceeds the asset limit of $2000 is divided by $1000 to arrive at the number of months of ineligibility. NOTE: This lump sum rule only applies to "recipients." If you know when the lump sum will arrive, have the client resign from assistance before the fiscal month in which the lump sum will arrive. The client then may reapply for assistance whenever the lump sum has been spent down below the asset limit (equal to one month's standard TA or SFCA payment).

What are the financial eligibility rules for Earnfare?

A person is financially eligible if he/she is receiving Food Stamps. Food Stamps rules for income and assets apply. One feature of this system is that the Earnfare participant can have income from other sources, so long as his total income does not make him/her ineligible for Food Stamps.

What are some of Earnfare's nonfinancial eligibility factors?

The person must be a U.S. citizen or meet one of the exceptions to the noncitizen bar on eligibility. Call for advice on this question.
The person must reside in Illinois and intend to keep living here. A permanent address is not necessary. The person must furnish an address where mail can be sent, but this can be anywhere, such as a relative's or friend's residence, a shelter, or the IDHS office itself.
Strikers may receive TA or SFCA if the strike is legal and official union leadership has approved it. Strikers must cooperate with Project Chance.
TA and SFCA recipients must cooperate with Food Stamps Employment and Training (TA) unless they are exempt or have good cause for not cooperating. Failure to cooperate without good cause can result in a sanction. A sanction is a termination of benefits to the sanctioned individual for three months the first time and six months thereafter. Medical benefits and Food Stamps continue during a sanction.

What offices are used for TA and SFCA purposes?

TA and SFCA applications may be filed at the IDHS district office in the client's neighborhood. (Homeless people may file at any office, but it is strongly advised that they file at the district office closest to where they spend the most time. The application will be handled by caseworkers in the Intake Unit.

Another relevant office is the SSI Advocacy Office (a special project of the Legal Assistance Foundation of Chicago). Clients receive appointment letters for this office.

What are the special provisions for homeless people?

A. The TA program will provide an advance for payment of rent. If the TA applicant or recipient has no place to live, has found a place to live but needs the first month's rent, and the landlord will accept a voucher, then IDHS will issue a voucher. The maximum amount is $142.00, or the rent, or the person's TA grant whichever is least. This voucher is an advance on the next month's TA payment.

B. TA applicants and recipients need not have a residence to be eligible. They must have a mailing address, but this can be the local IDHS office, if necessary.

Aid to the Aged, Blind, and Disabled (AABD) State Supplemental Payments

What It Is: The Aid to the Aged, Blind and Disabled Grant Program is an Illinois program which provides a cash grant to certain low income people with disabilities and to people age 65 and over. Its purpose is to provide for the basic income needs of people with disabilities and senior citizens. This grant is also sometimes known as State Supplemental Payments (SSP). The Illinois Department of Human Services (IDHS) administers the program.

Where To Apply: The Illinois Department of Human Services (IDHS).

Who May Be Eligible: Low income Illinois residents with disabilities and senior citizens.

Cash Assistance for Low-Income People who are Elderly, Blind, or Disabled

Who is Eligible for AABD Cash Assistance?

In order to be eligible for AABD, you must be either:

· Age 65 or over;

· Receiving Supplemental Security Income (SSI), or

· "Disabled," according to criteria of the Social Security Administration, but ineligible for SSI on the basis of your other income.

To be eligible for AABD, you must be an Illinois resident. You also must be a U.S. citizen or be within one of several specified categories of non-citizens.

How to Apply

You must make a written application at your local IDHS office. They will ask you to provide verification of your income, assets and your expenses. IDHS is required to process your application within 45 days.

Your Eligibility for AABD and Your Grant Amount

Eligibility Based on Your Income

The Illinois Department of Human Services (IDHS) has a list of allowances which they compare to your income. If your countable income is greater than these allowances, you are not eligible for the program. If the total allowances are more than your income, you may be eligible for a grant. IDHS does not count certain types of income, such as Circuit Breaker grants, Energy Assistance grants, Earned Income Tax Credits and Food Stamp benefits.

If you work, IDHS does not count the first $50 per month of income. If you are blind, they will not count an even greater amount of your earnings. They should deduct from your income your work-related travel and other work expenses.

If your monthly income is less than $740, it is very possible that you are eligible for AABD, and you are encouraged to apply.

Eligibility Based on Your Assets

IDHS will also determine if your assets are below the allowable limits. You are not eligible if you own assets of $2,000 or more. The asset limit amount is increased to $3,000 if you are living with a spouse or other dependent person, and is further increased by $50 for each additional dependent. This is called the asset disregard.

IDHS will not count certain assets at all. These are called exempt assets, and include the following:

· The family home;

· Clothing, personal effects and household furnishings (up to $2,000 total equity value);

· One automobile;

· Life insurance policies with a total face value of $1,500 or less and all term life insurance policies;

· Burial spaces which are intended for the use of the adult, his or her spouse, and other immediate family, and

· Funds set aside for the burial expenses of the adult and his or her spouse (up to a limit of $1,500 each).

The Amount of Assistance You Will Receive

There are regulations establishing the minimum amounts, called allowances, which a person needs to meet the costs of housing, utilities, clothing, laundry, household supplies, personal essentials, food, and transportation. If your income is not enough to meet these minimum living expenses, then IDHS will give you an AABD grant to make up the difference.

How to Appeal a Denial, Termination, or Reduction

Your Right to Notice and to Appeal

If you are found to be ineligible for assistance, or if your grant is reduced or terminated, IDHS must give you a written notice explaining the reasons. If you disagree, you are entitled to request an appeal. You can request your appeal by telephone or in writing. You must make this request within 60 days of the date of the written notice.

Where to go for More Information

Illinois Department of Human Services: www.state.il.us/agency/dhs

General Assistance (GA)

What It Is: A public welfare program that provides money or vouchers for food, rent, utilities, clothes, medical care, and other basic essentials. It is for people with very little income and assets.

Where To Apply: In Chicago, you apply at the Illinois Department of Human Services (IDHS). Elsewhere, you apply at your local Township office.

Who May Be Eligible: Low income persons of all ages who are not receiving other public benefits.

What is General Assistance?

The General Assistance program (GA) provides aid to very poor people who are not receiving, or do not qualify for, other public benefits.

"General Assistance" helps meet basic needs such as housing, utilities, food, clothing, and medical care. The aid can be in cash, vouchers, or medical assistance.

Every GA program must have specific rules that say who is eligible for the program and the amount of assistance that can be provided. The specific rules for your GA program depend on where you live. The GA programs in the city of Chicago and a few downstate townships are partially funded by the State, and those programs are operated under State rules.

In the rest of the state, the various townships administer GA. Most of these townships have adopted a standard set of rules, which are written in a book called the "General Assistance Handbook." The Township Supervisors of Illinois (TSI) compiled this handbook.

There are a few townships that have created their own set of rules. Finally, some counties have a county-wide Veteran's Assistance Commission, which administers GA for veterans and their families.

Who is Eligible for General Assistance?

GA is known as the program of last resort. This means that you can get GA only if you do not receive other forms of income assistance. To qualify, you can have very little income from other sources and very few assets. The specific income and asset limits depend on your township's rules.

The township may require that you apply for other government benefits for which you might be eligible, but you should be able to get GA while you are waiting to see if those other applications are approved.

How to Obtain General Assistance

Procedures

You should file an application for GA with the Township Supervisor for the township where you reside. Your local phone book should have a listing for the location of your township office. However, if you live in the City of Chicago, you file your application at the local Illinois Department of Human Services (IDHS) office. If you are a veteran living in a county with a Veteran's Assistance Commission, you should apply at the Commission's offices.

When you request GA, your township must provide you with an application form. The township must process every application. The township cannot deny the application or refuse you assistance simply because it claims to lack the funds.

The township may ask you to provide your rent receipts, utility bills, medical bills, wage stubs, or other types of verification of your income, assets, and needs. You should cooperate with these requests.

The Kinds of Assistance Available

Some townships issue a small cash payment, in the form of a monthly check.

The monthly payment levels generally are greater for family cases, where children reside in the household. The payment level increases with the number of persons in the family.

Many townships also will approve additional amounts for special needs, including a therapeutic diet allowance, and day care costs. In some cases, GA may provide assistance to pay for funeral and burial expenses.

Townships must pay for pressing medical needs if there is no other source of payment available. In general, townships cover only that medical care which is necessary or essential. Usually, they do not cover other types of care such as preventive care, optical and chiropractic care, and dental care (except for the relief of serious pain or infection). For non-emergency care, you must get pre-approval from your GA office, i.e., approval before you get the care.

Some townships will provide GA, but not in the form of a monthly check. These townships look at certain basic subsistence needs that you can show are unmet without help.
Examples: shelter costs, including rent; food; utilities; clothing; household supplies; personal essentials; and laundry.

In these instances, the township can provide assistance in the form of vouchers. By submitting the vouchers, you can pay your landlord, utilities, grocery store, or other provider for the goods or services they provide to you. Each voucher will be in an amount set by the rules. However, the monthly payment level for each voucher may not meet all of your needs.

If you do not have any food, shelter, clothing, or some other immediate need, some townships also provide emergency assistance. Although "emergency" assistance is limited to once a year, you still have the right to receive a regular, on-going GA monthly payment.

NOTE
The township must give you GA on an ongoing basis for each month as long as you qualify. Do not let a township try to tell you that it can only give you GA just for emergencies or for a limited time.

Your Right to Written Notice

The Township Supervisor must give you a written notice approving or denying your application within 30 days of the date of your completed application. The township also must give you a written notice whenever it takes any action to change the amount of your assistance grant or to terminate or suspend your assistance.

What to do if Your Assistance is Denied, Reduced, or Terminated

Filing an Appeal

You can appeal if you disagree with any decision of the township to:

· deny your application or

· reduce, suspend, or terminate your assistance.

The notice of decision must tell you how and where to file an appeal. If you want to appeal, you must do so in writing within 60 days of the date of the notice. If you are currently receiving GA assistance and you receive notice that your benefits will be reduced or stopped, you must file your appeal within 10 days of the date of the notice in order to continue to receive the same amount of assistance until there is a decision on your appeal.

Where to go for More Information

Many people applying for GA benefits encounter great difficulty. They may be discouraged from applying, or told that there is no assistance available, or improperly denied assistance. You should not hesitate to contact your local legal services office if you encounter problems getting the help you need.

Other Resources

Most townships that do not receive state funds to operate their GA program have adopted a standard set of rules, which can be found in the "General Assistance Handbook." You can see a copy at your township office. If the township has adopted its own rules, you can obtain a copy of those rules or review them at the local township office.

Food Stamps

What It Is: A program that provides financial assistance for the purchase of food.

Where To Apply: Illinois Department of Human Services (IDHS).

Who May Be Eligible: Anyone demonstrating financial need under the program rules. There are no age restrictions.

What is the Food Stamp Program?

The food stamp program of the U.S. Department of Agriculture is designed to improve the quality and quantity of diets in low income households. In Illinois, it is administered by the Illinois Department of Human Services (IDHS).

The IDHS provides food stamps using the electronic benefit transfer system called Illinois "Link." IDHS will issue a Link card to you which is used like a bank debit card. As you make food purchases using the card, the amount of the purchase is deducted from the balance on the card, and your receipt reflects this purchase.

In addition to using food stamps to buy food at the grocery store, food stamps can be used to pay for meals provided by the Meals-On-Wheels program. Also, they can be used to pay for group meals for the elderly and, in some cases, to pay for meals in certain restaurants.

Food stamps cannot be used to purchase non-food items like soap or toilet paper, or alcohol or tobacco. If necessary to accommodate a disability, you may be able to get food stamps in coupon form.

Who is Eligible?

Anyone of any age can qualify for food stamps, providing they meet IDHS eligibility requirements. Eligibility for food stamps is based on need. IDHS considers your income, your assets, and certain deductions. IDHS may also consider the income and assets of other people who live with you.

Income

While many factors determine the amount of and eligibility for food stamp benefits, the most important are:

amounts of household income and expenses;
number of persons living and eating together;
amount of available liquid assets, such as money in checking and savings accounts.

Assets

The asset limit for food stamp units with at least one member who is 60 or older is $3,000. For all other units, the asset limit is $2,000. IDHS does not count certain assets (called exempt assets) towards the limit.
Examples: Exempt assets include burial expenses, the homestead property in which you live, and one car.

Citizenship

To be eligible for food stamps, you must be an Illinois resident, and a U.S. citizen, or else be within one of several specified categories of non-citizens.

How to Apply

You must file a written application at your local IDHS office. You will be asked to provide verification of your income, assets, and expenses.

You are also able to determine your eligibility for food stamps through a new web site set up by the state Department of Human Services. The online calculator allows you to determine your eligibility and can be found at www.dhs.state.il.us/ts/fss/dhs_foodStamps_fsai.asp.

IDHS is required to process your application within 30 days. You are entitled to receive a written decision on your application.

How to Appeal a Denial, Termination, or Reduction in Food Stamps

You may file an appeal of any decision to deny, terminate, or reduce your food stamps. You can file your appeal in writing or by calling 800-435-0774 (toll free). You must file the appeal within 90 days of receiving the notice of decision that you want to appeal.

Where to go for More Information

Agencies and Organizations

Illinois Department of Human Services Website: www.dhs.state.il.us

Access Numbers and Internet Resources

Centers for Medicare and Medicaid Services (CMS)

Regional office: 1-312-353-7180

Comprehensive Health Insurance Plan (CHIP)

To apply:

Office of the Board of Directors

Comprehensive Health Insurance Plan

400 West Monroe Street, Suite 202

Springfield, Illinois 62704-1823

1-217-782-6333 (voice)

1-217-782-6410 (TTY)

Blue Cross Blue Shield of Illinois

1-800-367-6410 (voice)

1-800-545-2455 (TTY)

Illinois Department of Human Services (IDHS)

For information on AABD and other programs call: 1-800-252-8635 or 1-800-447-6404 (TTY)

www.state.il.us./agency/dhs

Illinois Department of Public Aid (IDPA)

www.state.il.us/dpa

Illinois Department of Revenue

To apply for the Pharmaceutical Assistance Program call: 1-800-356-6302

For information about covered medications and participating pharmacies call: 1-800-624-2459

www.revenue.state.il.us/app/cbci/

Medicaid (Adults and Children)

For information on eligibility status or help finding a medical provider call:

Client Health Benefits Hotline: 1-800-226-0768 (toll free) or 1-877-204-1012 (TTY)

Medicare

Phone: 1-800-633-4227 (toll free) or 1-800-820-1202 (TTY)

www.medicare.gov

The Medicare carrier that processes Medicare Part B claims in Illinois is

Wisconsin Physicians Services Insurance Corp. (WPS) 1-800-642-6930 (toll free) or

1-800-535-6152 (TTY)

National Alliance for the Mentally Ill of Greater Chicago

1536 West Chicago Ave

Chicago, IL 60622

Phone: 312-563-0445

www.namigc.org

www.nami.org

Social Security

1-800-772-1213

Temporary Assistance for Needy Families (TANF)

To apply: DHS Community Operations, 70 E 21st St, Chicago, IL 60616-1782. Phone: (312) 793-7500

Ticket to Work

Phone: 1-866-968-7841 or 1-866-833-2967 (TTY)

www.socialsecurity.gov/work

To request a copy of the work incentives publication Working While Disabled: How We Can Help call: 1-800-772-1213 or 1-800-325-0778 (TTY)

Wisconsin Physicians Services Insurance Corp. (WPS) 1-800-642-6930 (toll free) or

1-800-535-6152 (TTY) (The Medicare carrier that processes Medicare Part B claims in Illinois)

(Sources for this guidebook were: Illinois Law Help website www.illinoislawhelp.org, Social Security Website www.ssa.gov, and the Illinois Department of Human Services website www.dhs.state.il.us/. Please note that any amounts listed in the guidebook may change annually and to get the most up to date information, check with the agency where you need to apply for that particular entitlement program.)

ENTITLEMENT PROGRAMS:

An Overview for Mental Health Consumers and Their Families

Compiled March 2004 by:

Tammy Pesenti

Assistant Executive Director

NAMI of Greater Chicago

1536 West Chicago Avenue, Chicago, IL 60622

Phone: 312.563.0445

Website: www.namigc.org

TABLE OF CONTENTS

Pages

Medicare 8

Medicaid for Adults 12

The Qualified Medicare Beneficiary Program (QMB) 16

Medicaid for Children/KidCare 17

Comprehensive Health Insurance Plan (CHIP) 23

Temporary Assistance for Needy Families (TANF) 28

Aid to the Aged, Blind or Disabled (AABD) 34

General Assistance 36

Food Stamps 39

Access Numbers and Internet Resources 41

The Differences Between SSDI and SSI

Disability Requirements

Where to Go for More Information

Medicare

The Medicare Program in General

Medicare Part A (hospital insurance):

Medicare Part B (medical insurance):

Medicare Part C:

Who is Eligible for Medicare?

What does Medicare Cost?

How to Apply for Medicare

Automatic Enrollment

Services Covered By Medicare

Services Covered Under Part A

Services Covered Under Part B

Where to go for More Information

Agencies and Organizations

Other Resources

Medicaid (for Adults)

Who is Eligible for Medicaid?

What Services Are Covered?

The "Spend Down" Process

What to Do If You Are Denied Medicaid or Medicaid Coverage

Where to Go for More Information

Medicaid Coverage of Medicare Premiums and Deductibles: The Qualified Medicare Beneficiary (QMB) Program

Who is Eligible?

What Services Are Covered?

Special Rules Concerning the KidCare Share, Kid Care Premium, and KidCare Rebate

What to Do If You Are Denied KidCare or Denied Coverage of Needed Medical Care

Appeal Procedures

Where to Go for More Information

State of Illinois Comprehensive Health Insurance Plan

Who is Eligible? In order to be eligible, you must be an Illinois resident, and you must be a U.S. citizen or an alien lawfully permitted for permanent residence.

Types of Insurance Plans Available Under CHIP

How to Apply for CHIP

What to Do If Your CHIP Application or Claim is Denied

Where to Go for More Information

Who can get benefits through TANF?

What can I get from TANF?

If I get TANF, can I still get medical help and food stamps?

How does TANF work?

How do I apply?

What else should I know about TANF?

Transitional Assistance, Family and Children Assistance, and Earnfare

Who is eligible for Transitional Assistance (TA)?

Who is considered "not employable" for purposes of TA?

What procedures does IDHS use for TA determinations?

Who is eligible for State Family and Children Assistance (SFCA)?

Who is eligible for Earnfare?

How does a client get into the Earnfare program?

What are the cash benefits for these programs?

What are the financial factors of eligibility for TA and SFCA?

What are the financial eligibility rules for Earnfare?

What are some of Earnfare's nonfinancial eligibility factors?

Aid to the Aged, Blind, and Disabled (AABD) State Supplemental Payments

Cash Assistance for Low-Income People who are Elderly, Blind, or Disabled

Who is Eligible for AABD Cash Assistance?

How to Apply

Your Eligibility for AABD and Your Grant Amount

Medicaid Coverage of Medicare Premiums and Deductibles:
The Qualified Medicare Beneficiary (QMB) Program