After Applying for Medicaid
After you submit your application, a Medicaid caseworker uses the information on your application to determine if you are eligible for medical benefits. If the caseworker needs more information to process your application, you will get a letter with a list of documents that are needed. You will need to mail, fax, or hand-deliver these documents, to the office address listed on the letter, before the deadline on the letter. When your application has been processed, you will get a letter in the mail telling you if the application has been approved or denied.
Checking Your Application Status
If you are worried that your application is taking a long time to process, please do not apply again. This will cause confusion and additional delays. Instead, check on the status of your application by calling the Department of Human Services (DHS) helpline at 1-800-843-6154.
- Follow the prompts by first saying what program you are calling about and then say “case status”. This will get you to a caseworker who can tell you if your application is pending and if it’s been processed. Please have your application tracking number (“T” number) with you if possible.
What if you are Approved for Medicaid?
If you are approved for Medicaid, you will get an approval letter in the mail. This approval letter will list your benefit start date. It may be the month you applied or before that if you requested prior coverage.
Within 10 days of getting your approval letter, you will get another letter in the mail that includes your Recipient Identification Number (RIN). This letter is your State of Illinois Healthcare and Family Services (HFS) Medical Card.
Tips to Speed Up the Application Process
- Let DHS know if your mailing address or phone number changes. You can update your information by calling the DHS helpline at 1-800-843-6154, or online at: https://www.dhs.state.il.us/page.aspx?item=46873
- Answer your Phone - a caseworker may need to reach you about your application.
- Check your mail - the state will be sending you important letters, for example, a request for more information, or your Medicaid determination.
- Send in any requested additional documents as soon as possible.
Your State of Illinois Healthcare and Family Services (HFS) Medical Card:
This is a piece of paper that contains the name, Recipient ID number (RIN),and the date of birth for each household member who is eligible. Providers may refer to your HFS Medical Card. Always keep it in a safe place. Never allow anyone but the person whose name is listed on the HFS Medical Card to use it
Using your HFS Medical Card
- Take your HFS Medical Card and a picture ID to all healthcare appointments. Your provider will use it to look up what services they can give you.
- Do not throw out your paper HFS Medical Card. Even if your medical benefits end, keep the HFS Medical Card. You can use it again if you become eligible for Medicaid in the future.
Lost or Stolen HFS Medical Cards
- Call the DHS Helpline at 1-800-843-6154 to request a replacement HFS Medical Card be mailed to you.
- There is no charge for a replacement HFS Medical Card.
- In the meantime, you still can receive healthcare services, just bring a picture ID and your RIN or Social Security Number or date of birth to your medical provider. They can check your coverage with this information.
A Medical Card Does Not Guarantee Coverage
- There is no beginning and end date on the HFS Medical Card. That means that the HFS Medical Card does not guarantee eligibility for medical services for a specified time period. Medical providers must always verify a person's eligibility before providing services.
What if Your Application is Denied?
If you are denied Medicaid, you will get a letter in the mail telling you why.ard.
If you are denied because you did not send in information the State requested:
- You have 60 days from the date of the denial letter to send in the missing information. Your application will be re-opened and processed. If eligible, your healthcare coverage will begin in the month that you applied, or before that, if you applied for prior coverage.
- If you miss this 60-day window, you will have to reapply.
If you are denied because you make too much money:
- You may be eligible for a tax subsidy to buy private health coverage through the Federal Health Insurance Marketplace.
- Medicaid will automatically send your health care coverage application to the Marketplace. However, you can only buy health coverage on the marketplace during the open enrollment period or if you have a Qualifying Life Event (for example, a life change such as moving to a new state, getting divorced, or having a child) that makes you eligible for a Special Enrollment Period.
You have the right to appeal the Medicaid decision
- If you are appealing a decision, you must do so within 60 days of the date on the decision letter. The last page of the denial notice shows instructions on where to file an appeal.
- For more information on appealing, go to the Department of Human Services website at www.dhs.state.il.us/page.aspx?item=32119ply.