Illinois Medicaid Eligibility Requirements And Income Limits For Applicants

Which Illinois Medicaid Coverage Group Applies to You?

Illinois Medicaid sorts applicants into distinct coverage groups, and each group carries its own income rule instead of one statewide cutoff. The Illinois Department of Healthcare and Family Services (HFS) and the Illinois Department of Human Services (IDHS) jointly administer these groups: ACA Adults (ages 19-64 without dependent children), All Kids (children through age 18), FamilyCare (parents and caretaker relatives), Moms & Babies (pregnant individuals and infants), AABD Medicaid (seniors, and people who are blind or disabled), and Former Foster Care (young adults under 26 who left DCFS custody).

Each group uses a different percentage of the federal poverty level (FPL) to set its income ceiling, and two different calculation methods apply across the system. Children, parents, pregnant individuals, and ACA Adults use Modified Adjusted Gross Income (MAGI) rules, which count most earned and unearned income but skip any asset or resource test. Seniors and people with disabilities use non-MAGI rules under AABD, which count both income and countable resources against a $17,500 asset ceiling.

Knowing your group first prevents wasted effort: a parent checking the AABD asset limit, or a senior checking the ACA Adult income percentage, will get the wrong answer. The sections below break down the exact dollar and percentage figures for each group as they stand for 2026.

What Are the Income Limits for ACA Adults on Illinois Medicaid?

ACA Adults qualify for Illinois Medicaid at 138% of the federal poverty level, which HFS states as a monthly income limit of $1,366 for one person and $1,845 for a couple. This group covers adults ages 19 to 64 who were not previously eligible for Medicaid under older category rules, do not have Medicare, and typically do not have dependent children under 18 living with them. The 138% threshold is a MAGI calculation, so no asset or resource test applies regardless of savings, retirement accounts, or property value.

This income figure moves with the annual federal poverty guideline update, so the dollar amount changes each year even though the 138% percentage stays fixed. For context, the 2026 federal poverty guideline sets 100% FPL at $15,960 per year for an individual, and 138% of that annual figure lines up with the $1,366 monthly standard HFS publishes.

Monthly Income Thresholds by Household Size

Households larger than two people follow the same 138% calculation against the federal poverty guideline for that household size, though HFS publishes the individual and couple figures most prominently since most ACA Adult applicants apply without dependents in the household.

What Are the Income Limits for Children and Parents Under All Kids and FamilyCare?

Children qualify for All Kids Assist when family income stays within 147% of the federal poverty level, while the broader All Kids program extends coverage through paid premium tiers up to 318% FPL. All Kids Assist provides full benefits with no co-payments or premiums for the child. Families above the Assist threshold can still enroll in All Kids Share or All Kids Premium Level 1 or 2, which apply modest co-payments and monthly premiums instead of denying coverage outright.

All Kids Assist Income Chart

Parents and caretaker relatives living with a child 18 or younger qualify separately through FamilyCare, which uses its own income chart rather than the All Kids child chart above.

FamilyCare Income Chart for Parents and Caretakers

Each additional household member beyond eight adds $508 to the FamilyCare monthly limit. FamilyCare enrollees pay small co-payments per medical visit or prescription, ranging from $2 for generic drugs to $3.90 for brand-name drugs or emergency room visits used for non-emergencies, while All Kids Assist charges children nothing.

What Is the Income Limit for Pregnant Individuals Under Moms & Babies?

Pregnant individuals qualify for Moms & Babies coverage when countable family income sits at or below 213% of the federal poverty level. This program covers pregnancy-related and full-scope care during pregnancy and for up to 12 months after giving birth, with no co-payments or premiums charged to the enrollee. The unborn child counts as an additional household member when HFS calculates the applicable income limit, which effectively raises the dollar ceiling compared to a same-size household without a pregnancy.

Babies born to a mother covered by Medicaid at the time of birth remain eligible for coverage through their first year regardless of family income, a separate rule from the 213% FPL test applied to the pregnant applicant. This continuous-eligibility rule removes the need to re-verify a newborn’s income status during their first 12 months.

How Do Income and Asset Limits Differ for AABD Medicaid?

AABD Medicaid requires countable income at or below 100% of the federal poverty level, which equals $1,330 per month for a single applicant and $1,804 for a couple in 2026, plus countable resources under $17,500. This differs sharply from the MAGI groups above: AABD adds a resource test that MAGI-based Medicaid does not use, so a senior or disabled applicant with savings above $17,500 can be denied even with qualifying income. Exempt resources, meaning assets that do not count toward the $17,500 ceiling, typically include a primary home, one vehicle, personal belongings, burial spaces, and certain life insurance policies.

Countable income for AABD differs from the countable income formula Social Security uses for Supplemental Security Income (SSI), because AABD allows deductions for documented work expenses, day care costs, and transportation costs that SSI’s formula does not always permit. Anyone who currently receives SSI, or who qualifies for SSI’s 1619(b) provision after previously receiving it, automatically meets AABD Medicaid’s financial requirements without a separate income or resource review, though they must still file a Medicaid application to activate coverage.

AABD Spenddown Option for Income Above the Limit

Applicants whose income or resources exceed the AABD limit are not automatically denied; they can enter a spenddown arrangement instead. Under spenddown, the applicant pays for medical expenses out of pocket each month, up to the amount their income exceeds the limit, functioning similarly to an insurance deductible, and Medicaid covers costs above that threshold for the remainder of the month. A separate Pay-In Spenddown option lets the applicant pay HFS directly by money order, check, or card rather than tracking medical receipts and submitting them monthly.

Who Meets Illinois Medicaid’s Citizenship and Immigration Requirements?

U.S. citizens and specific groups of lawfully present noncitizens qualify for full Illinois Medicaid coverage, while undocumented immigrants generally qualify only for Emergency Medical Coverage unless they are a child or a senior eligible under separate state-funded programs. Most immigrants lawfully present for fewer than five years do not qualify for full Medicaid, though children and pregnant individuals in this group can still qualify through All Kids or Moms & Babies regardless of the five-year bar.

Starting October 1, 2026, federal rule changes narrow which noncitizens keep federally funded Medicaid eligibility. After that date, eligibility is limited to lawful permanent residents who have met the five-year waiting period (or are exempt from it, such as refugees, asylees, and trafficking survivors who adjust to LPR status), Cuban-Haitian entrants, citizens of the Compact of Free Associated States, children under 19 residing lawfully, and pregnant individuals residing lawfully. Noncitizens who lose federal Medicaid eligibility under this change may still qualify for Illinois-funded programs, including coverage for asylum applicants, torture and trafficking victims, domestic violence survivors, kidney disease patients, or people already enrolled in Health Benefits for Immigrant Seniors, since new enrollment in that senior program has been paused since November 6, 2023.

How Will the 2027 Medicaid Work Requirements Change Eligibility?

New federal work requirements take effect for ACA Adults starting with their first redetermination on or after January 1, 2027, and for new applicants who apply after 5:00 p.m. on December 31, 2026. The requirement applies specifically to the ACA Adult group, meaning adults ages 19-64 without dependent children under 18 at home and without Medicare; it does not apply to children, seniors, AABD enrollees, or people in FamilyCare or Moms & Babies.

An ACA Adult meets the work requirement by having monthly income above $580, or by completing at least 80 hours in one month of any combination of paid work, unpaid or in-kind work, self-employment, volunteering, part-time schooling (including GED or trade school), or a state work program. Being a student at half-time or greater status also satisfies the requirement without a separate hours count. Alongside this change, ACA Adults move from 12-month to 6-month redetermination cycles starting at their first redetermination in 2027, doubling how often HFS reviews their eligibility each year.

Who Is Exempt From the Work Requirement?

HFS exempts several categories from the work requirement automatically or through self-attestation starting in 2027: pregnant individuals, people in their 12-month postpartum period, veterans with a 100% disability rating, American Indian or Alaska Native individuals, former foster youth under 26, caregivers of a young child or a dependent with a disability, people with a medical condition preventing compliance, TANF recipients meeting TANF work rules, people meeting or in the grace period for SNAP work requirements, participants in drug or alcohol treatment programs, and people released from incarceration within the prior three months. HFS accepts self-attestation for exemptions it cannot verify through existing data, though conflicting data may trigger a request for additional proof. An enrollee who neither meets the requirement nor qualifies for an exemption loses Medicaid coverage at the end of their current eligibility period and can only access marketplace coverage without premium subsidies.

How Do You Apply for Illinois Medicaid?

You apply for Illinois Medicaid through four channels: the ABE online portal at abe.illinois.gov, by phone through the DHS Help Line at 1-800-843-6154, in person at a DHS Family Community Resource Center, or by paper application mailed or faxed to your local FCRC. The online application takes about 30 to 45 minutes and issues a tracking number (a “T-number”) immediately after submission, which you should record for future reference. The same ABE application also covers SNAP, TANF, Refugee Cash Assistance, and the Medicare Savings Program, so checking multiple benefit boxes on one form avoids filing separate applications.

Before starting, gather a mailing address, full names and dates of birth for every household member, Social Security numbers for applicants who have one, Alien Registration Numbers for noncitizen applicants who have one, household income details including spousal support (child support does not count as income), and existing health insurance information. Applicants who only qualify due to being 65 or older must also report financial resources such as checking, savings, and retirement account balances, since AABD’s asset test requires that information upfront. HFS verifies most information electronically; when it cannot, it mails a request for specific documents, and missing that deadline can result in denial.

What Happens if Your Income or Assets Change After Approval?

Illinois Medicaid enrollees must report income, immigration status, residency, or household size changes to their DHS Family Community Resource Center within 10 days of the change. You can report changes in person, by phone, or through the Manage My Case feature on ABE.illinois.gov. Reporting late does not automatically end coverage, but it can delay HFS’s recalculation of your eligibility group or income tier, and unreported increases discovered later can trigger a retroactive review.

If a change pushes your income or assets above your current group’s limit, HFS will determine whether you qualify for a different coverage category, such as moving from All Kids Assist to a premium tier, or from free AABD Medicaid to a spenddown arrangement, rather than terminating coverage outright in most cases. Anyone who disagrees with a resulting denial or reduction can file an appeal within 60 days of the decision letter’s date, and filing before the effective date of the change (or within 10 calendar days, whichever is later) preserves benefits while the appeal is pending.

Sources and Further Reading

• Medical Programs — Illinois Department of Healthcare and Family Services (HFS), accessed 2026-07-30
• FamilyCare — Illinois Department of Healthcare and Family Services (HFS), accessed 2025-06-20
• How Much Does It Cost? (All Kids Income Chart) — Illinois Department of Healthcare and Family Services (HFS), accessed 2025-06-18
• Applying for Medicaid — Illinois Department of Healthcare and Family Services (HFS), accessed 2026-04-20
• NEW Changes Coming to Medicaid — Illinois Department of Healthcare and Family Services (HFS), accessed 2026-08-06
• PM 07-02-01: Asset Limits — Illinois Department of Human Services (IDHS), effective 05/12/2023
• Aid to the Aged, Blind, and Disabled (AABD) Medicaid — DB101 Illinois
• How Health Benefits Work: Income-Based Medicaid — DB101 Illinois
• Medicaid Common Questions (FAQ) — Illinois Legal Aid Online, accessed 2026-08-17
• Federal Poverty Level (FPL) Glossary — HealthCare.gov, 2026 guidelines