Illinois Medicaid: Income Limits, Assets, and How to Apply

To qualify for Illinois Medicaid, most adults need household income at or below 138 percent of the Federal Poverty Level, which is about $22,025 a year for a single person in 2026.¹² Different rules apply to children, pregnant women, and people who are 65 or older or have a disability, and the program covers all of these groups through the Illinois Department of Healthcare and Family Services.³ What follows is how the state measures income and assets for each group, what to do if you are slightly over the limit, and how the application process works.

Income Limits by Group

Most applicants have their income measured against the Federal Poverty Level using Modified Adjusted Gross Income, roughly your tax-return income with a few adjustments. The 2026 FPL is $15,960 a year for a single person and $33,000 for a family of four.² The ceiling depends on which group you belong to.

Adults aged 19 through 64 qualify with income at or below 138 percent of the FPL. That works out to roughly $22,025 a year for a single adult and about $45,540 for a family of four.¹
Pregnant women qualify at or below 213 percent of the FPL, a figure that includes a 5-percent income disregard built into the calculation.⁴
Children under 19 are covered through All Kids, a tiered program. The lowest tier, All Kids Assist, is free coverage and reaches families of four with monthly income up to $3,246. Three higher tiers, Share and Premium Levels 1 and 2, add cost-sharing and extend coverage up to $7,023 a month for a family of four.⁵
Adults who are 65 or older, blind, or have a disability qualify with income at or below 100 percent of the FPL and must also meet an asset test.⁶

Residency and Citizenship

You must live in Illinois and be either a U.S. citizen or an eligible immigrant. Lawful permanent residents generally have to wait five years from getting their green card before they can enroll. Two groups skip that wait: children under 19 and pregnant women can qualify no matter how recently they became permanent residents. Refugees and asylees are also exempt from the five-year rule.⁷

Illinois used to run state-funded coverage for immigrants who could not qualify federally. The program for adults aged 42 to 64 ended in mid-2025, and enrollment for the seniors program is currently paused.⁸

Asset Limits for Seniors and People With Disabilities

The asset test for this group is strict. A single applicant can have no more than $2,000 in countable assets. A married couple applying together is limited to $3,000. Countable assets include bank accounts, stocks, bonds, and retirement accounts you can access. Your primary home, one vehicle, and personal belongings are generally not counted.⁶

If you are applying for nursing home Medicaid, Illinois will also look at the previous five years of your financial history. Gifts, transfers for less than fair market value, and undocumented withdrawals during that period can create a penalty period during which Medicaid will not pay for facility care. The penalty length is calculated by dividing the value of what was transferred by the average monthly cost of nursing home care in Illinois. Certain transfers are exempt, including transfers to a non-applicant spouse, to a disabled child, to an adult child who lived with and cared for you, or to a sibling who already had an ownership interest in the home. Paying off legitimate debts does not trigger a penalty.

If Your Income Is Over the Limit: Spend-Down

Being over the income cap does not automatically shut you out. People with disabilities, adults 65 and older, and children under 19 who exceed the standard thresholds can use the spend-down program, which works like a deductible. Each month, you cover a set amount of medical costs yourself. Once your bills hit that amount, Medicaid takes over for the rest of the month.

You can meet your spend-down by turning in receipts and unpaid bills for qualifying expenses: doctor visits, prescriptions, hospital stays, medical equipment, insurance premiums, and even transportation to appointments. Bills from up to six months before the current period can count, though each bill can only be applied once. In some cases, you can also pay the spend-down amount directly to the state, similar to a premium, or combine bills with a direct payment. One practical note: people on spend-down are not placed into a managed care plan.

How to Apply

Before you start, pull together documents that prove who you are, where you live, and what you earn:

A driver’s license, state ID, or other government photo ID
Proof of Illinois residency such as a utility bill or lease
Recent pay stubs, W-2s, or tax returns for everyone in the household
Social Security numbers for each person applying
Information about any current health insurance, including carrier name and policy number

The quickest route is the state’s online Application for Benefits Eligibility portal, usually called ABE.⁹ You can also mail or drop off a paper application at your local Family Community Resource Center.¹⁰ Your application is treated as filed on the date the state receives your signed form.

What Happens After You Apply

Illinois has 45 days to decide a standard application. If a disability determination is needed, the state has up to 60 days.¹¹ The eligibility system tries to verify income and identity electronically, which can shorten the wait. If something cannot be verified that way, you will get a written request for more documents.

If you had medical bills in the months right before you applied, they may still be covered. Illinois can backdate Medicaid up to three months before the month you applied, as long as you would have been eligible during that stretch.¹² People often skip this because they do not realize it exists. If you delayed applying and now have unpaid bills, ask about retroactive coverage.

Coverage is not permanent. Every year you have to complete a redetermination, submitting current income and household information. Miss the deadline and your coverage ends. Illinois does give a grace period: if you turn in the paperwork within 90 days of losing coverage, benefits can be restored retroactively with no gap, as long as you still qualify.¹³¹⁴ After 90 days, you have to start over with a new application.

If You Are Denied

A denial is not the last word. You have 60 calendar days from the date on the notice to file an appeal.¹⁵ The same window applies if the state reduces or terminates existing benefits. You can appeal through the ABE portal, by email, fax, mail, phone, or in person at your local Department of Human Services office.¹⁶

Once filed, a caseworker will review the decision and invite you to an informal meeting. If you still disagree afterward, the appeal moves to a formal hearing, and the state must issue a final decision within 90 days of your filing.¹⁶ The 60-day window is short. Once it closes, that particular decision is final.

1
Illinois Department of Human Services. PM 15-06-01-b – ACA Adults
2
HHS ASPE. 2026 Poverty Guidelines – 48 Contiguous States
3
Illinois.gov. Illinois Department of Healthcare and Family Services
4
Illinois Department of Human Services. PM 06-09-03 – Income Requirements
5
Illinois Department of Healthcare and Family Services. All Kids – How Much Does It Cost
6
Illinois Department on Aging. 2026 Illinois Medicaid Income Standards and Resource Limits
7
Illinois Department of Healthcare and Family Services. Immigrant Eligibility for Medicaid FAQ
8
Illinois Department of Healthcare and Family Services. Health Benefits for Immigrant Seniors
9
State of Illinois. Illinois Application for Benefits Eligibility (ABE) Home Page
10
Illinois Department of Human Services. ABE Customer Support Center
11
Illinois Department of Human Services. Frequently Asked Questions
12
Illinois Department of Human Services. PM 17-02-05-a – Backdating Medical
13
Illinois Department of Human Services. PM 19-04-02 – Restoring/Reinstating Assistance When a Client Cooperates
14
Illinois Department of Healthcare and Family Services. Medicaid Redetermination – Extended 30-Day Grace Period and Courtesy Renewal Follow-Up Letter
15
Illinois Department of Human Services. PM 01-07-03 – Time Period to File Appeal
16
Illinois Department of Human Services. Appeals and Fair Hearings for Those Receiving Cash, SNAP, or Medical Assistance