Section 118.600  Limited FamilyCare Expansion

a)         Caretaker relatives who were enrolled in FamilyCare as of June 30, 2009, as caretaker relatives (see 89 Ill. Adm. Code 120.390), qualify for medical assistance as long as they maintain continuous enrollment, and their countable income is above 185 percent and at or below 400 percent of the Federal Poverty Income Guidelines, as published annually in the Federal Register, for the appropriate family size.  All other requirements applicable to caretaker relatives eligible under 89 Ill. Adm. Code 120.34 must be met.

b)         If a caretaker relative becomes otherwise eligible for medical assistance under 89 Ill. Adm. Code 120, the provisions of this Section shall no longer apply, and nothing in this Section shall preclude a caretaker relative from otherwise qualifying for medical assistance.

c)         Caretaker relatives qualifying under subsection (a) will be covered as follows:

1)         If monthly countable income is above 185 percent and at or below 200 percent of the Federal Poverty Level (FPL) for the number of persons in the family, an eligible caretaker relative will be covered under FamilyCare Premium Level 1.

2)         If monthly countable income is above 200 percent and at or below 300 percent of the FPL for the number of persons in the family, an eligible caretaker relative will be covered under FamilyCare Premium Level 2.

3)         If monthly countable income is above 300 percent and at or below 400 percent of the FPL for the number of persons in the family, an eligible caretaker relative will be covered under FamilyCare Premium Level 3.

4)         Premium amounts will be adjusted to reflect adding or removing an eligible caretaker relative from the case and changes in countable income.

d)         Caretaker relatives shall pay premiums as follows:

1)         Caretaker relatives enrolled in FamilyCare Premium Level 1 who are not in families with American Indians or Alaska Natives shall pay premiums as  set forth in 89 Ill. Adm. Code 120.34(c).

2)         Caretaker relatives enrolled in FamilyCare Premium Level 2 shall pay premiums of $80 per person per month.

3)         Caretaker relatives enrolled in FamilyCare Premium Level 3 shall pay premiums of $140 per person per month.

e)         Caretaker relatives enrolled under this Section may receive coverage, and pay the same co-payments, for those medical services available to caretaker relatives eligible under 89 Ill. Adm. Code 120.34.

f)          Caretaker relatives enrolled under this Section have appeal rights, as set forth at 89 Ill. Adm. Code 102.80.  The provisions of Subpart A of the Department's administrative rules at 89 Ill. Adm. Code 104, Practice in Administrative Hearings, shall govern any appeals under this Subpart F.

(Source:  Added at 33 Ill. Reg. 15702, effective November 2, 2009)