Section 120.10  Eligibility for Medical Assistance

a)         Eligibility for medical assistance exists when a person meets the non-financial requirements of the program and the person's countable nonexempt income (Sections 120.330 and 120.360) is equal to or less than the applicable Medical Assistance − No Grant (MANG) standard and, for AABD MANG, countable nonexempt resources are not in excess of the applicable resource disregards (Section 120.382). Persons receiving basic maintenance grants under Article III or IV of the Public Aid Code are eligible for medical assistance.  Financial eligibility for medical assistance for other persons living in the community is determined according to Section 120.60 of this Part, unless otherwise specified.  Financial eligibility for medical assistance for persons receiving long-term care services, as defined in Section 120.61(a) of this Part, is determined according to that Section, unless otherwise specified.

b)         For AABD MANG, a person's countable income and resources include the person's countable income and resources and the countable income and resources of all persons included in the Medical Assistance standard.  The person's responsible relatives living with the child must be included in the standard.  The person has the option to request that a dependent child under age 18 in the home who is not included in the MANG unit be included in the MANG standard.

c)         For TANF (Temporary Assistance for Needy Families) MANG, a person's countable income includes the person's nonexempt income and the nonexempt income of all persons included in the Medical Assistance standard.  The person's responsible relatives living with the child must be included in the standard.  The person has the option to request that a dependent child under age 18 in the home who is not included in the MANG unit be included in the MANG standard.

d)         For AABD MANG, if a person's countable nonexempt income is greater than the applicable MANG standard and/or countable nonexempt resources are over the applicable resource disregard, the person must meet the spenddown obligation determined for the applicable time period before becoming eligible to receive medical assistance.

e)         For TANF MANG, if a person's countable nonexempt income is greater than the applicable MANG standard, the person must meet the spenddown obligation determined for the applicable time period before becoming eligible to receive medical assistance.

f)          A one month eligibility period is used for persons receiving long-term care services (as defined in Section 120.61(a) of this Part).  Nonexempt income and nonexempt resources over the resource disregard are applied toward the cost of care on a monthly basis, as provided in Section 120.61 of this Part.

g)         Newborns

1)         When the Department becomes aware of the birth of a child to a recipient of a TANF or AABD grant or related medical assistance or medical assistance due to the mother's pregnancy, the child shall be deemed to have applied for medical assistance only, without written request, if the mother had been receiving TANF or AABD related medical assistance or medical assistance due to her pregnancy on the date of birth of the child.

2)         The newborn shall be eligible to receive medical assistance for a period of time as determined in Section 120.400.

(Source:  Amended at 35 Ill. Reg. 18645, effective January 1, 2012)