Section 120.10  Eligibility For Medical Assistance

a)         Eligibility for medical assistance exists when a client meets the non-financial requirements of the program and the client'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 assets are not in excess of the applicable asset disregards (Section 120.380).

b)         For AABD MANG, the client's countable income and assets include the client's nonexempt income and assets and the nonexempt income and assets of all persons included in the Medical Assistance standard.  The client's responsible relative(s) living with the child must be included in the standard.  The client 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, the client's countable income includes the client's nonexempt income and the nonexempt income of all persons included in the Medical Assistance standard.  The client's responsible relative(s) living with the child must be included in the standard.  The client 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 the client's countable nonexempt income is greater than the applicable MANG standard and/or countable nonexempt assets are over the applicable asset disregard, the client must meet the spenddown obligation determined for the applicable time period before becoming eligible to receive medical assistance.

e)         For TANF MANG, if the client's countable nonexempt income is greater than the applicable MANG standard, the client 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 clients receiving care in an intermediate care facility (ICF) or skilled nursing facility (SNF) or in a Department of Human Services facility.  Nonexempt income and nonexempt assets over the asset disregard are  applied toward the cost of care on a monthly basis.

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 24 Ill. Reg. 7361, effective May 1, 2000)