Section 128.210  Eligibility Exclusions and Terminations

a)         A veteran shall not be determined eligible for Veterans Care if:

1)         The veteran is an inmate of a public institution.

2)         The veteran is a resident of a nursing facility.

b)         A veteran's coverage under the program shall be terminated if the veteran:

1)         Loses his or her Illinois residency.

2)         Attains 65 years of age.

3)         Becomes enrolled in Veterans Administration healthcare, medical assistance under the Public Aid Code or health benefits including rebates under the Children's Health Insurance Program Act.

4)         Meets the provisions of subsection (a) of this Section.

5)         Fails to pay the premium as specified in Section 128.330.

6)         Fails to report to the Department changes that affect eligibility for the program.

7)         Asks the Department to terminate the coverage.

8)         Is no longer eligible based on any other applicable State or federal law or regulation.

9)         Failed to provide eligibility information that was truthful and accurate to the best of the veteran's knowledge and belief and that affected the veteran's eligibility.

10)         Was incorrectly determined eligible.

11)         Fails to complete the redetermination of eligibility within the required timeframes or provide proof of on-going eligibility.

12)         Becomes covered by other health insurance.

c)         Following termination of a veteran's coverage under the program, the following action is required before the veteran can be re-enrolled:

1)         A new application must be completed and the veteran must be determined otherwise eligible.

2)         There must be full payment of premiums due under this Part for periods in which a premium was owed and not paid.

3)         If the termination was the result of non-payment of premiums, the veteran is ineligible for the program for three months, starting with the first month of cancellation or termination from coverage, before becoming eligible for re-enrollment.

4)         If there was an unpaid premium from a previous coverage period, the unpaid premium, in addition to the first month's premium, must be paid before new coverage may begin.