Section 140.5  Covered Medical Services Under General Assistance

a)         The following medical services shall be covered for recipients of financial assistance under General Assistance for both the State Transitional Assistance Program and the State Family and Children Assistance Program:

1)         Encounter rate clinic visits;

2)         Physician services;

3)         Vital pharmacy services (items necessary for life maintenance or to avoid life threatening situations);

4)         Vital medical supplies and equipment;

5)         Group care services, subject to prior approval;

6)         Family planning services;

7)         Laboratory and x-ray services;

8)         Transportation to secure medical services;

9)         Prostheses, orthoses (only when essential for employment or expediting hospital discharge);

10)        Home health agency visits (only on a prior approval basis when the medical condition is documented by the physician as terminal);

11)        Hospice services;

12)        Dental services;

13)        Chiropractic services;

14)        Podiatric services; and

15)        Optical services and supplies.

b)         The following medical services shall be covered for recipients of financial assistance under General Assistance only for the State Family and Children Assistance Program, not the State Transitional Assistance Program, in addition to the services covered under subsection (a) above:

1)         Inpatient hospital services.  (Physical rehabilitation services and psychiatric services are not covered for General Assistance recipients age 18 or over);

2)         Hospital outpatient and clinic services for surgical procedures, renal dialysis or cancer therapy; and

3)         Hospital emergency room visits.  The visit must be for the alleviation of severe pain or for immediate diagnosis and/or treatment of conditions or injuries which might result in disability or death if there is not immediate treatment.

(Source:  Amended at 23 Ill. Reg. 12697, effective October 1, 1999)