89 Ill. Adm. Code 125.225
Presumptive Eligibility for Children
Section
125.225 Presumptive Eligibility for Children
a) A child younger than 19 years of age may
be presumed eligible for an All Kids Health Plan under this Part if all of the
following apply:
1) an application for medical benefits has
been made on behalf of the child;
2) the child is a resident of Illinois;
3) the child is not an inmate of a public
institution as described in Section 125.205(a)(1);
4) effective October 1, 2013, the child is a
member of a family whose monthly countable income, as stated on the
application, is above 133% of FPL and at or below 200% of FPL as determined
using the MAGI methodology;
5) the State employee who registers the
application has no information that the child is not a U.S. citizen or a
qualified non-citizen as described in 89 Ill. Adm. Code 125.200(e) or 89 Ill.
Adm. Code 118.500; and
6) the child has not been presumed eligible
under this Part 125 or 89 Ill. Adm. Code 118 or 120 within the past 12 months.
b) Entities qualified to make a determination
of presumptive eligibility include State employees involved in enrolling
children in programs under this Part 125 or 89 Ill. Adm. Code 118 or 120.
c) The presumptive eligibility period begins
on the date of application.
d) The presumptive eligibility period ends on
the date the State's determination of the child's eligibility under this Part
125 or 89 Ill. Adm. Code 118 or 120 is updated in the data system.
e) No copayment or premium requirements apply
during the period of presumptive eligibility.