Illinois Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Illinois.
7.6 million Medicaid long-term care recipients nationwide
Illinois Department of Healthcare and Family Services
Processing Time
45-90 days for standard applications (45 days standard, 60 days for disability-related applications)
Illinois Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Illinois, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Illinois follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$1,304/month
Married Couple (One Applying)
$1,762/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$17,500
Community Spouse (At-Home Spouse)
$17,500
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Illinois Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $6,700/month average (the average monthly nursing home cost in Illinois).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Illinois
Nursing Home Care
Medicaid pays 100% of nursing home costs in Illinois once eligibility is established. The average monthly cost is $6,700/month average. Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Supportive Living Program (SLP): Illinois adults age 65+ and those with physical disabilities under 65 can receive assisted living services including medication oversight, health assessments, assistance with ADLs, and meals. Medicaid does not cover room and board - residents pay this from their monthly income (must meet minimum SSI income requirement of $943/month).
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Illinois offers 4 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Persons Who Are Elderly Waiver
Serves Illinois residents age 65+ or individuals with physical disabilities ages 60-64 who meet nursing facility level of care. Provides adult day service, in-home service (homemaker), automated medication dispenser, and emergency home response services.
Program Details →Adults with Developmental Disabilities Waiver
Provides comprehensive services including adult day service, community day services, and residential supports for adults with developmental disabilities who require ICF/IID level of care.
Program Details →Persons with Disabilities Waiver
Serves individuals age 18+ who are at risk of nursing facility placement due to disability. Provides adult day service, personal assistance, home accessibility adaptations, and assistive technology.
Program Details →Brain Injury Waiver
Provides specialized services for individuals with acquired brain injury, including adult day service, behavioral management, and community integration services.
Program Details →How to Apply for Medicaid in Illinois
Illinois Medicaid applications typically take 45-90 days for standard applications (45 days standard, 60 days for disability-related applications). Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Illinois through:
- Online at https://abe.illinois.gov
- Call DHS Help Line at 1-800-843-6154
- In-person at local Department of Human Services office
- Through hospital or nursing facility social worker
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Illinois from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Illinois-Specific Programs and Resources
Medicare Savings Programs
Helps eligible individuals pay Medicare premiums, deductibles, and co-payments. Includes QMB, SLMB, and QI programs for low-income seniors.
Learn MoreNeed Help with Illinois Medicaid?
Contact Illinois Department of Healthcare and Family Services for specific questions about eligibility, application status, or covered services.