§118.715. Eligibility Exclusions and Terminations  

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  • a)         An individual shall not be determined eligible for Health Benefits for Immigrant Seniors if the individual is an inmate of a public institution.


    b)         An individual's coverage under the Program shall be terminated if the individual:


    1)         No longer qualifies as an Illinois resident; 


    2)         Becomes eligible for medical assistance under the Public Aid Code that receives federal financial participation;


    3)         Fails to report to the Department changes that affect eligibility for the Program;


    4)         Asks the Department to terminate the coverage;


    5)         Is no longer eligible based on any other applicable State or federal law or regulation;


    6)         Failed to provide eligibility information that was truthful and accurate to the best of the individual's knowledge and belief and that affected the individual's eligibility;


    7)         Was incorrectly determined eligible;


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


    9)         Becomes an inmate of a public institution.


    c)         Following termination of an individual's coverage under the Program, the following action is required before the individual can be re-enrolled:


    1)         A new application is completed and submitted, or an existing application or case is reopened, and the individual is determined otherwise eligible; and


    2)         The individual cooperates with the Department to meet the prescribed timeframes regarding a determination of eligibility found in 305 ILCS 5/11-5.1(a)(2) and 89 Ill. Adm. Code 120.308(h).


    d)         If the Department determines the individual's exclusion or termination was in error, the individual can be re-enrolled.


(Source:  Added at 44 Ill. Reg. 19684, effective December 11, 2020)