December 21, 2023
[This article has been updated. Please click here for 2024 update.]
Note: Enrollment into the HBIA and HBIS program is currently paused. No new applications are being approved.
In partnership with the Illinois Department of Healthcare and Family Services, the Health Benefits for Immigrant Adults and Seniors program provides medical coverage to eligible adults regardless of immigration status. This program is administered through the Blue Cross Community Health PlansSM.
The state of Illinois developed this program as part of its vision to encourage positive outcomes, address the social determinants of health and foster the well-being of our members. Under this program, members receive a full benefit package. The program includes copays and prior authorization rules.
Eligibility
Health Benefits for Immigrant Adults 1. Between the ages of 42 and 64. 2. One of the following:
3. Resident of Illinois. 4. 2022 annual household income is at or below $18,754 for one person; at or below $25,268 combined income for a household size of two. The income limit differs depending on the number of household members. |
Health Benefits for Immigrant Seniors 1. 65 years old or older 2. Resident of Illinois 3. One of the following:
4. 2022 annual income at or below $13,590 or a couple with annual income at or below $18,310 5. An individual with assets below $2,000, or a couple with assets under $3,000* |
Member Identification
Members of the HBIA and HBIS programs can be identified in the Medical Electronic Data Interchange system. Members of the HBIA program will have a case type identified as Immigrant Adults. Members of the HBIS program will have a case type identified as Immigrant Seniors. Providers are recommended to check MEDI in addition to the MCO enrollment file.
Benefits and Coverage
What Benefits are Covered? The new medical program offers a full benefit package. The program may cover up to three months of health care services prior to the member’s enrollment. Covered services include:
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What is Not Covered?
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Copayments for the Programs
- Nonemergency Inpatient Hospitalization: Up to $250
- Nonemergency Emergency Room Visits: Up to $100
- Nonemergency Hospital or Ambulatory Surgical Treatment Center Outpatient Services: Up to 10% of the Medicaid payment. The amount that can be charged will vary depending on the service.
Interpretive Service, Translation and Alternative Materials
BCCHPSM provides language assistance services, at all points of contact to members with limited English proficiency and/or impaired hearing. Please call 877-860-2837 to arrange language assistance services during office visits at no cost. The BCCHP team has the following services for members:
- Qualified interpreters
- Information written in other languages (large print, audio, accessible electronic formats, other formats)
- TTY services
Care Coordination
Care coordination is a BCCHP service designed to assist members (and their families and caregivers) with physical, behavioral and special health care needs. The BCCHP Care Coordination team can assist with the coordination of medical and behavioral services. Please call 877-860-2837 to connect with your patient’s care coordinator.
Always check eligibility and benefits through Availity® Essentials or your preferred web vendor prior to rendering care and services to Blue Cross and Blue Shield of Illinois members. This step will confirm membership status, coverage details and prior authorization requirements.
Checking eligibility and/or benefit information and/or the fact that a service has been prior authorized is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have questions, call the number on the member’s ID card.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations, or warranties regarding third party vendors and the products and services they offer.