State Public Benefits Manual
A. PHARMACEUTICAL ASSISTANCE
This program is run by the Illinois Department of Revenue. It helps pay for prescription medication for certain medical conditions. The medical conditions covered are:
***An individual should check with his/her pharmacist to see if his/her particular prescriptions are covered under this program. Also check the Department of Revenues website: www.revenue.state.il.us/circuitbreaker
Who Can Receive Pharmaceutical Assistance
The following persons, so long as they are living in Illinois at the time of filing for the program, are eligible for pharmaceutical assistance:
are financially eligible for pharmaceutical assistance if they have a
household income of less than the following:
whose household incomes are below the federal poverty line must pay an
annual $5 fee for an identification card. Such persons pay no additional
prescription costs for the first $2,000 in benefits during the fiscal
year (July1-June 30) and 20% of costs of prescription drugs during the
remainder of the state fiscal year. Persons whose household incomes are
equal to or greater than the federal poverty level, but less than the
maximum amount (set forth above) must pay an annual $25 fee for an identification
card. These persons also pay $3 per prescription for the first $2,000
in benefits during the state fiscal year and 20% plus the $3 co-pay of
costs of prescription drugs during the remainder of the state fiscal year.
The Deptartment of Revenue will send the individual a Pharmaceutical Assistance card which shows an effective date of coverage (it is valid for one year from date it is issued).
Note: Any individuals who have Medicaid coverage without a spenddown are not eligible for Pharmaceutical Assistance coverage. Also, the drugs covered under this program may change. Please check every year with the Dept. of Revenue.
Please visit The SSI Coalitions website at www.ssic.org for further information.
is General Assistance?
Assistance (GA) is a welfare program like the ones offered by the Illinois
Department of Human Services (IDHS). That means it is there to provide
money and medical assistance to those in need. The difference is that
it is run by a local governmental unit called a Township. In some cases,
it is run by the county. The City of Chicago is unique in that it does
not operate a General Assistance program like other townships and/or counties
in Illinois. Instead, IDHS operates the TA program in Chicago.
can get General Assistance?
be able to get General Assistance, an individual must have little or no
money and not be eligible for any money from the Illinois Department of
Human Services or Social Security. Both single people and families can
get General Assistance. Sometimes families that are not eligible for TANF
(formerly AFDC) because one child receives Social Security Survivor's
Benefits can get General Assistance.
order to get General Assistance, the individual or parent(s) in a family
must register for work. Under some circumstances, individuals can work
and still get General Assistance.
Some townships (including all townships receiving state money) require that persons who do not have children under 19 be found "not employable" before being eligible for benefits. Some of the criteria for being found not employable include: (1) serious medical, physical or mental problem, (2) age 55 and over and no recent earning, (3) temporary illness or incapacity; or (4) required to take medication to control diabetes, high blood pressure or seizure disorders.
individual must apply in the township where s/he lives. It is not always
easy to know where to apply. In some small townships, the job of Township
Supervisor is not full-time and there may not be a General Assistance
office. Sometimes a supervisor works out of his or her home. To find out
where to apply, look in the yellow pages of a local telephone book under
"government" for the number of the County Board, which should
have the information you need.
this does not work, contact the county office of the Illinois Department
of Human Services (IDHS). That office must keep a list of all the township
supervisors. There is a list of IDHS offices in the Appendix.
Are The Benefit Amounts
vary in different parts of the state, but single people usually receive
about $100 - $160 per month. Families receive more. Some townships pay
by check and others pay by voucher. Payment by voucher means that the
money is paid directly to the person or business (such as the landlord
or utility company) providing you with goods or services.
Are The Notice And Appeal Rights
Persons applying for and receiving General Assistance have a right to:
C. STATE OF ILLINOIS CHIP PROGRAM
State of Illinois Comprehensive Health Insurance Plan, better known as
CHIP, is a state insurance program for persons who are unable to obtain
individual health insurance due to the existence or history of a medical
condition or have a presumptive medical condition which is presumed by
law to result in an automatic rejection by an insurance company. Participants
must pay their own health insurance premiums to receive coverage. There
are two parts to the program: (1) the Traditional CHIP Pool which is open
to persons who cannot purchase private insurance, are not eligible for
Medicaid, and are not covered by group insurance, and (2) the HIPAA-CHIP
Pool which is only open to persons who have had group health insurance
for at least 18 months prior to applying for CHIP, have not had a break
of more than 62 days in coverage, and have recently exhausted any COBRA
continuation rights as well as meet all of the requirements of the Traditional
CHIP Pool. For example, a person is covered under an employer group health
plan, leaves their employment, exercises their option to pay their own
premiums for group health insurance in accordance with COBRA, and after
COBRA ends in 18 months, applies within 63 days for CHIP.
have a lifetime maximum in benefits of $1 million with an average annual
premium of $3700 according to1998 reports. Premiums charged by CHIP are
currently set at 135 percent of the average rates charged in the individual
health insurance market in Illinois. Premiums vary by gender, age, geographic
area, deductible amount, and type of plan. Persons apply directly to the
programs and applications can be requested from the CHIP Board Office
The Traditional CHIP Pool program currently has a waiting list for new participants because the funds allocated to the program are limited each year. However, for persons eligible for HIPAA-CHIP, state and federal law require that there be no limitation on enrollment and no waiting lists.