Work Incentives Working Group

State Public Benefits Manual

Returning to Work:
Questions and Answers for People Recieving SSI and/or SSDI

 

State Public Benefits Manual

CHAPTER SIX
OTHER STATE AND LOCAL PROGRAMS THAT PROVIDE CASH OR MEDICAL ASSISTANCE

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:

  • Heart and blood pressure problems;
  • Diabetes (and syringes and needles used to administer insulin);
  • Arthritis;
  • Cancer;
  • Alzheimer’s disease;
  • Parkinson’s disease;
  • Glaucoma; and
  • Lung disease and smoking related illnesses

***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 Revenue’s 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:

  • 65 or older (anytime during the year); or
  • 16yrs. of age or older and are totally disabled; or
  • widow or widower who is at least 63 yrs. of age before the deceased claimant’s death

Financial Requirements

Persons are financially eligible for pharmaceutical assistance if they have a household income of less than the following:


Persons 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 Coalition’s website at www.ssic.org for further information.


B. TOWNSHIP AND OTHER LOCAL GOVERNMENT GENERAL ASSISTANCE *

What is General Assistance?

General 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.

Who can get General Assistance?

To 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.

In 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.


How To Apply For General Assistance

The 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.

If 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.

What Are The Benefit Amounts

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.
The supervisor cannot stop someone’s benefits because the Township has no more money, because someone has been on assistance too long, or because General Assistance is only for emergencies.

What Are The Notice And Appeal Rights

Persons applying for and receiving General Assistance have a right to:

  1. File a written application for General Assistance and have a decision within 30 to 40 days of the date the application is filed.
  2. Receive a written notice stating whether or not the individual or family was approved and the specific reason for the decision.
  3. Receive a written notice before a General Assistance amount can be reduced or cut-off and the specific reason for the decision.
  4. Appeal if an individual or family is denied or if benefits are reduced or cut-off. The appeal must be filed within 60 days of the date of the notice.
  5. Continue to get benefits until a decision is made on the appeal if the appeal is filed prior to the proposed reduction or cut-off. The township should never give less than ten days notice of a change.
  6. Get a written decision on the appeal.
  7. Be treated with respect by all township staff.

C. STATE OF ILLINOIS CHIP PROGRAM

The 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.

Participants 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 at 1-800-962-8384.

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.

 

BACK TO TOP

CHAPTER ONE
SOCIAL SECURITY DISABILITY PROGRAMS

CHAPTER TWO
HOW TO WORK AND MAINTAIN SOME SSDI OR SSI BENEFITS

CHAPTER THREE
STATE ADMINISTERED BENEFITS

CHAPTER FOUR
HOW THE MEDICAL ASSISTANCE PROGRAMS WORK

CHAPTER FIVE
MEDICARE

CHAPTER SIX
OTHER STATE AND LOCAL PROGRAMS THAT PROVIDE CASH OR MEDICAL ASSISTANCE

CHAPTER SEVEN
FOOD STAMPS

CHAPTER EIGHT
OFFICE OF REHABILITATIVE SERVICES (ORS)

CHAPTER NINE

OTHER BENEFITS AND/OR PROTECTIONS