The Illinois Waiver for the Elderly exists for individuals who require the level of care typically provided in a nursing home, but prefer to be at home instead. This program provides adult day care services during daytime hours and provides a personal emergency response service for the home. In addition, the program will pay for homemaker services that help individuals with the instrumental activities of daily living around their place of residence.
This program falls into a category of programs called HCBS Waivers, or Home and Community Based Services Waivers. These programs are popular in the state with individuals who prefer to receive care in their home environment. In addition, the government saves money by leveraging family caregivers and avoiding high-priced, institutional care.
Illinois residents must be at least 65 years old and be assessed to require the level of care provided in a nursing home. Alternatively, if applicants are between the ages of 60-64, they must have a disability recognized by the Social Security Administration.
Single seniors cannot have income greater than 100% of the Federal Poverty Level (FPL). For 2023, this equates to $1,215 / month. For a couple with both spouses applying, the monthly income limit is $1,643. When only one spouse is applying, the non-applicant spouse can continue to work or receive income in his or her name alone and this will not be counted toward the applicant spouse’s eligibility.
The asset limit for a single applicant is $2,000. Married applicants with both spouses applying have an asset limit of $3,000. If only one spouse is applying, the non-applicant spouse can have up to $112,344 in assets, while the applicant spouse still has a $2,000 limit.
Some items are considered exempt and not counted toward the asset limit, including the primary vehicle and the applicant’s primary home, provided the home’s equity is under $688,000.
Over the Financial Limits?
The state of Illinois allows individuals whose financial resources are over the allowable limits to still qualify for Medicaid. One such way is if their medical expenses are too high relative to their current income and assets. These are referred to as “Medically Needy” individuals.
Another option is to work with a benefits planning professional, who will help rearrange one’s assets into trusts and annuities. This can help protect wealth for the spouse or children of the senior and make sure that the applicant becomes eligible for benefits. Learn more about how professional assistance could help you.
Medicaid has a 60-month look-back period in which all transfers within this time frame are scrutinized. Assets are not allowed to be gifted in order to meet financial requirements, otherwise the individual will be penalized with a period of Medicaid ineligibility.
Benefits and Services
This waiver is intended to prevent the institutionalization of the elderly by providing services to them in their homes. In addition to personal home care, the available services can include:
- Homemaker services – Assistance with instrumental activities of daily living such as laundry, grocery shopping, housekeeping.
- Adult day care service – Social and personal care assistance on weekdays during normal business hours. This is intended to allow the primary caregivers to work.
- Emergency home response – Personal emergency alerts services sometimes abbreviated as PERS.
- Automated medication dispenser – A programmable system that can dispense medication or give alerts that it is time to take medication.
How to Apply / Learn More
This program is available statewide across Illinois. There are, however, a maximum number of available slots for this waiver. If that number is reached, qualified individuals will be put on a waiting list for services. This is not a Medicaid entitlement program, which means meeting the eligibility requirements does not ensure one will automatically receive benefits.
Very detailed information is available about this waiver as a PDF download here. This document is not intended for consumers and is not easily understood. More, but limited information, is found on the Illinois Department of Healthcare and Family Services’ website.
Get started through the Illinois Department of Human Services’ application for Medical Assistance. Alternatively, one can learn more through their local Area Agency on Aging. To identify which AAA serves your area, search our directory of AAAs by state and county.
Seniors can also call the Senior Helpline at 800-252-8966 to get help determining if they are eligible.