Illinois Medicaid and Medicare Delays in 2025: Wait Times, Recertification Backlogs, and Premium Pressures

ILLINOIS — If you’ve applied for Medicaid or Medicare in 2025 — or tried to renew your benefits — there’s a good chance you’ve hit a wall. Across Illinois, residents are reporting long wait times, confusing recertification letters, and rising out-of-pocket costs.

Here’s what’s behind the delays, how rising premiums are impacting families, and what you can do to stay covered.

Medicaid Recertification Backlogs Are Growing in Illinois

Since pandemic-era protections ended, the Illinois Department of Healthcare and Family Services (HFS) has resumed annual Medicaid redeterminations — and the system is overwhelmed.

Illinois is processing hundreds of thousands of eligibility renewals each month, often with limited staff.

Common problems residents are reporting:

• Not receiving recertification forms in the mail

• Getting cut off even after submitting paperwork

• Long call center wait times (over 1 hour in some regions)

• Managed care plans suddenly dropping coverage

If your Medicaid was canceled without notice, call 1-800-843-6154 or visit abe.illinois.gov to reapply or file an appeal.

“We’re hearing from seniors and families who had no idea their coverage ended until they showed up at the doctor,” said a caseworker with Legal Aid Chicago.

Medicare Premiums Are Rising in 2025

While Medicare doesn’t require yearly recertification like Medicaid, the cost to stay covered has gone up in 2025, putting more pressure on low-income seniors.

According to the Centers for Medicare & Medicaid Services:

Even small increases can be a burden for seniors living on Social Security checks averaging $1,900/month.

Seniors with limited income should apply for:

• Medicare Savings Programs (cover Part B premium)

• Extra Help (Low-Income Subsidy) for Part D drug plans
  👉 Apply via ssa.gov/extrahelp

Accessing Care Is Getting Harder, Especially for Dental and Vision

Even with coverage in place, Illinois residents are struggling to access basic care — especially dental and vision services under Medicaid and Medicare Advantage plans.

Common barriers include:

• Few dentists accepting Medicaid in suburban and rural areas

• Three-month+ wait times for eye appointments

• Network changes in Medicare Advantage plans (doctors no longer in-network)

If you’ve been dropped by your provider, contact your managed care plan or call the Illinois Client Enrollment Services line: 1-877-912-8880

How to Avoid Losing Coverage

To avoid a gap in your Medicaid or Medicare benefits in 2025:

Update your mailing address in ABE or SSA portal
Set calendar reminders for renewals and Medicare enrollment periods
Check your managed care provider list every few months
Use legal aid groups if you’re denied without cause

Nonprofits like AgeOptions, Legal Council for Health Justice, and Catholic Charities of Chicago offer free help across Cook County.

Quick Help Guide

Are You Facing Health Coverage Delays in 2025?

Have you had your benefits cut off or seen your premiums rise without warning? We’re covering how these changes affect real Illinois families. Share your story at chicagosuburbanfamily.com and help others in your community stay informed and prepared.