ILLINOIS — Whether you’re turning 65, living with a disability, or struggling with low income, Medicaid and Medicare are two of the most important health coverage options in Illinois. But knowing which one applies to you — and how to apply — can be confusing, especially with changing rules in 2025.
This guide breaks down exactly how Illinois residents can apply for Medicaid or Medicare, who qualifies, and where to get help if you’re stuck.
Who Qualifies for Medicaid in Illinois (2025)?
Medicaid is a state-run program for low-income individuals and families, including:
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Adults earning less than 138% of the federal poverty level
(That’s about $20,783/year for an individual or $43,056/year for a family of four) -
Pregnant individuals
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Children under 19
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People with disabilities
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Seniors over 65 who also meet income limits
Medicaid covers:
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Doctor visits
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Hospital stays
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Dental and vision care
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Prescription drugs
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Long-term care
How to Apply for Medicaid in Illinois
Step 1: Go to ABE.illinois.gov
The Illinois ABE (Application for Benefits Eligibility) portal is the main place to apply:
https://abe.illinois.gov
Step 2: Create an account
You’ll need:
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Name, birthdate, address
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Social Security Number (or immigration documentation)
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Proof of income (pay stubs, SNAP eligibility, or tax returns)
Step 3: Choose Health Coverage
During the application, select “Health Coverage” to apply for Medicaid.
You can also apply for:
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SNAP (food stamps)
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Cash assistance (TANF)
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Disability-related aid
Step 4: Submit Documents
Upload your documents online or submit them by mail or fax. You can also bring them in person to a local DHS office.
Step 5: Track your status
Log into your ABE account or call 1-800-843-6154 to check your case status. Most applications take 2–4 weeks to process.
Who Qualifies for Medicare in Illinois (2025)?
Medicare is a federal program primarily for people who are:
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65 or older
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Under 65 with certain disabilities
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Living with End-Stage Renal Disease or ALS
Most people become eligible around their 65th birthday and do not need to meet an income limit (unlike Medicaid). However, low-income seniors may qualify for both Medicare and Medicaid.
Medicare includes:
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Part A: Hospital care
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Part B: Doctor visits, lab tests, preventive care
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Part D: Prescription drug plans
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Part C: Medicare Advantage (private plan option with extras like dental/vision)
How to Apply for Medicare in Illinois
Step 1: Apply through Social Security
Go to https://www.ssa.gov/medicare/sign-up or call 1-800-772-1213
You’ll need:
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Social Security Number
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Birth certificate or proof of age
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Existing work history (to determine if you qualify for premium-free Part A)
Step 2: Choose how you want to receive coverage
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Original Medicare (Parts A & B)
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Or enroll in a Medicare Advantage (Part C) plan
Use Medicare.gov Plan Finder to compare local plans.
Step 3: Enroll in Part D (Optional but recommended)
Even if you’re healthy, getting a Part D drug plan helps avoid late penalties later on.
Step 4: Apply for Extra Help (if needed)
If your income is low, you may qualify for:
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Medicare Savings Program (covers Part B premium)
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Extra Help for Part D (lowers drug costs)
Applications for these can be made via SSA.gov or through the Illinois Department on Aging’s SHIP counselors.
In-Person Help Available in Cook County
Several nonprofits and government partners can assist with both Medicaid and Medicare applications:
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Catholic Charities of Chicago
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AgeOptions (Cook County SHIP partner)
📞 1-800-699-9043
💻 https://www.ageoptions.org -
Legal Council for Health Justice
Focused on people with chronic illness, HIV, or disabilities
💻 https://legalcouncil.org -
Chicago Department of Family & Support Services (DFSS)
Helps seniors and people with language barriers navigate Medicare
Common Questions from Illinois Residents
“Can I have both Medicaid and Medicare?”
Yes. This is called “dual eligibility.” You’ll often get extra benefits and lower out-of-pocket costs.
“What if I missed my Medicare enrollment window?”
You may qualify for a special enrollment period if you lost other coverage or meet specific circumstances. Call SSA to confirm.
“I applied but haven’t heard back. What do I do?”
For Medicaid: Call 1-800-843-6154
For Medicare: Call 1-800-772-1213 or check your SSA.gov account
Still Confused About Medicaid or Medicare in Illinois?
You’re not alone — and we want to help simplify the system. Share your questions or experiences at chicagosuburbanfamily.com and help us guide others through this process with real community knowledge.
