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Can you prove that you are a U.S. citizen or lawfully residing resident? NO. You CAN’T buy insurance in the marketplace or qualify for Medicaid/ Medicare.

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Presentation on theme: "Can you prove that you are a U.S. citizen or lawfully residing resident? NO. You CAN’T buy insurance in the marketplace or qualify for Medicaid/ Medicare."— Presentation transcript:

1 Can you prove that you are a U.S. citizen or lawfully residing resident? NO. You CAN’T buy insurance in the marketplace or qualify for Medicaid/ Medicare. You will get care through the Ryan White program. YES. Do you have Medicaid or Medicare? YES. IF you are already receiving Medicaid or Medicare you do not need to apply for new programs. You CAN’T buy insurance in the marketplace. NO. Does your employer, or your spouse’s employer, offer health insurance that... - Is affordable? (costs less than 9.5% of household income to cover you) - Has decent benefits? (“mini-med” doesn’t count) YES. You are already covered. You CAN’T buy insurance in the marketplace. NO. Is your income lower than column A in the Income Table on the next page? (Use your best guess for your income.) YES. You may qualify for Medicaid in Illinois. Are you a resident of Cook County? YES. You may qualify for CountyCare NOW. Apply online at countycare.com or call NO. You may qualify for Medicaid in Illinois. You can start applying on October 1, NO. Is your income higher than column B in the Income Table on the next page? YES. You may be required to buy insurance on the marketplace. The federal government and ADAP will help you afford the cost. You can apply starting October 1, Health Care Reform and YOU Living with HIV or chronic disease? Follow the question tree to find out where you fit in health care reform. Receive Ryan White services Stay on Medicaid or Medicare Stay on company health insurance Apply for Medicaid after October 1 Apply for CountyCare now Apply for the Insurance Marketplace after October 1 *Enrollment for new health plans begins October 1, You will fill out the same application for Medicaid or the marketplace. Stay tuned to find out how to apply. Start Here Under health care reform I think I qualify for ___________________________ health coverage. (Use the question tree to find out where you fit into health care reform).

2 Medicaid, Marketplace Insurance, and Illinois ADAP Income Thresholds ABC Number of people in your household If your income is less than this amount you should apply for Medicaid in Illinois. If your annual income is more than this amount you can get insurance on the marketplace. The federal government will help you pay for the insurance. ADAP will also help pay but only for some plans (list available after Oct. 1). Your income must be below this amount to qualify for federal help affording marketplace plans and ADAP assistance. 1 $15,856/year or $1,320/month$15,857/year or $1,321/month Marketplace: $45,960 ADAP $57,450 2 $21,404/year or $1,783/month$21,405/year or $1784/month Marketplace: $62,040 ADAP $77,550 3 $26,951/year or $2,245/month$26,952/year or $2,246/month Marketplace: $78,120 ADAP $97,650 4 $32,499/year or $2,708/month$32,500/year or $2,709/month Marketplace: $94,200 ADAP $117,750 Income thresholds are: A.Eligible for Medicaid in Illinois: income under 138% of federal poverty level. People under this income level can qualify for Medicaid in Illinois. B.Required to have coverage : income over 139% of federal poverty level (some exemptions apply). Coverage can come from employer, marketplace, government, or private market C.Income ceilings: individuals must have income below 400% of federal poverty level to qualify for federal help on the marketplace, and 500% of federal poverty level to qualify for Illinois ADAP assistance. Adapted from Duke AIDS Legal Project, June 2013, by AIDS Foundation of Chicago. July 16, Contact Lucy Baglin at or


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