Medicaid Changes in Illinois
Medicaid requirements are changing. Here's what Illinois Medicaid members need to know about who may be affected, what they need to do and when they need to act.
What is Changing for Illinois Medicaid?
A new federal law (the One Big Beautiful Bill Act) and new Illinois state law are adding work requirements — also called community engagement requirements — to Medicaid.
Beginning January 1, 2027, many adults part of the Affordable Care Act Medicaid eligibility group ages 19 to 64 who have Medicaid, will need to complete and report at least 80 hours per month of qualifying activities to keep their coverage.
Qualifying activities include:
- Working at a job (employed, self-employed, and/or seasonal)
- Taking part in a work program or job training
- Volunteering or doing community service
- Attending school or an education program at least half-time
- Reporting an income or at least $580 or more per month
- If work is seasonal, earn an average of that same amount over the last 6 months
- A combination of any of these activities
The state will also review Medicaid eligibility more often, with re-determinations occurring every six months instead of every 12 months.
How to Report Your Community Engagement Requirements:
You can report a qualifying activity
- Online, under "Manage By Work Requirement" in your ABE Manage My Case account
- By phone, through calling the ABE Customer Service line at 1-800-843-6154 (1-866-324-5553 TTY)
Who May Be Exempt?
Not everyone has to meet the work requirement. You may be exempt if one or more of the following applies to you:
- You are under 19 or over 64 years old
- Enrolled in Medicare Part A or Part B
- You are enrolled in another Medicaid category, such as AABD, Moms & Babies, Family Care, or other programs.
- You are a parent or caretaker of a dependent child age 13 or younger
- You are a caregiver for a person with a disability
- You are medically frail or have a serious health condition that keeps you from working, such as:
- A serious physical, intellectual or developmental disability (including blindness)
- A substance use disorder
- A serious mental health condition
- Another serious or complex medical condition
- You are pregnant or had a baby up to 12 months ago (postpartum)
- You are taking part in a drug or alcohol treatment program
- Are an inmate of a public institution (jail or prison) or were released in the last 90 days
- You are a veteran with a total (100%) disability rating
- You are under age 26 and were formerly in foster care
- You are a recognized member of a federally recognized tribe (certain American Indian or Alaska Native individuals)
- You are already following the work rules for TANF
- You are meeting or are in the 3-month grace period for SNAP work requirements.
How to Report Your Exemption:
You can report your exemption to Illinois Medicaid by
- Submitting an exemption request through "Manage My Work Requirement" in your ABE Manage My Case account
- Calling the ABE Customer Service line at 1-800-843-6154 (1-866-324-5553 TTY)
In 2027, Illinois will accept “self-attestation” from customers of exemptions to work requirements if we are unable to verify the exemptions through our data sources. Self-attestation requires you to promise that the information is true under penalty of perjury. If the state’s data sources provide conflicting information, we may request additional proof from you.
Please note: even if you are exempt from work requirements, you will still need to renew your coverage every six months.
What You Can Do Now
Even if the changes do not take effect right away, there are steps you can take now to prepare.
1. Create or Log-Into your "Manage My Case" Account
An Illinois HFS account is fastest way to get updates and notices, check if you’re exempt, submit paperwork and prepare for work requirements. Go to https://abe.illinois.gov/access For more information on how to create an account and what information you will be able to access, please visit https://www.thewellfund.org/illinoismedicaidabe. Make sure your address is up-to-date so that you receive any notices or mail to come.
2. Watch your Mail
The Illinois Department of Healthcare and Family Services (HFS) will send you a notice about your work-requirement status. Read it carefully and respond by the date listed.
3. Do Not Wait: Take Action Before Your Deadline
Because these requirements begin January 1, 2027, confirming your status early gives you time to fix any problems before your coverage is affected.
Important Dates
Your may have additional personal deadlines. Be sure to review any notices from Illinois HFS for deadlines that apply to you specifically.
Date | What happens | What you need to do |
October 2026 | All new Medicaid applications will require work requirement compliance for approval unless the applicant is exempt. | Watch for a notice from your state Medicaid agency with your work-requirement status. Report Medicaid requirements and documentation or confirm an exemption with your state by the date listed. |
November 1, 2026 - January 15, 2027 | The ACA Open Enrollment Period allows you to sign up for a health insurance plan through the federal or state Marketplace. | If you think you may not meet the Medicaid work requirements or qualify for an exemption, call The WellFund at 812-329-2579 to explore Marketplace coverage options. |
January 1, 2027 |
| Watch for continuing notices from your state Medicaid agency. Report exemptions, qualifying activities, or eligibility reviews as required. |
Worried You Might Lose Medicaid? The WellFund Can Help.
If you think you may no longer qualify for Medicaid because of the new work requirements, please contact The WellFund. We can help you understand your options and, if you do lose Medicaid coverage, help you enroll in coverage through the Health Insurance Marketplace and explore any premium assistance you may qualify for.
Call The WellFund at 812-329-2579, Monday through Friday from 8:00 a.m. to 5:00 p.m. or email at Deaconess@TheWellFund.org. We strongly encourage you to call if you have questions or need help. There is no charge for this service.
Learn more about The WellFund →
