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Copays remain suspended for undocumented individual healthcare program

19 Oct 2023 6:04 PM | Deborah Hodges (Administrator)

Copays will remain suspended in a program that provides Medicaid-like coverage to undocumented individuals, an official from the Department of Healthcare and Family Services said Tuesday. [Health News Illinois]

Omar Shaker, a department attorney, told members of the Joint Committee on Administrative Rules that work continues to address an issue that prevented the existing system from allowing them to receive matching federal dollars when a non-citizen requires an emergency room visit.

“We do concede that at this time we are not prepared to move forward with the copay and cost-sharing elements,” Shaker said.

The agency sent a notice last month to providers saying they should not charge cost-sharing for the population “until further notice.” Any cost-sharing that providers may have already collected must be returned.

Shaker said they do not have a hard timeline for when cost-sharing measures may return. The earliest could be January.

The agency this summer also placed a pause on new enrollees between the ages of 42 and 64. Seniors can still join the program until their enrollment reaches 16,500.

Shaker said Tuesday that 16,117 individuals 65 years and older are enrolled in the program.

 Additionally, Shaker said the department remains in communication with managed care organizations to establish a coordinated effort to incorporate them into the program next January. The move, he said, will help in “lowering the cost of the program while still providing all of the necessary elements.”

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