In order to qualify for waiver services or to reside in a Supportive Living Facility, you must meet certain eligibility requirements. Molina Healthcare does not determine your eligibility into the Waiver or Nursing Home programs. Eligibility is determined by the Illinois Department of Human Services' Division of Rehabilitative Services (DRS) or by the Illinois Department on Aging (IDoA).
If DRS or IDoA has decided you are eligible, you will be asked to select a health plan or managed care organization. A health plan will be assigned for you if you did not make a choice.
The following are some of the eligibility requirements of the Departments:
- Be a resident of the State of Illinois
- Be a citizen of the United States or a legally admitted alien
- Have a DON score of 29 points or more
- Have less than $17,500 in assets or $35,000 family assets for a child under the age of 18
- Needs will be met at a cost less than or equal to the cost of nursing services in an institutional setting
- Fully cooperate with the Medicaid application process and maintain Medicaid eligibility
If you do not meet or maintain your eligibility requirements to get waiver services according to DRS or IDoA standards, you may be disenrolled. DRS or IDoA will send you a notice if they find that you are no longer eligible to get waiver services. The notice will include the date that the waiver services will stop because you are no longer eligible. Molina Healthcare will also be told. This would not impact your medical health care benefits with Molina Healthcare. You will still be a Molina Healthcare member, and Molina Healthcare will still cover your medical health care benefits.