Medicaid Awareness Month
Medicaid has been helping low-income individuals access care since it was established in 1965 under the Social Security Act and expanded further in 2010 through the Affordable Care Act (ACA).
Medicaid is paid jointly by the federal and state governments and currently covers 3.4 million people in Illinois—that’s 1 in 4 residents statewide. Of those covered, 44% are children, illustrating how vital Medicaid is for supporting family health and development.
What Is Medicaid?
Understanding Medicaid’s benefits and eligibility can help you make informed decisions about your health care. Medicaid is a government-funded health insurance program that covers the cost of medical care for people who qualify. It is available only to individuals and families with low income who meet specific eligibility criteria. Medicaid pays health care providers directly. Depending on the service, you may still be responsible for a small copay if Medicaid doesn’t cover the full cost.
How Do I Know If I Qualify for Medicaid?
To qualify for Medicaid, you must meet income requirements based on the federal poverty level. Because Medicaid is administered by each state, eligibility rules in Illinois may differ from those in other states.
In Illinois, Medicaid covers:
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Preventive care
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Primary care
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Hospital and emergency services
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Mental health and substance use treatment
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Prescription medications
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Maternity care
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Long-term care services
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Dental and vision care (for eligible individuals)
As of October 2024, more than 3 million individuals in Illinois are enrolled in Medicaid and the Children’s Health Insurance Program (CHIP), according to Medicaid.gov.
Most Illinois residents qualify for Medicaid based on Modified Adjusted Gross Income (MAGI). Adults ages 19–64 may be eligible if their income is up to 138% of the federal poverty level under Illinois’ expanded Medicaid program. This ACA expansion currently covers 770,000 Illinoisans and is funded 90% by the federal government. Unfortunately, this group—single adults without children—is the population most at risk of losing coverage due to proposed federal cuts.
Who Else Can Qualify for Medicaid?
In addition to low-income adults, other groups may qualify for Medicaid coverage, including:
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Pregnant individuals, regardless of marital status
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Parents or guardians of children under 18
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Seniors (65+), people with disabilities, or those who are blind
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Individuals receiving Supplemental Security Income (SSI) or certain other public benefits
How Can Pillars Community Health Help?
Pillars Community Health (PCH) offers several affordable options for patients to receive care. In addition to accepting commercial insurance, we also accept Medicaid and participate in Medicaid Managed Care Plans—commonly used in Illinois.
For those without insurance, PCH offers a sliding fee scale for individuals whose income falls below the federal poverty level. Through partnerships with the Community Memorial Foundation and UChicago Medicine AdventHealth La Grange, qualifying patients in specific geographic areas may receive further discounted rates on select services.
PCH doesn’t just accept Medicaid—we help people navigate it. Our Benefits & Enrollment Team specializes in supporting patients through every step of the health care process, including:
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Applying for Medicaid for the first time
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Completing annual redeterminations to maintain coverage
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Transitioning from Medicaid to commercial insurance, with explanations about deductibles, copays, and covered services
During visits to our health centers, our team can help determine what benefits you may be eligible for. Many individuals lose coverage simply because they forget to complete their annual redetermination. Medicaid coverage is not permanent—renewal is required each year. If you receive a renewal notice, responding on time is essential. We’re here to help.
Our team also attends community events throughout the year to raise awareness about Medicaid and provide on-the-spot support. When not out in the community, we’re at our health centers, ready to help patients apply for Medicaid or complete their redetermination process. If you’re transitioning to commercial insurance, we’ll walk you through what your new coverage will look like and explain unfamiliar terms like deductibles and copays.
We’re Here for You
Medicaid provides peace of mind to millions by ensuring access to essential health care—and Pillars Community Health is here to help you every step of the way. Whether you need help applying, renewing, or understanding your Medicaid options, our team is here to support you.
We work closely with you to get you the best care possible, connecting you to services that meet your physical, behavioral, and social needs. Contact us today to connect with our Benefits & Enrollment Team and take control of your health coverage.