To Apply for Illinois Medical Benefits

Persons who come to Illinois from designated Hurricane Katrina disaster areas may be temporarily enrolled for medical benefits in Illinois if they meet Illinois' eligibility criteria and regardless of whether they are enrolled in their home state.

HFS encourages persons who have come to Illinois from disaster areas to apply at the local Department of Human Services Family and Community Resource Center (FCRC) to make certain they receive all available benefits. However, they may also apply solely for medical benefits through our existing processes for completing a mail-in or online applications.

HFS has relaxed verification requirements for disaster evacuees. To take advantage of these special procedures, Form 2378KAT, Supplemental Information From Hurricane Katrina Evacuees Applying For Medical Benefits By Mail Or Online 2378 KAT, must be completed and submitted with any application for medical benefits that is submitted by mail to Department of Human Services Family and Community Resource Centers or by mail or online to HFS’s KidCare Unit.

Instructions for completion of Form 2378KAT:

• enter the applicant's name, birth date and Social Security Number;
  
• enter the applicant's mailing address from their home state;
  
• enter the applicant's home state and county or parish;
  
• check the reason you know the applicant has come to Illinois from a designated disaster area.
  
• enter the name and phone number of the person completing the form.
  
• submit completed 2378KAT with the application for medical benefits.

Form 2378KAT is also available in Spanish.

To apply for Medical Benefits only:

For Children parents or caretaker relatives may use the KidCare/FamilyCare application.

Seniors and persons with disabilities may use the mail-in application for Medical Benefits 2378H.

Anyone may call toll-free with questions, 1-800-226-0768, (persons who are hearing impaired may call, toll-free, 1-877-204-1012 to have an application and supplemental form mailed to them).

Providers may reproduce these forms or can request copies online using the Medical Provider Forms Request.