Medicaid Changes Starting in 2027
Some Illinois adults will need to take new steps to keep Medicaid. Here's what to know and where to get official answers.
Illinois Medicaid Changes in 2027: What You Need to Know
New federal rules will change how some adults in Illinois get and keep Medicaid. Many people won't be affected. This page covers the basics and points you to the State of Illinois, which decides who qualifies.
The Most Important Thing You Can Do Now
Make sure the Illinois Department of Healthcare and Family Services (HFS) has your current address, phone number, and email. HFS will send you a letter if you need to take action. If that letter can't reach you, you could miss a deadline.
What's Changing
A federal law passed in July 2025 changes Medicaid for one group of adults, called "ACA Adults." These are adults who get Medicaid through the Affordable Care Act (ACA) expansion. Illinois must follow this law. HFS says people in this group will need to:
- Renew their coverage every six months instead of once a year.
- Meet new work requirements or qualify for an exemption. In general, this means working, going to school, volunteering, or joining a work program for at least 80 hours a month, or earning at least a set amount each month. HFS has the full rules.
Key Dates
| December 31, 2026, 5 p.m. | New applications sent after this time will follow the new rules. |
|---|---|
| January 1, 2027 | The new rules take effect. If you already have Medicaid, they apply starting at your first renewal on or after this date. |
| March 2027 | HFS says the first renewals that include work requirements will start this month. |
Who May Be Affected
HFS says the changes apply to ACA Adults. In general, that means people who:
- Are ages 19 to 64
- Don't have a child under 18 living with them
- Don't have Medicare
The changes do not apply to everyone with Medicaid. HFS says you won't need to meet work requirements if you are under 19 or over 64, have Medicare, or get Medicaid through another program, such as All Kids or Moms & Babies. Many ACA Adults can also qualify for an exemption. Only HFS can decide if the rules apply to you.
How to Check Your Medicaid Group
- Look for "ACA" in the medical group listed on letters from the State of Illinois.
- Log in to Manage My Case at abe.illinois.gov and open the Benefit Details tab.
- Call HFS at (877) 805-5312.
See the full list of exemptions on the HFS website
What to Do Now
HFS says work requirements haven't started yet, and you don't need to report anything right now. These steps can help you get ready.
Keep Your Contact Info Current
If you move or get a new phone number or email, tell HFS right away. Use the Medicaid Address Change Form or call (877) 805-5312.
Open Mail From the State Right Away
Letters from HFS may be about your coverage. HFS mailed a notice in September 2026 to people who may be affected. Read every letter and follow its steps by the date it gives.
Set Up Manage My Case
Create or log in to your account at abe.illinois.gov. You can check your renewal date, read notices, and update your information.
Keep Proof of Your Hours
Save pay stubs, school schedules, or volunteer records. HFS may ask for proof of work, school, volunteering, or an exemption when you renew.
Where to Get Help
These state agencies and programs are the official sources for Medicaid rules in Illinois. They can answer questions about your coverage.
Illinois Department of Healthcare and Family Services (HFS)
Health Benefits Hotline: (877) 805-5312 · TTY: (877) 204-1012
Check your Medicaid group, update your information, and get answers about the changes. Visit the HFS Medicaid changes page
State Agency
Application for Benefits Eligibility (ABE)
Apply for or renew Medicaid, and use Manage My Case to see your notices and renewal date.
Online
Your Medicaid Health Plan
Call the member services number on your health plan card.
Your plan can help you understand the changes. Learn about HealthChoice Illinois plans
Health Plan
Get Covered Illinois
(866) 311-1119 · getcovered.illinois.gov
The state's health insurance marketplace. It may have other coverage options if you don't qualify for Medicaid.
Marketplace
Illinois Department of Human Services (IDHS)
Customer Help Line: (800) 843-6154 · TTY: (877) 734-7429
Questions about SNAP (Link card) work requirements. Read the IDHS SNAP questions page
SNAP
Get Medicaid Facts (Cook County Health)
Plain language answers and a short quiz. Some events and health plans on this site are for Cook County only.
Partner Resource
Official Documents From HFS
- HFS frequently asked questions about the changes
- HFS notice mailed to ACA Adults in September 2026 (PDF)
- HFS flyer: Changes to Medicaid (PDF)
- HFS SNAP and Medicaid fact sheet (PDF)
Información en español
Common Questions
Will I Lose Medicaid on January 1, 2027?
The new rules start January 1, 2027. But HFS says people who already have Medicaid won't need to show they meet work requirements until their first renewal on or after that date. HFS expects the first of these renewals in March 2027. Be sure to finish every renewal on time.
Do I Need to Do Anything Right Now?
HFS says you don't need to report work hours yet. For now, keep your contact information up to date, open all mail from the State, and set up Manage My Case at abe.illinois.gov.
If I Qualify for an Exemption, Do I Still Need to Renew?
Yes. HFS says ACA Adults will still need to renew every six months, even if they qualify for an exemption.
What If HFS Needs More Information From Me?
HFS says it will first check the information it already has. If it needs more, it will send a notice with your renewal form, and you'll have 30 days to respond. Follow the steps and dates in your notice.
What If My Medicaid Ends?
Your notice from HFS will explain why and how to appeal if you think there's a mistake. You may also be able to find other coverage through Get Covered Illinois.
Who Decides If I Qualify for Medicaid?
Only HFS decides who qualifies for Medicaid and who is exempt from work requirements. For answers about your own case, call HFS at (877) 805-5312 or log in to Manage My Case.
Avoid Scams
The State of Illinois will never ask you to pay to apply for or renew Medicaid. If someone asks you for money to keep your coverage, it's a scam. If you aren't sure a call or message is real, call HFS directly at (877) 805-5312. Report fraud to the Medicaid fraud hotline at (844) 453-7283 or report fraud online.
About This Page
This page shares general information from the Illinois Department of Healthcare and Family Services (HFS) as of October 15, 2026. It is not legal advice, and it does not decide whether you qualify for Medicaid. Rules and dates may change, so check with HFS for the latest information about your coverage. Links to outside websites are offered for your convenience. Riverside Healthcare does not control those sites and is not responsible for their content.