How Health Benefits Work

Health Benefits for Workers with Disabilities (HBWD)

Look at HBWD if:

  • You are 16-64 years old
  • You have a disability
  • You work
  • You have limited resources, and
  • You are a citizen or eligible immigrant.

Is It Right for You?

Medicaid is government-funded health coverage for people in certain situations. You may qualify if you:

Answer the questions on this page to see if you might qualify for HBWD. If so, it’s a good option to consider because it lets you work, earn more money, and still get great coverage from Medicaid.

Do You Meet HBWD’s Basic Requirements?

To qualify for HBWD, you must:

  • Live in Illinois
  • Be 16 – 64 years old
  • Have a disability
  • Be working and paying FICA taxes, and
  • Be a U.S. citizen or meet specific noncitizen requirements.

If you live in Illinois, are 1664 years old, working, have a disability, and are either a U.S. citizen or a non-citizen who qualifies, HBWD might be an option for you.

Medicaid Rules for Immigrants:

Note: Some immigrants who don't qualify for Medicaid may qualify for other Illinois programs that are similar to Medicaid: if they are 18 or younger, they may qualify for All Kids; if they are 42 to 64 years old, they may qualify for Health Benefits for Immigrant Adults; and if they are 65 or older, they may qualify for Health Benefits for Immigrant Seniors. Note: Illinois has temporarily paused new enrollment in the Health Benefits for Immigrant Adults and Health Benefits for Immigrant Seniors programs.

Do You Have a Disability That Meets Social Security’s Standards?

To qualify for HBWD, you must have a disability that meets Social Security’s definition of disability. For adults, Social Security says you have a disability if:

  • You have a physical or mental impairment or combination of impairments, and
  • Your condition has lasted or is expected to last for at least 12 months.

Note: For HBWD, Social Security’s disability rules related to earned income do not apply.

If you currently get disability benefits, like Social Security Disability Insurance (SSDI), you already meet Social Security’s disability standards. If not, the state will check to see if your disability qualifies for HBWD.

If you already have a disability determination from Social Security or think that your disability meets Social Security’s standards, HBWD might be an option for you.

Do You Have Low Resources?

Resources are money and property you own. For HBWD, you must have less than $25,000 in resources.

Some assets don’t count towards HBWD’s resource limit, like the money that you have in retirement accounts or ABLE Accounts.

If your assets are below the limit, HBWD might be an option for you.

Is Your Income Below HBWD’s Income Limit?

For HBWD, you must have countable income at or below $4,253 per month.

To calculate your countable income, money you spend on some things, like work expenses, day care costs, transportation, and more may be deducted. You could earn as much as $51,930 per year and still qualify!

If your income is low enough and you meet all other requirements, you should apply for HBWD.

Monthly premiums based on income

If you have HBWD coverage, you may have to pay a premium each month. The higher your income, the higher your premium. The maximum premium is $500 per month, but most people pay less.

The HBWD premium is usually a lot lower than the premiums most people pay for individual coverage, and HBWD covers more services than most private insurances.

Note: Medicaid Spenddown is another way to get Medicaid coverage if your income is higher than the regular Medicaid limits. However, a spenddown is almost always more expensive than paying a HBWD premium.

How to Apply

You can apply for HBWD:

For more information or to get an application mailed to you, talk to a Health Benefits for Workers with Disabilities (HBWD) expert at 1-800-226-0768 or 1-866-675-8440 (TTY).

Staying on HBWD

Usually, once approved for HBWD, you continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, disability status, or household size changes, report the change to a Health Benefits for Workers with Disabilities (HBWD) expert within 10 days at 1-800-226-0768 or 1-866-675-8440 (TTY).

Learn more