Health insurance for undocumented immigrants in Illinois looks very different in 2026 than it did a year ago. Children under 19 can still get full coverage through All Kids regardless of immigration status. Adults 65 and older can enroll in Health Benefits for Immigrant Seniors. Everyone in between lost their state-funded option on July 1, 2025, when the Health Benefits for Immigrant Adults program closed, and now has to rely on emergency medical coverage, hospital charity care, community health centers, or private insurance purchased outside the government marketplace.
Children Under 19: All Kids
All Kids covers children in Illinois regardless of immigration status. It pays for doctor visits, hospital stays, prescriptions, dental care, vision, and behavioral health services, and it is one of the most generous children’s health programs in the country.1Illinois Department of Healthcare and Family Services. About All Kids
Cost depends on family income. All Kids Assist has no premiums or copayments and covers a family of four earning up to roughly $36,168 per year. Premium Level 1 charges $15 per month for one child (up to $30 for three) with small copays, and reaches families of four earning between about $38,640 and $51,420. Premium Level 2 costs $40 per month for one child ($80 for two), adds higher copays and a $100 hospital copay, and covers families of four earning up to about $78,228. These income figures may be adjusted annually.
Once a child is enrolled, coverage continues for a full 12 months regardless of income changes during that period.1Illinois Department of Healthcare and Family Services. About All Kids
Adults 65 and Older: Health Benefits for Immigrant Seniors
HBIS is the only comprehensive state-funded health program still open to undocumented adults in Illinois. Run by the Department of Healthcare and Family Services, it covers primary care visits, hospital stays, prescription drugs, dental and vision services, vaccinations, and medical transportation. The coverage closely mirrors standard Medicaid.2Illinois Department of Healthcare and Family Services. Health Benefits For Immigrant Seniors
Most services carry no out-of-pocket cost. There are two exceptions: non-emergency inpatient hospital stays have a $250 copayment per admission, and non-emergency outpatient hospital or ambulatory surgical center visits require you to pay 10 percent of what HFS would reimburse the provider. Primary care doctors, federally qualified health centers, and pharmacies remain free.2Illinois Department of Healthcare and Family Services. Health Benefits For Immigrant Seniors
To qualify, you must be 65 or older, live in Illinois, be a noncitizen who does not qualify for standard Medicaid because of immigration status, and fall within the program’s income limits. The income threshold has historically been set at roughly 100 percent of the federal poverty level, which for 2026 is $15,960 for a single person and $21,560 for a two-person household.3U.S. Department of Health and Human Services. 2026 Poverty Guidelines Call 1-800-843-6154 or check the HBIS page for the current program figures before applying.
HBIS is funded entirely by Illinois tax revenue, with no federal match. Its future depends on annual budget decisions by the General Assembly, and that same fiscal pressure ended the companion program for younger adults.
Adults 19 to 64: What Remains After HBIA Closed
The Health Benefits for Immigrant Adults program, which covered undocumented residents aged 42 to 64, ended on July 1, 2025. The last day of coverage was June 30, 2025. HFS cited State Fiscal Year 2026 budget constraints and chose to keep funding only the senior program.4Illinois Department of Healthcare and Family Services. Health Benefits For Immigrant Adults
No replacement has been created. If you previously had HBIA, that comprehensive benefit is gone. Adults between 19 and 64 who cannot access employer coverage are left with a patchwork: emergency Medicaid for crises, hospital charity care for large bills, and community health centers for routine care.
Emergency Medical Coverage for Noncitizens
Undocumented adults who do not qualify for HBIS can receive emergency medical coverage when a qualifying medical crisis occurs. This is not insurance you carry around. It is retroactive coverage for a specific emergency after treatment has been provided.5Illinois Department of Human Services. Emergency Medical Coverage for Noncitizens
A qualifying emergency is a condition with acute symptoms severe enough that a doctor would reasonably expect it to place your health in serious jeopardy, cause serious impairment of bodily functions, or result in serious dysfunction of an organ. Labor and delivery qualifies. The attending physician must complete an HFS Form 3801 documenting the diagnosis, onset date, and the date you were stabilized.5Illinois Department of Human Services. Emergency Medical Coverage for Noncitizens
Two rules catch people off guard. You must file a separate application for each emergency, and coverage cannot be authorized in advance. You must also meet Illinois residency requirements, so someone who came to the state specifically to receive medical care does not qualify.5Illinois Department of Human Services. Emergency Medical Coverage for Noncitizens
Hospital Financial Assistance
The Illinois Hospital Uninsured Patient Discount Act requires hospitals to offer discounted or free care to uninsured patients regardless of immigration status. This is one of the most underused protections available in the state.
At most hospitals, if your income is at or below 200 percent of the federal poverty level, the hospital must waive 100 percent of charges for medically necessary services exceeding $150 in a single visit or admission. For a single person in 2026, that threshold is $31,920 in annual income. If your income is at or below 600 percent of the federal poverty level (up to $95,760 for a single person), the hospital must provide a discount, though not necessarily a full waiver, on medically necessary services exceeding $150.6Illinois General Assembly. Hospital Uninsured Patient Discount Act3U.S. Department of Health and Human Services. 2026 Poverty Guidelines
You must apply for the discount. The hospital defines “uninsured patient” as an Illinois resident not covered by any health insurance or public benefits program. The discount applies to medically necessary care only, not elective procedures. If you receive a large hospital bill, ask the billing department about this program before you pay anything or agree to a payment plan.
Community Health Centers
Federally qualified health centers serve everyone regardless of insurance status, ability to pay, or immigration status. Illinois has a network of FQHCs across the state that provide primary care, preventive services, dental care, and behavioral health on a sliding fee scale tied to household income. For someone with no insurance and low income, out-of-pocket costs at an FQHC can be minimal or zero.
For adults between 19 and 64 who lost HBIA, an FQHC is often the most practical option for routine medical care. It will not cover hospitalizations or specialist referrals the way insurance would, but it keeps you connected to a primary care provider who can manage chronic conditions and handle preventive care.
Private Insurance and the Marketplace
Undocumented residents cannot buy health insurance through Get Covered Illinois or any Affordable Care Act exchange. Federal law limits marketplace enrollment to U.S. citizens, nationals, and lawfully present noncitizens, and this bar applies even if you would be paying full price with no subsidy.7Get Covered Illinois. Frequently Asked Questions
You can buy directly from a private carrier outside the marketplace. Those plans do not qualify for federal premium tax credits, so you pay the full cost. Some insurers offer plans designed for people who cannot access the ACA marketplace, though premiums run significantly higher than subsidized marketplace plans. Before signing up, check whether the plan covers pre-existing conditions, has annual or lifetime benefit caps, and includes the hospitals and doctors you use.
Employer-sponsored coverage is often the more affordable route because the employer pays part of the premium. Eligibility depends on the employer’s internal policies, and not all employers verify immigration status for health plan enrollment.
How to Apply
Applications for HBIS, All Kids, and emergency medical coverage all go through the Application for Benefits Eligibility portal at abe.illinois.gov.8Illinois.gov. Application for Benefits Eligibility You can also request a paper application or apply in person at a local Department of Human Services Family Community Resource Center.9Illinois Department of Human Services. Cash, SNAP and Medical Assistance
Before you start, gather proof of identity (a passport, consular identification card, or other government-issued photo ID), proof of Illinois residency (a utility bill, lease agreement, or mortgage statement showing your name and address), and proof of income (recent pay stubs, tax returns, or a signed letter from an employer if you are paid in cash). After you submit, expect a phone or in-person interview during which the caseworker will tell you what additional documentation is needed.
If you enroll in HBIS, the state reviews your eligibility every year. HFS sends a redetermination form, and you must verify that you still meet the income, age, and residency requirements. Ignore that form and you lose coverage, and people who let it lapse often face gaps in care while they reapply. The Immigrant Family Resource Program can help walk you through the process at 312-793-7120.10Illinois Department of Healthcare and Family Services. Health Benefits for Immigrants
What Enrolling Means for Immigration Status
Fear of immigration consequences keeps many eligible people from signing up for programs they qualify for. Under the 2022 public charge rule, the federal government generally does not consider noncash benefits when evaluating whether someone is likely to become a public charge. Medicaid, SNAP, housing assistance, and children’s health programs are explicitly excluded from that determination. The only health-related benefit that counts against you is long-term institutionalization at government expense, such as an extended stay in a nursing facility or mental health institution paid for by Medicaid or a state program. Enrolling in HBIS, All Kids, or receiving emergency medical coverage does not fall into that category.11U.S. Citizenship and Immigration Services. How Receiving Public Benefits Might Impact the Public Charge Ground of Inadmissibility Fact Sheet
Immigration policy can change. If you have a pending application for a visa or change of status, talk with an immigration attorney before making decisions based on general guidance. The analysis for your specific situation may look different.