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  • Il Dhs Form Il444-2378b 2021

Get Il Dhs Form Il444-2378b 2021-2025

State of Illinois Department of Human ServicesRequest for Cash Assistance Medical Assistance Supplemental Nutrition Assistance Program (SNAP) Last Name: First Name:MI:Maiden Name:2aabfaa2d3e747d285471ab9b3cfbd4cPresent.

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How to fill out the IL DHS Form IL444-2378B online

This guide provides clear instructions for completing the IL DHS Form IL444-2378B online. By following the steps outlined below, users can efficiently fill out the form for cash and medical assistance.

Follow the steps to successfully complete the form online.

  1. Click ‘Get Form’ button to obtain the form and open it in your editor.
  2. Start by entering your last name, first name, middle initial, and maiden name as needed in the designated fields.
  3. Fill in your present address, including the apartment number, city, state, zip code, and county.
  4. Provide your birth date and social security number in the designated fields.
  5. Complete the mailing address section if it differs from your present address, including the same city, state, and zip code.
  6. Indicate your telephone numbers for both home and work, and provide the best time to reach you.
  7. Respond to the question about homelessness by selecting 'Yes' or 'No'.
  8. If you wish to name an approved representative, complete that section with their name, address, and phone number.
  9. Sign Page 18 to confirm the application, noting that this signature will start the application process.
  10. Review all entered information for accuracy before saving, downloading, or printing the form.

Complete your applications online today and take a step towards securing your benefits.

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Related content

Medical Forms | HFS - Illinois.gov
Request for Cash Assistance - Medical Assistance - Supplemental Nutrition Assistance...
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SNAP - Rock Valley College
IL444-2378B (R-11-17) Request for Cash Assistance - Medical Assistance ... form at home...
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Illinois Medicaid? Household Size*Maximum Income Level (Per Year)1$20,1212$27,2143$34,3074$41,4004 more rows

By Phone Call the DHS Help Line at 1-800-843-6154; 1-866-324-5553 TTY. Available Monday - Friday, 8:30 AM - 4:30 PM. Closed State holidays. Follow the prompts for SNAP, Cash and Medical benefits to speak to a Customer Service Agent.

This may include medical care/treatment/supplies, nursing home services, in-home personal care, Medicare premiums, and prescription drugs. Effective April 2023 – March 2024, the Medically Needy Income Limit (MNIL) in IL is $1,215 / month for an individual and $1,643 / month for a couple.

Who is eligible for Medicaid? If you are 65 or older, you are eligible for Medicaid if you have income below $973 a month and countable assets below $2,000. People on SSI or SSDI or who are disabled ing to the Social Security definition of disability are also eligible for Medicaid.

Not be eligible for the state's regular medical program for those with disabilities - the applicant cannot be eligible for a regular non-spenddown medical card....​To be eligible for the HBWD program, the individual must: Family Size350% Federal Poverty Level1$ 3,4332$ 4,6463$ 5,8604$ 7,073

ACA Adults – under the Affordable Care Act (ACA), adults age 19-64 who were not previously eligible for coverage under Medicaid can now receive medical coverage. Individuals with income up to 138 percent of the federal poverty level (monthly income of $1,366/individual, $1,845/couple) can be covered.

Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Eligibility limits for single adults without dependent children are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

This may include medical care/treatment/supplies, nursing home services, in-home personal care, Medicare premiums, and prescription drugs. Effective April 2023 – March 2024, the Medically Needy Income Limit (MNIL) in IL is $1,215 / month for an individual and $1,643 / month for a couple.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232