Illinois § 12-4.59

§ 12-4.59.

Informational guide on Medicaid 5-year look-back period. (a) Informational guide. On and after July 1, 2025, the Department of Healthcare and Family Services shall develop, post, and maintain on its official website a comprehensive informational guide that explains the Medicaid 5-year look-back period as it applies to eligibility for long-term care coverage under the medical assistance program established under Article V of this Code. The contents of the informational guide must include the following: (1) Overview of the Medicaid 5-year look-back period: A detailed explanation of the 5-year look-back period, including its purpose and relevance to eligibility for medical assistance. (2) Eligibility criteria affected by the Medicaid 5-year look-back period: Clear information on how the 5-year look-back period affects eligibility criteria, including income and asset requirements. (3) Calculation of the Medicaid 5-year look-back period: Step-by-step guidance on how the 5-year look-back period is calculated, including the start date and end date considerations. (4) Examples and scenarios: Real-life examples and scenarios illustrating how the 5-year look-back period applies in different situations, providing practical insights for the public. The guide must include a calculator that allows a user to enter the transfer dates and monetary value of any assets the user transferred during the 5-year look back period in order to estimate the earliest date upon which the user may qualify for medical assistance for long-term care services. (5) Transfers or gifts during the Medicaid 5-year look-back period: Explanation of the consequences and implications of transfers or gifts made during the 5-year look-back period, emphasizing the impact on eligibility and potential penalties. (6) Exceptions and exemptions: Information on exceptions and exemptions to the 5-year look-back period, clarifying circumstances where certain transfers or assets may not be subject to scrutiny. (7) Documentation requirements: Guidance on the documentation individuals may need to provide or maintain to demonstrate compliance with the 5-year look-back period. (8) Planning for eligibility: Tips and considerations for individuals and families on how to plan for eligibility for medical assistance under Article V of this Code, taking into account the 5-year look-back period. (9) Appeals and dispute resolution: Information on the process for appeals and dispute resolution related to decisions made based on the 5-year look-back period. (10) Contact information and resources: Clear and accessible contact information for the Department of Healthcare and Family Services, as well as a listing of additional resources or agencies that individuals can reach out to for assistance or further clarification. (11) Frequently asked questions: A "Frequently Asked Questions" section that lists common questions and concerns related to the 5-year look-back period and provides a quick reference for users. (b) Accessibility of the guide. To ensure user-friendly navigation and visibility, the Department of Healthcare and Family Services shall post on its official website detailed information on how users can easily access the comprehensive guide on the website and a hyperlink that directs users to the comprehensive guide. (Source: P.A. 103-997, eff. 1-1-25.)