All Kids Programs for Pregnant Women
Illinois’ CHIP program, All Kids, covers future moms with two programs, making sure they can obtain necessary services during their pregnancy.
- Medicaid Presumptive Eligibility (MPE): Effective instantly upon approval, MPE provides temporary coverage for outpatient medical services designed for pregnant women.
- Moms & Babies: Paying for prenatal and maternity care, this program covers women through pregnancy up to 60 days after the birth of their child. Moms & Babies members have access to covered inpatient and outpatient healthcare, including delivery.
These two programs give pregnant women the care they need to keep their babies healthy. You can apply for both programs at the same time. If you are eligible, MPE will cover you for pregnancy care starting the day you apply until your Moms & Babies application is reviewed. Please continue reading to get more information about healthcare for pregnant women.
Medicaid Presumptive Eligibility
Medicaid Presumptive Eligibility (MPE) is a state-funded program for pregnant women living in Illinois. For eligible women, MPE provides short-term health insurance for select approved services needed during pregnancy, including outpatient care. In order to enroll, you must meet certain income requirements. If you qualify for MPE, you do not have to pay co-payments or premiums for services received through the program.
To enroll in MPE, you must visit an MPE-approved medical provider to determine your eligibility for the program. The provider then gathers proof of pregnancy and income information (gross monthly income for all household members). If you are pregnant and meet the income guidelines you can receive these temporary benefits.
- There are no citizenship or immigration requirements for the MPE program.
- MPE does not require Social Security Numbers to apply.
Finding an MPE Provider
If you already have a primary care physician, including OB/GYNs and community clinics, you can first ask if the doctor or facility is an MPE provider. Otherwise, to locate an MPE provider, call the All Kids Hotline at 1-866-255-5437. A member services representative will help you find a local provider near you.
Immediate Coverage Through MPE
The perk of MPE is that though the program provides limited coverage, once you are approved, your benefits are effective immediately. As soon as an MPE provider confirms you are pregnant and your income meets program guidelines, you can begin receiving care. You can receive services the same day you sign the application if the provider finds you qualify for the program.
MPE Covered Services
You can get outpatient services like prenatal checkups, doctor visits, lab tests, prenatal vitamins, medicine, specialty medical care, eye care, dental care, emergency room care, mental health and substance abuse services, transportation to get medical care and other services. You cannot get hospital services, like labor and delivery, from the MPE program. To get hospital services, you must apply for Moms & Babies.
Length of Coverage
Coverage for outpatient services begins the same day an MPE provider says you qualify for the program and lasts until the last day of the following month — a very temporary plan.
Example 1: On October 1, you sign the MPE application and the MPE provider says you are eligible. You can get outpatient services from October 1 until November 30.
Example 2: On October 31, you sign the MPE application and the MPE provider says you are eligible. You can get outpatient services from October 31 until November 30.
If you don’t apply for the Moms & Babies program, your coverage under MPE will end and you will no longer have access to covered services. Therefore, it is pertinent for all pregnant women enrolled in MPE to apply for Moms & Babies before their benefits expire.
Moms & Babies
The Children’s Health Insurance Program in Illinois, All Kids, provides coverage for pregnant women and their children through Moms & Babies. This program covers inpatient and outpatient hospital care for women during their pregnancy and for for 60 days after giving birth. Additionally, the program covers newborn and infant care until an enrolled child’s first birthday if the mother is insured by Moms & Babies at the time of its birth. Members of Moms & Babies are not required to pay copays or premiums of coverage or services.
It’s essential for current recipients of MPE to apply for Moms & Babies, as MPE only last about a month and only covers a number of outpatient services. Moms & Babies is much more comprehensive, covering all medical care during pregnancy until 60 days after you give birth.
How to Apply
An All Kids Application Agent can help you apply. Many doctors or clinics that care for pregnant women are All Kids Application Agents and can help you complete an application. If you do not have a doctor or clinic, you can:
- Call the All Kids Hotline at 1-866-255-5437 to find a doctor or clinic.
- Call the All Kids Hotline at 1-866-255-5437 to find an All Kids Application Agent in your area who can help you complete the All Kids application.
- Complete the All Kids application yourself and mail it to All Kids.
- Make an appointment at your local Department of Human Services (DHS) office.
If you are pregnant and meet the income requirements for Moms & Babies, you can get Moms & Babies.
- You do not have to be a citizen or a legal immigrant to get Moms & Babies.
- You do not need to have a Social Security number to get Moms & Babies.
If you want other services, like cash assistance or food stamps, you must go to your local DHS office to complete an application.
If you already have MPE when you submit a Moms & Babies application, your MPE coverage is automatically extended while your Moms & Babies application is reviewed. You can keep getting care from your doctor or clinic while All Kids decides if you can get Moms & Babies.
Receiving Your Benefits
You will be sent a written notice indicating whether or not you are approved for Moms & Babies. If you qualify, the notice will tell you the date that your Moms & Babies coverage begins.
Moms & Babies Covered Services
Moms & Babies pays for outpatient maternity care and other outpatient services unrelated to pregnancy, including:
- Prenatal exams
- Prenatal vitamins
- Physician services
- Lab tests
- Specialty medical care
- Emergency room visits
- Medical transportation
- Mental health and substance abuse services
- Hospital services, including labor and delivery
- Newborn checkups, well-baby care, and immunizations
Additional services not listed are also covered by the program. Ask your provider or call the All Kids program to find out if a specific type of care is covered.
Duration of Coverage
Moms & Babies is also short-term, as it lasts the course of your pregnancy and birth. You can receive coverage for services starting up to three months prior to enrollment, while you are pregnant, and for 60 days following childbirth. Women enrolled in Moms & Babies at the time of their baby’s birth can receive All Kids coverage for their baby for one year.
To secure low-cost coverage after your Moms & Babies benefits expire, look into the other programs in your state, such as Medicaid for low-income adults, or the Get Covered Illinois, the health insurance marketplace.