Start date
During 2027, based on application or redetermination date
Coverage group
Affordable Care Act Adults
Qualifying activity
Generally 80 hours in one month or another pathway
Who may be affected?
The new rules affect certain adults in the Affordable Care Act Medicaid eligibility group, often called ACA Adults. This group generally includes adults age 19 through 64 who are not entitled to Medicare.
You can find your medical group by logging in to Manage My Case, reviewing your Illinois Medicaid notices or calling HFS at 1-877-805-5312.
When do the requirements begin?
If you are applying for Medicaid: New applicants who are subject to the requirements must meet or be exempt from them for applications submitted after 5 p.m. on December 31, 2026.
If you already have Medicaid: ACA Adults already enrolled must meet or be exempt from the requirements beginning with their first redetermination on or after January 1, 2027.
ACA Adults will also move from 12-month to six-month redetermination periods after their first redetermination in 2027.
How can you meet the requirements?
If the requirements apply to you, qualifying pathways may include:
- Working at least 80 hours in a month;
- Volunteering at least 80 hours in a month;
- Attending school, including high school, GED, college or trade school;
- Participating in a work program;
- Combining qualifying activities to reach 80 hours in a month; or
- Meeting Illinois’ countable-income pathway.
If you attend school at least half-time, you meet the work requirement. Less-than-half-time school hours can be combined with other qualifying activities. Use the official HFS resources below for current details.
You may qualify for an exemption
You may not have to meet the work requirements if Illinois HFS confirms that an exemption applies.
Examples of possible exemptions
- Pregnancy or being within 12 months after giving birth;
- A 100% disability rating from the U.S. Department of Veterans Affairs;
- Being an American Indian or Alaska Native;
- Being a former foster youth under age 26;
- Caring for a young child or a dependent person with a disability;
- Having a medical condition that prevents you from meeting the requirements;
- Receiving TANF and meeting TANF work requirements;
- Meeting or being in the three-month grace period for SNAP work requirements;
- Participation in a drug or alcohol treatment program; or
- Current incarceration or release from jail or prison within the last three months.
The work requirements also generally do not apply to people under age 19 or over age 64, people enrolled in or entitled to Medicare, or people enrolled in another Medicaid eligibility category such as AABD, Moms & Babies or FamilyCare.
What should you do now?
- Create or log in to Manage My Case. Check your medical group and redetermination date, review notices, report changes and manage your case.
- Keep your contact information current. Make sure Illinois HFS has an address, phone number and email address that reach you.
- Read every notice. Illinois HFS will contact Medicaid customers directly before a change affects coverage.
- Keep records. Save proof of work or other qualifying activities and information that may support an exemption.
- Complete every redetermination. Even if you qualify for an exemption, you must still renew your coverage when required.
How will Illinois verify information?
Illinois will use information already available to the state when possible. If the state cannot verify an exemption using its data, customers may be allowed to self-attest to certain exemptions. HFS may request documentation when information conflicts with state records.
If HFS cannot verify that you met the requirement or qualify for an exemption, it may request more information during your redetermination. You will have 30 days to respond. Coverage may end at the end of the current eligibility period if the requirements are not met, no exemption applies and the requested information is not provided.
Get official Illinois information
Use these Illinois resources for current requirements and instructions.
Need help finding information?
Centerstone Navigators across Illinois can help you find information and resources. In some cases, they may be able to help you understand whether the requirements may apply or help you submit documents requested by the state.
Ask your Centerstone provider to connect you with a Navigator. Centerstone cannot make an official Medicaid eligibility or exemption decision.
Important: This page provides general information and is not an eligibility determination or legal advice. Rules and implementation details can change. Follow notices from Illinois HFS and use the official resources above for the latest information. Last reviewed September 2026.
