How to Qualify for Medicaid Dental in Illinois
Medicaid is a state and federally funded program that provides healthcare—including dental benefits—to low-income individuals and families. In Illinois, the Medicaid program is managed by the Illinois Department of Healthcare and Family Services (HFS).
To qualify for dental coverage under Medicaid in Illinois, you must meet certain income, residency, and demographic criteria.
Eligibility Criteria for Medicaid Dental in Illinois
Illinois Medicaid dental eligibility depends on several factors:
- Income Requirements
Income limits vary by household size and the applicant’s age or status. As of 2025, here’s a general breakdown (subject to annual updates):
- Adults (19-64 years old): Up to 138% of the Federal Poverty Level (FPL)
- Children (under 19): Up to 318% of the FPL
- Pregnant Women: Up to 213% of the FPL
- Seniors (65+) or Disabled Individuals: Income limits are generally lower and may require asset tests
Tip: Always check the Illinois HFS website for the most recent income guidelines.
- Residency and Citizenship Status
To qualify, you must:
- Be a resident of Illinois
- Be a U.S. citizen or meet immigration status requirements
- Provide a valid Social Security Number (SSN) or proof of lawful presence
- Other Qualifying Factors
Special groups that often qualify include:
- Foster children or those under DCFS care
- Individuals receiving SSI (Supplemental Security Income)
- Low-income parents or caregivers
- Individuals with disabilities
How to Apply for Medicaid Dental in Illinois
Applying is simple if you follow the correct steps.
Step 1: Gather Required Documents
Before you apply, prepare:
- Proof of income (pay stubs, tax returns)
- Proof of identity (driver’s license, state ID)
- Proof of residency (utility bills, lease agreement)
- SSN or immigration documents
Step 2: Submit Your Application
You can apply:
- Online: Visit ABE.Illinois.gov
- By phone: Call the Illinois DHS Help Line at 1-800-843-6154
- In person: Visit a local DHS Family Community Resource Center
Step 3: Wait for Approval
Once submitted, you’ll receive a notice of approval or denial. If approved, you’ll get a Medical card to use for dental services.
What Dental Services Are Covered by Illinois Medicaid?
Dental benefits vary by age group:
- Children: Preventive, diagnostic, restorative, and emergency services
- Adults: Exams, cleanings, fillings, extractions, and some specialty care
- Pregnant women: Enhanced dental services during pregnancy
Note: Orthodontic care (like braces) is typically only covered for children with medically necessary conditions.
Conclusion
Qualifying for Medicaid dental in Illinois doesn't have to be complicated. By understanding the eligibility criteria, gathering the right documents, and submitting your application through the correct channels, you can gain access to crucial dental services. Whether you're a parent looking out for your children or an adult managing chronic dental issues, Illinois Medicaid offers support for those in need.