Apply Without Account Help

This is a secure website run by the Illinois Department of Human Services and the Illinois Department of Healthcare and Family Services. As required by law we will keep your information private and secure.

You can help keep your information secure. If you are using a public computer, close your browser window when you are done.

ABE will prompt you to continue completing the application after 30 minutes.

• Select YES to continue completing your application. And you will have another 30 minutes to submit your application.
• Select NO and your application will NOT be submitted, and you will be redirected to ABE.illinois.gov

You have the right to submit your application after completing only the Name, Address and Signature fields. (Signature is in the Electronic Attestation section at the bottom of the page.)

You may avoid delays in processing your application by filling out as much information as possible.

The following information is helpful and could assist in processing your application faster:

• Full names and dates of birth for everyone who is applying for benefits.
• Social Security numbers for everyone applying. If Social Security numbers are pending, give the date(s) the application(s) were made.
• Address of where you live.
• Information about all the income everyone receives.
• If someone applying for benefits is not a US citizen, have the Non-Citizen Registration Numbers
• If someone is applying for Cash or Health Care Coverage for the Aged, Blind or Disabled, have information about the value of everyone's cash, checking and savings accounts.
• If someone is applying for SNAP or Cash, provide:
  • the names of any absent parents.
  • the amount of child or spousal support paid.
  • housing and utility costs.
  • the amount paid for care of a child or disabled adult.

If you apply for SNAP, you might be able to get benefits right away, if:

• your gross income and assets are less than your monthly rent or mortgage payment and the appropriate utility standard.
• your assets are less than $100 and your monthly income for the month of application is less than $150, or
• your assets are less than $100 and at least one person applying is a migrant worker who does not expect to earn at least $25 in the next 10 days.

Complete each section with as much information as possible, then sign and submit the application.

1. Applicant Information
2. Approved Representative
3. Household Composition - Complete Person 1 as the Head of Household and Applicant Information. Click the "Add Person" button to add and complete person information for additional people in your home.
   1. Person - General Information
   2. Person - Program Selection
   3. Person - Additional Medical Questions
   4. Person - Citizenship Questions
   5. Person - Race/Ethnicity
   6. Person - General Questions
4. Benefit Program Detail Questions
   1. SNAP Questions
   2. Income - Benefits - Expenses
   3. American Indian or Alaska Native Family Member (AI/AN)
   4. SNAP and Cash Applicants
   5. Application Interview - Cash and SNAP
   6. Your Family's Health Coverage
   7. Health Coverage from a job
   8. General Medical Questions
   9. Resource Information
   10. Employment and Employment Related Expenses
5. SNAP Coverage - Client Rights and Responsibilities
6. Cash/Healthcare Coverage - Client Rights and Responsibilities
7. Fraud Penalty Affidavit
8. Electronic Attestation

In this section, please type your first name and last name in the boxes. This should be the name of the person that will be receiving mail and talking to us, even if that person is not asking for benefits for themselves. This person will be " Person 1" on the application, also known as the Head of Household.

• Use your full, legal name.
• Do not use nicknames.
• If you have two last names, type them both into the last name box.
• If your name does not fit in the boxes, just type as much as you can.

Please tell us where you live. Enter your home address in the Present Address section. We will use the Present Address to send letters and other information to you - including the decision about whether you can get benefits.

If you are homeless right now, please check the " I am homeless right now." box. If you have a reliable mailing address we can use to send you letters, you should type it in here. Leave the mailing address blank if you do not have an address right now. If you do not provide an address, you can get your letters at the local Family Community Resource Center where your case is serviced.

If you do not want letters about your benefits sent to your home address, please give us another address in the " Mailing Address" section on this page. Keep in mind that if you give us another mailing address, we will use it instead of your home address.

Please give us as much information as you can about how to get in touch with you. If you do not have one of these types of telephone numbers, just leave it blank.

By alternate phone, we mean a phone number where we can call and leave a message for you. This could be your own voicemail, or the phone number of a social service agency or shelter, a family member or a friend. Keep in mind that if you give us an alternate telephone number, it is a good idea to let the agency or person know that someone might be calling.

If you are homeless right now, it is very important to give us a telephone number where we can reach you or leave a message. If you do not, we will not be able to reach you with important information about your benefits.

Tell us the best time to call. Tell us if you wish to receive text alerts and reminders about important due dates and appointment reminders. Standard fees may apply from your mobile service provider. If you want text alerts and reminders, enter the telephone number where we can text you.

Select your spoken language and written language preferences.

Spoken language is the language preferred when speaking to the agency about your case. Written language is the preferred language to use when we send notices about your case.

Please tell us the benefit programs for which you are applying. Later, you will complete this for each person on the application because some people in your household may not be applying for the same benefits. See Program Selection below for more information on programs and how to request backdating your medical application.

An Approved Representative is a person or organization who has been given permission by the customer to act on their behalf when conducting business with the Department. In order for an approved representative to be added to the case the IL444-2998 - Approved Representative or the IL444-2998 S - Formulario Para Representante Aprobado form or other applicable legal document such as power of attorney (POA) and legal guardian must be submitted.

• Use the full, legal name.
• Do not use nicknames.
• If this person has two last names, type them both into the last name box.
• If the name does not fit in the boxes, just type as much as you can.

• Use the full, legal name of the organization.
• Do not use nicknames.
• If the name does not fit in the box, just type as much as you can.

Enter the Approved Representative address.

You must check the box and type your name in the Signature of Applicant field to authorize an Approved Representative. The agency may ask you to complete an Approved Representative form. This signature is only for the Approved Representative section. You must sign the application at the bottom to meet the signature requirement to submit your application.

Complete the " Person" information for everyone in the household. Complete a " Person" section for each person that lives with you even if they are not requesting assistance.

• Complete the " Person 1" section for yourself.
  Note: By " you", we mean the person who is applying for benefits. If you are helping someone, use this website, please fill out this page as if you were that person.
  
  

  If you are applying for Burial Services, please fill out information about the deceased person.

• Click the " Add Person" button to add a " Person" to the application.
• Click the " Delete Person" button to remove a person from the application.

To determine when to " Add Person" to the application, consider the following for each program/benefit:

You may add up to six (6) " Person" sections to your application. If your household needs more than six " Person" sections, you will be provided an area to complete for additional household members.

TIP: The more information you can give now, the faster we will be able to process your application.

When completing each " Person" section all the data in that section should apply to the person named in the Personal Information area. " Person 1" should be the name of the person filling out the application for the household. This should be the person who will receive mail and speak with the state if needed, this person is also known as the Head of Household and was entered in the Applicant Information section above. You will not be able to edit the Person 1 name. It will be prefilled from the Applicant Information section.

To complete the Personal Information area, use the following guidelines:

Name (First Name, Middle Initial, Last Name, Suffix, Former Name, if any)

• Use the full, legal name.
• Do not use nicknames.
• If this person has two last names, type them both into the last name box.
• If the name does not fit in the boxes, just type as much as you can.
• If this person has the same first name as someone else in the home, please type something in the First Name box to help us know the difference between them. For example, if Mark William Smith and Mark Randall Smith live in the same home, please type their first and middle name (" Mark William" and " Mark Randall") in the First Name box.
• If you have Mark William Smith Jr and Mark William Smith III in your home, please add the Jr or the III to the suffix box.

Relationship to you

If you are completing the Person 1 information, the application is populated with SELF.

If you are completing the relationship for a different person on the application (Person 2 or greater), select the relationship that best describes the relationship between Person 1 and the person you are adding to the application.

Social Security Number

If a person is asking for benefits and they have a SSN, their SSN should be provided.

If a person is asking for benefits but does not have a SSN, they will need to tell us the date an application was submitted. If a person does not have one and refuses to apply for one, they may not be able to get Cash or SNAP benefits. Children and pregnant women may be eligible for healthcare benefits even if they do not have a SSN.

If a person is not asking for benefits, they do not have to report a SSN or any information about immigration status. If you or any other persons are not applying because you do not wish to provide information about your immigration status, you do not have to give us that information.

The failure to provide immigration information will not affect processing the application for the remaining persons.

Birth Date

Indicate the person's date of birth. Make sure you use this format: mm/dd/yyyy.

For example, if the person's birthday is March 12,1973, enter 03/12/1973. Use slashes to enter the date.

Marital Status

Select a marital status for this person.

Gender at Birth

Enter Male or Female as assigned at birth. The response to this gender question may be used for program eligibility and billing services. For example, if a person is pregnant, select " Female" so that you can tell us about the pregnancy later in the application.

If the selected gender conflicts with a covered service, claims may be denied or rejected.

Pregnant? If yes, due date.

If a person is pregnant, enter their due date.

How many babies?

If a person is pregnant, enter the number of babies expected.

Select the programs for which each person is applying. Each person may apply for different benefits.

• SNAP (Supplemental Nutrition Assistance Program)/State Food helps people and families buy food they need for good health. This program used to be called Food Stamps. More about SNAP.
• Cash Assistance helps pay for food, shelter, utilities, and expenses other than medical costs for people who qualify. If you apply for Cash Assistance, you will automatically apply for Health care coverage.
• Healthcare provides access to healthcare benefits to people of all ages in Illinois. More about healthcare coverage.
• The Illinois Family Planning Program is a partial-benefit program that offers coverage for family planning and related services for men and women. Select this option to apply for the Family Planning services only. More about Family Planning Program.

All the programs below provide the same medical coverage, but you may select a preference.

Medical Program	Summary
Aid to Aged, Blind and Disabled (AABD) Medical	Covers seniors, person who are blind and persons with disabilities with income up to 100% of the federal poverty level (FPL) and resources below the allowable limit. If income or resources are over the limit, the person may be eligible for spenddown. Please see our Medical Programs page for more information.
Family Care/All Kids	Covers children 18 years of age and younger, and their parents or caretaker relatives. To be eligible, children must live in families with countable family income within 318% of the federal poverty level (FPL). The parents/caretaker relatives are eligible for coverage if the countable income is up to 138% FPL.
ACA Adults	Covers adults 19-64, who are not parents or caretakers of minor children with income up to 138% of the federal poverty level.

If you would like to backdate your medical application, you must select YES. Medical backdating can help you pay for bills you have before you applied for medical benefits.

If you do not qualify for HFS medical programs, we may send your information to the federal Health Insurance Marketplace. The Marketplace will contact you to complete the application process by reviewing available tax credits and choosing and enrolling in a health plan.

Person - Additional Medical Questions

All the questions in this section are optional. However, the more information you can give now, the faster we will be able to process your application.

Person - Citizenship

You can get benefits even if you are not a U.S. citizen. We need to ask this question so we know what documents we will need from you. We want to ensure you get the most benefits possible.

Person - Race/Ethnicity

Select this person's race/ethnicity. You may select more than one Race. You do not have to answer these questions if you do not want to. Your answers will not be used to make a decision about your benefits.

Person - General Questions

Please complete each question.

If someone is pregnant, you should not count them as disabled unless they have a condition other than pregnancy that makes them unable to work. It is possible for someone to be pregnant AND disabled, but pregnancy alone is not a disability.

Benefit Program Detail Questions

SNAP Questions

If you or anyone in your application is applying for SNAP, complete this section. You may avoid delays in processing your application by filling out as much information as possible.

Income - Benefits - Expenses

Complete this section if you or anyone on the application is applying for cash, medical and/or SNAP benefits and receives income or has expenses.

American Indian or Alaska Native Family Member (AI/AN)

Complete this information if it applies to you, or any person listed on your application.

SNAP and Cash Applicants

Complete this section if you or any person on the application is applying for cash and/or SNAP benefits.

Your Family's Health Coverage

Complete this section if you or any person on the application is applying for cash and/or medical benefits.

Health Coverage from a Job

Complete this section if you or any person on the application is applying for cash and/or medical benefits and anyone listed on this application is offered health coverage from a job.

General Medical Questions

Complete this section if you or anyone on the application is applying for medical benefits.

Resource Information

Complete for persons who are blind, have a disability or are age 65 or older and requesting cash and/or medical. If married and living with spouse, also enter any resources the spouse owns. If yes to any of the following, enter the details in this section. You may be required to provide proof.

Employment and Employment Related Expenses

Complete for employed persons who are blind, have a disability or are age 65 or older and applying for cash and/or medical. Also enter the employment expenses for an employed spouse or parent of a child under age 18 if they live together.

SNAP Coverage - Client Rights and Responsibilities

Cash / Healthcare Coverage - Client Rights and Responsibilities

Fraud Penalty Affidavit

Electronic Attestation

To submit your application, you must check the boxes to acknowledge your rights and responsibilities, fraud and the electronic attestation and type your name to sign this application.