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State of Illinois Pat Quinn, Governor Illinois Department on Aging John Holton, Director

State of Illinois Pat Quinn, Governor Illinois Department on Aging John Holton, Director. UPDATES 2011 Circuit Breaker and Illinois Cares Rx IL-1363 and Related Schedules. Online Filing Application. 235,326 in 2009 283,284 in 2010 303, 556 to date in 2011 .

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State of Illinois Pat Quinn, Governor Illinois Department on Aging John Holton, Director

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  1. State of Illinois Pat Quinn, Governor Illinois Department on Aging John Holton, Director

  2. UPDATES 2011 Circuit Breaker and Illinois Cares Rx IL-1363 and Related Schedules

  3. Online Filing Application • 235,326 in 2009 • 283,284 in 2010 • 303, 556 to date in 2011 BENEFITS OF ONLINE FILING • Reduces the number of errors • Reduces processing time Seniors Ride Free

  4. Form IL-1363 Booklet Seniors Ride Free

  5. Pages 1 and 2 Page 1 • The Senior Ride Free was added Page 2 • In the “Contents” section removed the “Filing on the Internet” and the Rebate Information • In the “When May you Expect to Receive your Benefits” section a question was added regarding the transit card

  6. Section A Page 3 • Personal information about claimant Removed the People with Disabilities Ride Free Transit card at the top of the page in the heading and now call the benefit the Ride Free Transit Card. Added civil unions to the status information on 2 & 3 of Line 6.

  7. Section C • Income, losses and deductions for claimant and spouse

  8. Section C (continued) page 4 • Moved Line 24 from the 1st page of the application to the top of the second page • In Line 24b we added the word out

  9. Section D The words “Line 2” were added after Schedule B.

  10. Section E • Two notes were combined into one

  11. Section F page 5 • All rebate information was removed for the claimant

  12. Section G • Removed all rebate information for the spouse

  13. Section H Section H • Changed the amount for a married couple from $25,010 to $25,260 • Changed the amount for single individual from $12,516 to $12640 • Bolded the portion of the statement “If you are not married or you do not live with your spouse

  14. Section I Section I • Added Seniors Ride Free

  15. Section J page 6 • Added the note under the preparer to attach proof of authority if Someone else signs for you or your spouse

  16. Page 7 The amounts In the second column were changed to reflect the new dollar amounts for income to qualify for IL Cares Rx

  17. Page 8 In the chart at the bottom of the page the numbers have all been changed to reflect the ½ grant amount Under Item 1 on the chart “Line 25” should say Line 23

  18. Page 9 Added the second question to explain civil unions and IL Cares Rx

  19. Page 10 and Page 11 • Page 10 • No changes • Page 11 • Removed all of the rebate information

  20. Pages 12 and 13 The stand alone coordinating plans remained the same. New Medicare Advantage Plans have been added and some have been removed. Be sure to recheck the advantage plans if you are enrolling someone

  21. Page 14 and Page 15 Page 14 • Under #6 in the second column, status1 and 2 have the words “civil union” added • Page 15 • No changes

  22. Page 16 and Pages 17,18 and 19 Page 16 The $250 rebate when you reached the coverage gap has been removed Pages 17,18 and 19 No changes

  23. Page 20 and Page 21 Page 20 • Removed the instructions regarding the rebate in both Section F and Section G Page 21 • Added the Senior Ride Free to Section I

  24. Pages 22,23 and 24 • No changes

  25. Schedule A Seniors Ride Free

  26. Schedule A pages 25 and 26 • In the 1st statement under the heading “civil union partner” was added

  27. Schedule C Seniors Ride Free

  28. SCHEDULE C pages 27,28,29 and 30 Page 27 • “Parties to a civil union must each file a separate Schedule C” was added to the statement after the heading. Pages 28,29 and 30 • No changes

  29. Pages 31 and 32 Page 31 • The address on PSA 1 has changed Page 32 • No changes

  30. Schedule B Seniors Ride Free

  31. Schedule B: • Removed the monthly Rebate questions

  32. Schedule P Seniors Ride Free

  33. Schedule P pages 1,2,and 3 • Pages 1 and 2 • No changes • Page 3 • The dollars amounts to apply for prescription coverage were changed

  34. Schedule P note • A Schedule P will no longer cause a person who files one to be eliminated from the other benefits of Circuit Breaker. If you qualify for IL Care Rx you will also qualify for all the other benefits because the income guidelines for IL Cares Rx are lower.

  35. ADAD-16 Seniors Ride Free

  36. ADAD-16 step 1 All rebate information has been removed.

  37. Adad-16 Step 2 All rebate information has been removed for the spouse.

  38. Adad-16 step 3 The savings, investments or real estate for a married couple has changed from $25,010 to $25,260 and for a single individual from $12,510 to $12,640

  39. Adad-16 step 4 All rebate information has been removed for the QAR.

  40. Amended Application IL 1363X Seniors Ride Free

  41. IL-1363 X note An IL-1363X should not be used to change the in formation in Section A of the form or to apply for pharmaceutical coverage. Only in the case where an individual has made an error in the numbers he originally reported should an IL-1363X be used. Changes to Section A should either be phoned , e-mailed or mailed to us. Rx coverage can be applied for on the ADAD 16 form.

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