What is the Illinois State Hemophilia Program (SHP)?
The SHP is available for all Illinois residents who have bleeding disorders. It is administered by the Illinois Department of Public Aid but is not public aid. In fact, persons on Medicaid are not eligible unless they have a Medicaid spend down and their bills exceed the determined spend down. The SHP provides money to help offset the costs that insurance does not cover, and helps offset the cost of Anti Hemophilic Factor concentrate. Services covered depend, in part, by the age of the patient.
What does the Illinois State Hemophilia Program pay for?
For persons 21 and older the program will fund up to $2,000 for the services of 2 comprehensive clinic visits per year. These services include physician services, labs, and x-rays. However, payment is made as a last resort, after insurance has paid their portion or denied coverage. The other thing this program can help with is factor. The state offers a co-payment program for factor, based o household income and size of your family. Upon evaluation of your state income tax form (IL-1040) and family size, the state program will determine a “participation fee.” This can range from $0 to several thousand dollars. The program will pay the amount your insurance does not in, in full to the extent allowed by their price limitations on each product. Often, this is paid in full.
For persons under 21, the SHP only pays for factor, as above. However, children eligible for SHP are automatically financially eligible for coverage of comprehensive hemophilia clinic visits by DSCC. The Department of Specialized Care for Children, beyond what insurance pays. Once a child is accepted into SHP, parents can initiate a DSCC application to maximize assistance. SHP recipients do not need to complete the financial eligibility portion of the DSCC application. To find your local DSCC office, you may call 800-322-3722.
How can I apply for the State Hemophilia Program?
Call (877) RUSH-KID to request an application.
Do I need to re-apply each year?
Yes. Applications must be made each year. Coverage begins July 1st, the beginning of the fiscal year. If applying mid-year, applications may be submitted retroactively.
How do I make a claim to the State Hemophilia Program?
The provider submits claims on your behalf. You need to make sure your home care company knows you have SHP, and the amount of your participation fee.