Laserfiche WebLink
ILLINOIS DEPARTMENT ON AGING <br /> - CIRCUIT BREAKER PROGRAM - <br /> Do I qualify for Form IL-1363 benefits? <br /> Apply on Form IL-1363 if you meet the following requirements: <br /> 1. Age.......................... <br /> 2. Residency................ <br /> 3. Income Limit for Circuit Breaker grant and License Plate discount <br /> Your*total income in 2010 must be less than <br /> o $27,610 if filing an application for yourself only; or <br /> o $36,635 if filing an application for yourself and your spouse*, or yourself and one <br /> Qualified Additional Resident; or <br /> o $45,657 if filing an application for yourself, your spouse* and at least one Qualified <br /> Additional Resident, or yourself and at least two Qualified Additional Residents. <br /> *You must include your spouse's income if married and living together on December <br /> 31, 2010. If you file as a surviving spouse, then only your income will be counted in <br /> determining household income. If your spouse died in 2010, you would file as single <br /> and claim only your income. Be sure to include both taxable and nontaxable amounts <br /> unless indicated otherwise in the instructions. Do NOT include any Qualified Additional <br /> Resident's income. For more information on what is considered income, see page 15 <br /> of the Form IL-1363 application booklet. <br /> Projecting Your Income— If your 2010 income was over these limits, but you have <br /> experienced an event that has decreased your income to less than the income <br /> limitations for 2010, and you have met the age and citizenship/residency requirements, <br /> you may qualify for drug coverage by projecting your income. <br /> For example, a qualifying event might be the death of your spouse, a divorce, the onset <br /> of a disability, or your spouse entering a nursing home. <br /> Who is a Qualified Additional Resident? <br /> A Qualified Additional Resident is an individual, other than your spouse, <br /> • who lived with you in the same residence in 2010 and in 2011 at the time you file your 2010 <br /> Form IL-1363; and <br /> • for whom you, or you and your spouse, provided more than half of that person's total financial <br /> support in 2010; and <br /> • who is not filing a separate 2010 Form IL-1363. <br /> A Qualified Additional Resident may receive prescription drug benefits, a Circuit Breaker grant, <br /> License Plate discount and a People with Disabilities Ride Free transit card if he or she files a <br /> separate 2010 Form IL-1363 in his or her own name. A person cannot file a separate Form IL-1363 <br /> and also be reported as a Qualified Additional Resident on another application for the same year. <br /> What if I am NOT a U.S. citizen? <br /> You do not have to be a U.S. citizen to qualify for a Circuit Breaker grant, License Plate discount, <br /> or Illinois Cares Rx BASIC prescription drug benefits. <br /> SOURCE: http://vwvw.cbrx.ii.gov/aging/lrx/cbrx/qualifications.htm#1363-req <br />