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ORIGINAL ILLINOIS HEALTH FACILITIES AND SERVICES REVIEW BOARD APPLICATION FOR PERMIT SECTION I. IDENTIFICATION, GENERAL INFORMATION, AND CERTIFICATE r:ClEIV1E Q kg This Section must be completed for
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Original - Illinois Health refers to the initial health insurance application submitted to the state of Illinois.
Any individual or family applying for health insurance coverage in the state of Illinois is required to file an original - Illinois Health application.
Original - Illinois Health applications can be filled out online through the state's health insurance marketplace, in person at a designated enrollment center, or over the phone with a certified application counselor.
The purpose of the original - Illinois Health application is to determine eligibility for health insurance coverage and financial assistance programs.
The original - Illinois Health application requires personal information such as name, address, income, household size, and any existing health insurance coverage.
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