Instructions And Benefits Information For Form Il-1363 - Illinois Department Of Revenue - 2002
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20Illinois Department of Revenue
2002
IL-1363 Instructions and Benefits Information
Application for Circuit Breaker and Prescription Coverage
What’s new in 2002
Prescription coverage dates changing!
All prescription coverage we issue during 2003 will end June 30, 2004. Apply early to get more months of
coverage. Remember, you must re-apply every year.
New SeniorCare benefits!
Expanded prescription coverage
SeniorCare benefits have been added. If you qualify
for SeniorCare, you can choose either the expanded
SeniorCare prescription coverage will pay for the
prescription coverage or the rebate option.
same categories of drugs as the Pharmaceutical
Assistance program, but will also cover most other
To qualify for SeniorCare, you must:
prescription drugs and some over-the-counter drugs
be 65 years of age or older,
if a doctor prescribes them.
live in Illinois,
If we approve your application and you qualify for
be a U.S. citizen or qualified legal immigrant,
SeniorCare, we will send you a SeniorCare
have income at or below 200 percent of the federal
prescription card.
poverty level,
SeniorCare rebate
tell us about any other insurance you have that
helps you pay for prescription drugs, and
If you receive a SeniorCare prescription card, you
file on Form IL-1363 as the claimant or spouse. To
may choose to cancel your SeniorCare prescription
apply for SeniorCare for yourself, check the box in
coverage and request a $25 monthly SeniorCare
Line 5a and complete Line 5b or 5c. To apply for
rebate. You must have insurance that pays for
SeniorCare for your spouse, check the box in
prescription drugs to qualify for the rebate.
Line 12a and complete Line 12b or 12c.
You can have either SeniorCare’s
prescription coverage or the rebate, but not both.
Table of Contents
What’s new for 2002 ...................................... 1
Prescription coverage guide ....................... 8
Form IL-1363 — line-by-line instructions ... 10
Who should apply? ....................................... 2
Information on eligibility
You may need to attach ............................. 17
When must I apply? ...................................... 2
Describes the information you may need to attach
to help avoid delays in receiving your benefits.
How do I apply for benefits? ........................ 2
Customer Connection ............................... 19
Questions about who qualifies .................... 3
Get fast answers to your questions and receive
information about your account, 24 hours a day,
Questions about benefits
7 days a week.
4
Prescription coverage ......................................
5
SeniorCare rebate ............................................
Local offices where you can get help ...... 20
6
Grant ..................................................................
Estimate your grant
7
License plate discount .....................................
1
Avoid a delay
Apply by March 31
IL-1363 instructions (R-12/02)
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