Senior citizens and persons with disabilities can use Form IL-1363 to apply for:

• Illinois Cares Rx coverage,
• a Circuit Breaker grant,
• a license plate discount, and
• People with Disabilities Ride Free.

Answers provided to the following questions are meant only to give general guidance and not legal advice. The answers do not replace legal requirements set by applicable federal or state laws and regulations.

Illinois Cares Rx (help paying for prescription drugs)
You and your spouse may ask for optional help paying for prescription drugs through Illinois Cares Rx.

1. If you have Medicare, Illinois Cares Rx will provide additional coordinating benefits. These benefits include helping pay your monthly premium, annual deductible, co-insurance, and the coverage gap if you are enrolled in a coordinating Medicare Part D prescription drug plan. We will NOT pay any late enrollment penalty under Medicare Part D. You will NOT receive Illinois Cares Rx coordinating benefits if you enroll in a non-coordinating Medicare Part D plan. Also see "Extra Help" with your out-of-pocket prescription drug expenses under Medicare Part D.



2. If you do NOT have Medicare, Illinois Cares Rx provides two benefits: Illinois Cares Rx BASIC and Illinois Cares Rx PLUS.

For more information, see Prescription Drug Assistance.

Circuit Breaker grant
You may get a Circuit Breaker grant if you

1. paid property tax or mobile home tax on your home,
   or



2. rent or live in a nursing, retirement, or shelter care home that was subject to property taxes.

For more information, see Circuit Breaker Tax Grant.

License plate discount
If your Form IL-1363 is approved, the Illinois Secretary of State’s office will allow you a license plate fee discount for one vehicle.

For more information, see License Plate Discount.

If you send us your completed Form IL-1363, you have automatically applied for a Circuit Breaker grant and a license plate discount. You do not have to receive a grant to qualify for other benefits.

To get help paying for your prescription drugs, you should also complete Sections F, G (for your spouse) and H on Form IL-1363. NOTE: If you mark "no" on Line 34, you must also complete Schedule C. Parties to a civil union must each complete a separate Schedule C.

To receive the People with Disabilities Ride Free transit card, you should also complete Section I: Line 35 and 36 (for your spouse).

The information on your Form IL-1363 application will determine your prescription drug benefits. If you qualify for benefits, we will issue you a card to use at participating pharmacies in the Illinois Cares Rx program. Make sure you carefully read and follow all of the instructions. For more details on obtaining a transit card, see People with Disabilites Ride Free.

To get your benefits quickly, send us your completed Form IL-1363 as soon as you have the necessary information if you want drug coverage.

All drug coverage we issue in 2012 from a 2011 IL-1363 application form will end December 31, 2013.

Your 2011 Form IL-1363 must be postmarked on or before December 31, 2012.

You can find out the status of your application by linking to Check Your Application Status, which is a featured link in the right-hand column of each page on this Web site.