CCP Cost Sharing and Sliding Scale Fees in Illinois

CCP Has No Income Limit — But It Is Not Free for Everyone

The Illinois Community Care Program is unusual among state home care programs because it has no upper income cap. A senior earning $4,000 per month can still qualify for CCP services as long as their non-exempt assets fall at or below $17,500 and their Determination of Need (DON) score hits the 29-point threshold.

But "no income limit" does not mean "no cost." For participants whose monthly income exceeds the federal poverty level ($1,330 per month for a single individual in 2026), the state calculates a cost-sharing copayment — a monthly contribution the participant pays toward the cost of their care plan.

How the Sliding Scale Works

The state assesses a sliding-scale copayment based on the participant's ability to pay when income is above the federal poverty standard. Do not assume a fixed percentage band or a universal cap. The Care Coordination Unit calculates the exact copayment during the financial eligibility review and includes it in the written care plan.

The Service Cost Maximum (SCM)

Every CCP participant's care plan carries a Service Cost Maximum — the total monthly dollar value of services the state authorizes. The SCM is determined by the participant's DON score: higher functional impairment means more authorized service hours and a higher SCM.

The SCM is the monthly ceiling for authorized services, but the copayment is not established here as a fixed percentage of that ceiling. Ask the CCU how the participant's ability to pay and service plan affect the amount.

What the SCM covers: homemaker services, adult day services, emergency home response (EHRS), and automated medication dispensing. The CCU builds the care plan within the SCM ceiling, allocating hours across these service categories based on the participant's functional needs.

An Example Calculation

A 75-year-old parent with a monthly Social Security income of $1,800 and a DON score of 40 is assessed under CCP:

• Income is above the federal poverty standard ($1,330 for a single applicant in the 2026 AABD figures)
• The CCU applies the CCP sliding scale based on the participant's ability to pay
• At a $30–$35 private-pay rate, 20 hours per week would cost roughly $2,600–$3,000 per month before any subsidy
• The participant's exact CCP copayment comes from the CCU's financial eligibility review

Without CCP, 20 hours per week of private-pay home care in Illinois would cost roughly $2,600 to $3,000 per month at the stated hourly range. The actual savings depend on the CCP copayment the CCU assesses.

When to Choose CCP Over the Medicaid Waiver

If your parent's income is at or below the Medicaid AABD limit ($1,330/month), the Care Coordination Unit will route them to the Medicaid Persons Who Are Elderly waiver instead of CCP. Waiver participants pay zero copayment.

For parents with income between $1,330 and roughly $2,000 per month, a choice exists: apply for Medicaid through the monthly spend-down process (submitting medical bills to offset income), or accept CCP with its copayment. The right answer depends on whether the administrative burden of monthly spend-down documentation is worth the copayment savings.

Compare the actual CCP copayment with the participant's Medicaid spend-down amount; they are different mechanisms and depend on the individual's circumstances. Medicaid may also provide benefits that CCP alone does not provide.

How to Reduce or Challenge the Copayment

Report income changes promptly. If your parent's income decreases (a pension reduction, a change in Social Security benefits), notify the CCU immediately. The cost share is recalculated based on current income.

Verify the calculation. If the amount seems wrong, ask the CCU for a written explanation of how it was determined and for the applicable review or appeal process.

The Illinois home care guide includes cost comparison worksheets for CCP vs Medicaid waiver vs private pay, along with the full DON preparation and financial review checklists.

See more Illinois guides →