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Shopping for health insurance in the state of Illinois might seem like a daunting task. Thankfully, there are many options open to Illinoisans who are uninsured or underinsured. Whether you're healthy or not, this page will provide you with valuable information for obtaining health coverage. Read on to learn about COBRA, short-term insurance, and the difference between group and individual coverage. If you're healthy enough to obtain coverage on the individual market, need a short-term plan, or if you have a small business and qualify for small group, Health Plan One can help. If not, review the information on this page about Illinois Medicaid, Health Benefits for Workers with Disabilities, FamilyCare, All Kids, Healthy Women, and CHIP. All of these government programs can help those who are medically uninsurable or who cannot afford private insurance to obtain basic health coverage.
What Every Illinois Resident Should Know About Health Insurance
The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not subject to medical underwriting, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.
Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through Health Plan One. Simply visit our Short-Term information page for your free quotes. It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.
What If I'm Between Jobs?
As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job, look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs to invest in an individual/family insurance policy through Health Plan One.
With individual coverage, you choose the health insurance carrier and benefits you want with the help of Health Plan One. We will quote plans for you and your family from all the different carriers available in Illinois so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through Health Plan One could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Illinois each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months.
If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the Health Plan One quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.
Small Group Plans
If you are self-employed you could qualify for a small group plan in Illinois. If you own a small business and have at least 2 eligible employees, you can apply for a small group plan at any point during the year. Eligibility for employees varies by carrier: Aetna is 25 hours per week and BCBS is 30. Small groups which meet these requirements may apply, but know that groups are subject to medical underwriting. This means that though no one in the group can be denied coverage, the carrier can increase the rates based on the health history of employees enrolling.
Health Plan One can help you by quoting plans for small groups. Simply call our toll-free number at (877) 567-5267.
If you're not healthy, there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.
For more information about small group plans in Illinois, view our Illinois Small Business Plan page
Medicaid in Illinois
Medicaid is a state-federal cooperative program which provides medical assistance to those who cannot afford private health insurance. Medicaid works in practice much like having regular health insurance; if you qualify you'll receive a Medicaid card which you can show your doctor at an appointment. If your doctor participates in Medicaid, the State will pay the bill for the appointment minus any other health insurance you may have. The program pays for many medical services including in- and outpatient hospital care, laboratory services, nursing home care, home health care, transportation necessary to receive medical care (ambulance rides), and other services. You must meet several eligibility requirements to apply, and be below an income ceiling. For information on how to apply for Medicaid in Illinois, see http://www.hfs.illinois.gov/medical/apply.html
Health Benefits for Workers with Disabilities (HBWD)
Illinois has recently joined a national movement of states helping people with disabilities return to work. Disability advocates have long noted that returning to work is difficult for people with disabilities. Many are deterred from working because they fear that working means losing Medicaid healthcare coverage. Often private insurance is difficult or impossible to obtain for those with serious disabilities. HBWD seeks to help people with disabilities work with full Medicaid benefits. HBWD encourages enrollees to work and to increase the number of hours they are currently working. If you are an individual with a disability, between the ages of 16 and 64 and working, you may qualify for HBWD. Workers with countable income of up to $3,159 per month for a single person and $4,250 per month for a couple can qualify. Unlike other Medicaid programs, HBWD allows enrollees to have up to $25,000 in assets. Depending on their income, enrollees pay a monthly premium based on their income range to receive comprehensive healthcare coverage. For full program details, benefits, premium levels, and detailed eligibility requirements, visit the HBWD website at http://www.hbwdillinois.com/
Illinois Comprehensive Health Insurance Program - CHIP
The Illinois Comprehensive Health Insurance Program (CHIP) was established to help those Illinoisans who are medically uninsurable on the individual market find basic health coverage. The Traditional Plan option is for persons under age 65 and not enrolled in Medicare. It provides benefits through preferred providers, both hospital and physician, from among the Blue Cross and Blue Shield of Illinois providers.
Illinois residents may qualify if they meet one of the following criteria:
- If they have applied for individual health insurance and have been rejected because of a pre-existing condition;
- If they have an individual policy that is substantially similar to CHIP which costs them more than they would pay for CHIP coverage;
- or if they have one of an approved list of medically uninsurable conditions (also called presumptive conditions), a.k.a. conditions presumed to result in automatic rejection by an insurance company.
For a full list of presumptive conditions, click here: http://www.chip.state.il.us/planfacts.html#PRESUME Premiums are established by law at 125%-150% of the average rates charged individuals for comparable major medical coverage by five or more of the largest insurance companies in the individual health insurance market in Illinois. There is also a plan option available for those over 65, called the Medicare Plan. For full details about CHIP, see their website at http://www.chip.state.il.us/premadmin.htm
Of the 250,000 uninsured children in Illinois, more than half come from families who earn too much to qualify for other state programs like Medicaid, but not enough to afford private health insurance. Through the All Kids program comprehensive health insurance is available to every uninsured child at a low-cost to their parents. Benefits of the program include doctor visits, hospital stays, prescription drugs, vision care, dental care and medical devices like eyeglasses and asthma inhalers. Parents pay monthly premiums for the coverage, but rates for middle-income families are significantly lower than those generally available on the individual market. For income and eligibility requirements as well as a full list of benefits, see the program's website athttp://www.allkids.com/customers/
Much like the All Kids program, FamilyCare offers coverage to parents of children 18 and under who earn too much to qualify for Medicaid, but who cannot afford coverage on the individual market. To see the income eligibility table, click herehttp://www.familycareillinois.com/income.html Specifically, in order for adults to qualify for FamilyCare they must be parents living with their children (under age 18) or be the relatives of such children caring for children in place of their parents. Many of the same services as All Kids are offered to parents through FamilyCare, including doctor visits, dental care, specialty medical care, hospital care, emergency services, and prescription drugs. There are monthly premiums and copays for parents in the program, but these are very low. For additional information, see http://www.familycareillinois.com/
Illinois Healthy Women
Illinois Healthy Women is a voluntary, confidential program which provides family planning (birth control) and related reproductive healthcare for free. The program covers birth control and other services provided at the family planning visit such as the physical exam, pap smear, lab tests, testing and medication for STIs, and sterilization. The program also covers mammograms, multivitamins, and folic acid if necessary. Women in Illinois who qualify will automatically receive a pink Illinois Healthy Women card in the mail when they lose regular medical benefits. Enroll in the program by filling out the card or print the application online at http://www.illinoishealthywomen.com/ You can also call their toll-free number for more information or to request an application (800) 226-0768. You are eligible for Healthy Women if you are a US citizen or legal permanent resident with a Social Security number, live in Illinois, are at least 19 but no older than 44, have lost regular medical benefits, have no health insurance coverage for birth control, are currently not pregnant, and meet the income guidelines available here:http://www.illinoishealthywomen.com/eligibility.html If you are pregnant, you can apply for the Moms & Babies program through All Kids by calling (866) 255-5437.
There are several other programs available through the state of Illinois for people with more specific health problems. For example, see the Your Healthcare Plus program here: http://www.hfs.illinois.gov/dm/healthcare_plus.html