A new Illinois private health insurance plan may be right for you if:
We can help you compare Illinois individual and family health insurance products and select the plan best suited to your health care needs.
If both you and your spouse or domestic partner are looking for a new Illinois health insurance plan, we recommend you review health insurance quotes both together and separately to find the solution that is most affordable.
Though it varies by health insurance company, Illinois health insurance rates for couples can significantly differ from the cost of buying separate policies. Sometimes it costs more. Sometimes it costs less. Different insurance companies use different rating methods.
Couples with greater age differences are more likely to see meaningful rate variations. In summary, couples sometimes benefit by evaluating both combined and separate coverage.
Illinois residents have legal protection when they purchase individual and family health insurance.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Those needing individual health insurance when leaving an employer-sponsored plan are protected under the HIPAA federal law, which limits Illinois health insurance companies in imposing a waiting period for pre-existing health conditions. However, this law is often misunderstood.
HIPPA Limitations and Misconceptions
We get frequent calls from folks who believe HIPAA entitles them to affordable private health insurance, but it does not work that way. If you have disqualifying health conditions an Illinois health insurance company can still decline to insure you under an individual or family policy. HIPAA does not change that.
If necessary continuity of coverage conditions are met, HIPAA requires the insurance company not apply the pre-existing condition exclusion -- but only if they agree to insure you in the first place. In addition, HIPAA does not prevent an Illinois health insurance company from placing exclusionary coverage waivers (distinct from the pre-existing condition exclusion) or from assessing additional premium charges on an individual or family health insurance policy involving pre-existing conditions.
COBRA (Consolidated Omnibus Budget Reconciliation Act)
Under the COBRA federal law Illinois residents can continue, subject to duration limits, health coverage from a prior employer. If you would like to learn more about how COBRA could impact you, visit:
Illinois Prohibition against Unwarranted Rescissions
After an Illinois resident is accepted into a private health plan, Illinois state law prohibits (in absence of fraud or material misrepresentation) insurers from canceling coverage if the person becomes sick or is injured.
Illinois requires certain benefits in individual/family health insurance policies. It is a reasonably extensive list. Some noteworthy Illinois private health insurance benefit mandates include:
National Health Insurance Reform (ObamaCare)
The Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act of 2010 will overhaul the whole system. Some facets have already gone into effect, though the most meaningful provisions do not begin until 2014. Review our health care reform implementation summary.
We are in the business of marketing private health insurance to Illinois residents who can afford to buy it. It is no secret that health insurance can be expensive, though we do our best to help our customers find the most affordable quality coverage.
Illinois residents who cannot afford private coverage or who are unable to qualify due to pre-existing medical conditions should explore the following:
Enrollees are required to pay a premium and out-of-pocket costs. Eligibility criteria for IPXP includes:
People who enroll in the IPXP program are not charged a higher premium because of their medical condition. Program participants pay comparable premium rates to healthy people in the individual insurance market. By law, premiums may vary only on the basis of age, geographic area and tobacco use.
With ICHIP pre-existing conditions are immediately covered only if you are considered "HIPAA eligible" with qualifying prior continuous coverage. If you are not considered "HIPAA eligible" ICHIP coverage is subject to a 6-month pre-existing condition waiting period.
ICHIP eligibility requirements include:
There is some eligibility overlap between IPXP and ICHIP, and people who would have previously enrolled in ICHIP may now find IPXP to be the more attractive alternative. If you have been without coverage for six or more months and you are eligible for both plans, you should contact each to gather information and determine which will provide you the better overall health insurance value.
In our view a primary advantage of ICHIP versus IPXP is that ICHIP does not require you be uninsured for six months. But if you have already been uninsured for at least six months and you have a serious pre-existing medical condition that requires immediate care, then IPXP will almost surely be the better alternative as they will not subject you to a pre-existing condition exclusion.
Illinois Department of Insurance
320 West Washington Street
Springfield IL 62767
Illinois Department of Public Health
535 W. Jefferson Street
Springfield IL 62761