As one of UniCare's designated Premier Agents, MedPlan Access has been working with UniCare since their arrival in the Midwest. We feel qualified to offer some perspectives on UniCare health insurance for Illinois residents.
UniCare (with its parent company Wellpoint) is the most innovative company in the individual health insurance business. By introducing products such as the Sound plans for Illinois residents, UniCare demonstrates why they're the industry leader in advanced plan design for an evolving market.
UniCare is also a leader in using the internet to make health insurance more accessible, and in providing clients with online tools for managing both their health insurance plans and their health.
UniCare products are characteristically designed with strong disincentives against using non-network providers. This motivates utilization of PPO hospitals and physicians, which is a key element in UniCare's competitive pricing.
So, as a general rule, don't purchase a UniCare product unless you expect to be using hospitals and physicians participating in UniCare's extensive PPO networks.
UniCare products are also designed with strong incentives to purchase generic prescriptions. This is particularly true with the Sound plans, which have a separate $2000 deductible for brand name drugs.
If you are enrolled in a Sound plan and your physician is going to write you a prescription, you should be prepared to discuss generic equivalents with him or her.
The dental and vision coverage included with the Sound plans is not extensive.
Sound plan dental benefits are essentially limited to checkups, cleanings and fillings. It's nice that this coverage is included, but do not mistake these benefits for comprehensive dental insurance covering more expensive items like crowns and root canals.
The Sound plans also reimburse up to $50/year for vision exams and vision materials. Again, it's nice that this coverage is included, but do not mistake it for comprehensive vision care benefits.
The Sound plans and all UniCare's other individual plans in Illinois do not include coverage for routine maternity. If maternity benefits are important to you, UniCare is probably not your best choice.
UniCare's parent, Wellpoint Health Networks, is, by any measure, one of the USA's top few health insurance organizations. Their internal growth has been fueled by an impressive combination of well-designed products, sound underwriting, expansive networks, competitive pricing and solid management.
Most health insurers charge lower rates for new customers and higher rates for their longer-term customers. This is known as durational rating, and UniCare doesn't do it.
In determining rate adjustments, UniCare makes no distinctions based on policy duration. This translates into superior long-term relative cost stability for UniCare clients.
UniCare customers still get premium increases, which are never popular. But the UniCare rate increases are even-handed, and long-term clients are not punished for their loyalty -- which happens far too often with other insurance companies.
To give the Sound Health Plans maximum accessibility, UniCare has implemented streamlined underwriting, which is mostly good, but sometimes bad.
The good part is that applications are approved more quickly, there are no condition-specific exclusion riders and UniCare applies limited extra premium requirements.
The bad part is that some people, who would qualify for other UniCare products, are rejected when applying for a Sound plan. The Sound plans may not be a viable option for persons with chronic medical conditions and long-term prescription needs. If your health condition makes you concerned about being declined for health insurance, you probably should not apply for a Sound plan.
UniCare charges an additional 40% for smokers, which does not compare well with their primary competitor, Blue Cross and Blue Shield of Illinois. In addition, UniCare will definitely charge higher rates for persons whose weight places them in higher health risk categories. Here too, the advantage goes to Blue Cross and Blue Shield of Illinois, which tends to be a more competitive choice for persons who are overweight, but not morbidly obese.
Obtaining medical records can cause long delays in processing applications, so UniCare does much of their fact gathering through phone interviews with applicants.
Depending on an applicant's health circumstances, UniCare may still require medical records (rare for Sound Plan applicants), though they'll pay administrative charges -- up to a limit -- required by the doctor or hospital.
UniCare is an exceptionally well managed company with experienced employees and advanced administrative systems. When you call for assistance, customer hold times are typically short.
UniCare gets high marks for paying claims, which they process quickly. They also employ knowledgeable claim representatives. Claim disagreements are infrequent and typically resolved quickly.
Customer Service for Illinois policyholders is centered in UniCare's regional home office in Bolingbrook IL.
No one health insurance company is best for everybody. However, we believe UniCare is a consistent superior choice for most Illinois insurance consumers.
