High risk pool health insurance is available to Illinois residents.
The Illinois Comprehensive Health Insurance Plan (ICHIP) website acknowledges that insurance can be confusing. Several programs are available to Illinois residents based upon age, previous coverage and whether there are pre-existing conditions. In addition, some ICHIP programs have federal requirements that applicants must meet to qualify.
Qualifications
The following criteria can help to determine if an Illinois resident might qualify for ICHIP: The resident has applied for individual health insurance and the insurer rejected his application because he has a pre-existing condition. The resident has a policy but it costs substantially more than a similar ICHIP policy. The resident has one of the 31 predefined presumption conditions, which would result in automatic rejection for health insurance coverage.
Traditional Plan
This plan is a preferred provider organization (PPO) plan, and to obtain maximum benefits the resident must use a designated provider. It is available to Illinois residents denied major medical coverage by a private insurer because of their health. Deductible options include $500, $1,000, $1,500, $2,500 and $5,000, and there is a six-month limitation for pre-existing conditions.
Medicare Plan
This plan is for people under age 65 who qualify for Medicare because of a disability or end stage renal failure and have enrolled in Medicare Parts A and B. Coverage does not include prescription drugs. The benefits are secondary to Medicare and stop when the Illinois resident would have qualified for regular Medicare based upon age. This plan also has deductible options of $500, $1,000, $1,500, $2,500 and there is a six-month limitation for pre-existing conditions.
HIPAA Plan
The HIPAA plan is also a PPO. It is available to Illinois residents who meet federal eligibility requirements. These include a previous total of 18 months or more of coverage with no more than a 90-day gap between coverage. Alternatively, their most recent coverage was with a group, government or church health plan. Or they are not eligible for group, Medicaid or Medicare coverage and have no other coverage. Their previous coverage did not end due to nonpayment or fraud. Or they have used and exhausted COBRA coverage. The plan has deductible options of $500, $1,000, $1,500, $2,500 and $5,000 with no limitations for pre-existing conditions.
Health Coverage Tax Credit Plan
The Health Coverage Tax Credit (HCTC) plan is available to residents who lost their jobs and received trade adjustment assistance (TAA), or receive a pension from the Pension Benefit Guaranty Corporation. This is a PPO and has requirements similar to the HIPAA plan. Deductible options and pre-existing condition rules are the same as the HIPAA program.
Further Assistance
Professional staff members are available to assist with ICHIP questions. Illinois residents can call toll free from within the state to 866-851-2751.
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