Illinois Individual Health Insurance
Health insurance is an important safety net that allows you to take care of your family's basic medical needs without any financial worries. If you do not have group health insurance through your employer, then you should look into purchasing Illinois individual health insurance from a private insurer. As an Illinois resident, you should educate yourself in the state laws and regulations that affect these individual health plans.
Eligibility: How Am I Evaluated?
Each private health insurance company has the flexibility to create their own rules regarding which applicants will be accepted for an individual health insurance policy in Illinois. Applicants are generally evaluated on the basis of their age, gender, health status, health history and their lifestyle habits. The applicant can be turned down by in insurance provider for any reason. The only exception to this is for newborns who are required to be covered under their parent's policy for the first 30 days and disabled, dependent children whose parents have a policy that covers dependents.
Although private insurance in the state is not guarantee issue, to comply with HIPPA Group-to-Individual Portability Coverage regulations, the state does guarantee acceptance into the Illinois Comprehensive Health Insurance Plan (CHIP), the state's high-risk insurance pool for those who are HIPPA eligible but have been unable to obtain coverage through a private insurer.
Illinois Guaranteed Benefits & Pre-Existing Conditions
In Illinois, individual health insurers are not required to provide standardized health plans, but there are certain benefits that insurers are required to cover, such as diabetes care, post-delivery hospital stay and screenings for breast, colorectal, prostrate and cervical cancer.
In Illinois, private insurers are allowed to go as far back as 24-months in an applicant's medical history to uncover a pre-existing condition. They can then either impose a 24-month exclusion period on the condition or add it to the policy's elimination rider (which means that it will likely never be covered). Additionally, if you make a claim for treatment related to a specific condition within the first 2 years of your policy, the insurer can look back up to 24-months prior to your application to see if it was a condition that should have been listed as pre-existing. If so, then your claim can be denied. The state also mandates health insurance companies to offer equal coverage limits and maximums for mental health conditions as for physical health conditions.
Illinois Individual Health Insurance Premiums
The state allows for private health insurers to set their premiums at whatever rate they see fit, hoping that market competition will help keep them at a reasonable cost. Your insurer will take many factors into consideration when determining your rate, including age, gender, health, and plan type. There are no laws or restrictions regarding what an individual can be charged for a policy or exclusions on the reasons for quoting a high premium. When it is time to renew your policy, your insurer also has the right to raise your premium for any reason. However, the health insurance provider cannot cancel your policy because of your sickness, at the time of renewal. They can raise your premium to compensate for this increased risk.
When looking for health insurance alternatives in Illinois, it is important to be aware of the coverage details and the costs of owning a health plan that you are particularly interested in. Getting in touch with a qualified broker/agent can assist you in choosing a health coverage option perfect for you and your family.