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Illinois Health Insurance

Want to get an Illinois health insurance plan? You can count on us to give you accurate Illinois health insurance quotes from trusted health insurance providers in the state of Illinois. We’ll give you information to help you save on your health coverage. Enter your zip code above to start looking for the best Illinois health insurance plans in your area.

Facts and Figures

  • Place in State
    Health Report Card
    28th
  • Insured 10,929,396
  • Uninsured 1,764,600
  • Insurance
    Carriers
    18
  • Number of
    Primary Care Physicians
    28740
  • Number of
    Hospitals
    189

Breakdown of Insureds

  • Employer-sponsored health insurance 63%
  • Private plans 6%
  • Medicaid 17%
  • Medicare 14%
  • Others 0%

Insurance Carriers

State Health Report Card

While smoking has decreased significantly from 22.3 percent to 15.7 percent of adults in the past ten years, 179,000 individuals still smoke in Idaho. There are 306,000 obese adults in Idaho, 131,000 more individuals than 10 years ago. In the past year, the rate of preventable hospitalizations decreased from 49.1 to 45.3 discharges per 1,000 Medicare enrollees. In the past five years, diabetes increased from 6.8 percent to 7.9 percent of adults. 90,000 Idaho adults now have diabetes. In the past five years, the percentage of children in poverty increased from 12.4 percent to 18.9 percent of persons under age 18. Idaho ranks lower for determinants than for outcomes, indicating that overall healthiness may decline over time.

Illinois Health Insurance Laws and Regulations

Illinois health insurance plans must be sold with a guaranteed renewability clause. An insurance policy cannot be cancelled as long as the subscriber keeps up with the premium payments. Providers cannot cancel an existing policy because of an illness. If a parent’s policy covers dependents, their newborn or adopted children will be automatically covered for up to 31 days. When writing new Illinois health insurance plans, insurers can exclude coverage for a pre-existing condition. This exemption period can be limited or permanent. Switching to a different health plan may also lead to changes in the exemptions without considering any previous delays. Illinois state law does not have much control on health insurance prices, this results to significant changes in premium prices depending on factors like age, sex, health, marital status, and other risk factors. Insurers can deny coverage to an applicant based on these criteria. Insurers in Illinois are not allowed to cancel an existing plan due to health issues, that is why it is important for individuals to consider buying health insurance while still young and healthy. Small businesses in Illinois can purchase any form of small-business group health insurance being offered in other parts of the state with some restrictions. Illinois health insurance quotes for group coverage can vary according to the risk factors of its members. However, small group health plans cannot be cancelled due to a member’s health condition. The state of Illinois does not allow self-employed individuals to purchase small-business health insurance if they do not have any other employee. They can purchase individual plans instead and with this plan a portion of the premium payment can be deducted from overall tax liability.

Heath Care Reform

With the new health care law, children under the age of 26 can choose to stay under their parent’s Illinois health insurance as long as they are not offered an employer-based health insurance. This provision enabled 2.5 million young adults to have insurance nationwide. In Illinois, 102,659 young adults have insurance coverage through this provision as of June 2011.

The new health care law allowed 152,170 Medicare policyholders in Illinois to receive a $250 rebate check to help with prescription drug costs when they fell into the Medicare gap in 2010. In 2011, 144,226 Medicare plan holders were given a 50% discount on brand-name prescription drugs covered by their plan when they hit the donut hole. An average of $667 per person or a total of $96,216,548 was saved in Illinois.

Previously uninsured individuals without health coverage because of a pre-existing condition can now apply for a Pre-Existing Condition Insurance Plan. This plan is available to U.S. citizens or legal residents with a pre-existing condition and have been uninsured for at least 6 months. In 2011, 1,962 individuals in Illinois have benefited from this new law.

When looking at Illinois health insurance quotes, applicants are assured that at least 80 percent of the price will go directly to health care services and other related improvements. A rebate or premium discount shall be provided if the minimum is not met. All private policyholders in Illinois will get greater value for their premium payments because of this 80/20 rule.

Preventive care services like immunizations, colonoscopies, mammograms, or annual wellness doctor visits must be included in all Illinois health insurance with no deductibles or co-pays. In 2011, more than 1,350,000 Medicare subscribers and 2,390,000 individuals with private policies received such services in Illinois.

Under the new law, insurance companies are no longer allowed to impose an annual dollar limit — a cap on the yearly spending for your benefits, or a lifetime dollar limit — a lifetime cap for spending for your covered benefits. This law frees chronically ill individuals like cancer patients from worrying about getting further treatment because of such limitations. In 2011, 4,670,000 residents in Illinois have benefited from this law.

If insurance companies want to raise their premium rates by ten percent or more, they are required by federal law to publicly announce and justify their actions. To guard against such unreasonable increases, the state of Illinois received a total of $4.5 million.

All fifty states receive increases in funding for community health centers under the Affordable Care Act. This will help construct new health centers, provide medical services to more patients, improve preventive and primary health care services, and fund infrastructure projects. In Illinois, 534 community health centers received a total of $102.3 million to fund these improvements.

In 2010, the Affordable Care Act created the Prevention and Public Health Fund. This new fund was created for wellness promotion, disease prevention, and protection against public health emergencies. Illinois has already received a total of $31 million to support its policies, programs, and communities to help its residents lead healthier lives.

State Government Insurance Programs Offered

Comprehensive Health Insurance Plan (CHIP)

217-782-6333 (Illinois Residents) 800-962-8384 (General Info) 866-851-2751 (Eligibility Info)

Comprehensive Health Insurance Plan (CHIP) is a guaranteed health coverage program which offers health insurance to Illinois residents who were denied coverage because of a pre-existing condition. CHIP’s benefits include doctors visits, diagnostic care, x-rays, inpatient and outpatient care, preventive care, home health care, hospice, nursing care, surgery, transplant coverage, therapy (speech, physical, and occupational), mental health and chemical dependence, and prescription drug card. Applicants can also opt for a high deductible health plan. Eligibility: The plan is open to all U.S. citizens living in Illinois who did not lose previous insurance due to fraud or failure to pay the monthly premium. Applicants must meet one of the following categories in order to be eligible: 1. Traditional Plan: Denied coverage due to a pre-existing condition, ineligible for Medicare or have a similar policy but is more expensive than CHIP, has at least one qualifying health condition. 2. Medicare Plan: Enrolled under Medicare Parts A and B. 3. Federal Eligibility: Latest coverage must be under a group plan lasting at least 18 months without a break lasting 90 days or more. Must have exhausted all options for COBRA coverage. Ineligible for any group plans. 4. HIPAA Plan: Must satisfy both Federal and HIPAA eligibility. 5. Health Coverage Tax Credit (HCTC) Plan: Must satisfy both Federal and HCTC eligibility. 6. Presumptive Condition: Applicants under 65 years old and has proof of a qualifying health condition.

Pre-Existing Condition Insurance Plan(IPXP)

877-210-9167 TTY: 866-883-8551

The Illinois Pre-Existing Condition Insurance Plan (IPXP) is a temporary high-risk pool created by the Health Care Reform and operated by Illinois Department of Insurance and Public Health. This program provides coverage for individuals with a pre-existing condition who have a hard time finding private coverage. Benefits of the plan include office visits, emergencies, preventive care, ambulance, inpatient and outpatient care, x-ray and laboratory services, rehabilitation, surgery and anesthesia, organ transplants, blood and blood products, cancer clinical trials, family planning, pregnancy and maternity care, therapies, inpatient and outpatient services for mental health and substance abuse treatment, and many more. Eligibility: 1. Must be a U.S. citizen or legal resident living in Illinois. 2. Must be uninsured for at least six months. 3. Must have a qualified pre-existing health condition.

Medicaid

800-843-6154

Medicaid offers coverage to low-income individuals and families who cannot pay for their medical care. Applicants for this program should meet financial and other eligibility requirements. Benefits for this program include physician services, medical and dental check-ups, diagnostics, prescriptions, hospital services, and more depending on the type of program. Special programs are available for pregnancy, breast and cervical cancer, MS patients, kidney dialysis, AIDS, TB, and hyperalimentation. Eligibility: 1. Must be U.S. citizens or legal residents living in Illinois. 2. Must not exceed income limits: Children aged 1 to 18: 133% of the Federal Poverty Line (FPL). Pregnant women and infants: 200% of the FPL if mother has Medicaid coverage at the time of birth and 133% of the FPL for those without Medicaid coverage. Parents or Caretakers with Children aged 0 to 18 years: 185% of the FPL. Aged, Blind, Disabled: 100% of the FPL. SSI Recipients: 40% of the FPL. Medically-Needy: 100% of the FPL.

FamilyCare

866-255-5437

FamilyCare offers health coverage to parents or relatives (in place of parents) living with children 18 years old and below. Benefits of this program include: doctor visits, hospital care, emergency services, specialty medical services, prescription drugs, dental and vision care, regular check-ups and more. Eligibility: 1. Must be U.S. citizens or qualified residents living in Illinois. 2. Must be parents or caretakers living with children 18 years old and below. 3. Must not exceed an income of 200% of the Federal Poverty Line.

ALL Kids

866-255-5437

All Kids offers comprehensive health coverage to children living in Illinois. Benefits of the program include doctor visits, hospital stays, immunizations, prescription drugs, vision and dental care, medical devices, therapy (speech and physical), and regular check-ups. Eligibility: 1. Must be a resident of Illinois aged 18 years and below. 2. Must be uninsured for at least 12 months. 3. Family must meet income limits if child has health insurance or lost it less than 12 months ago.

Illinois Breast & Cervical Cancer Program (IBCCP)

888-522-1282

The Illinois Breast and Cervical Cancer Program offers free breast and cervical cancer screening to eligible women living in the state. Women diagnosed with cancer may also be eligible for treatment. Benefits of the program include mammograms, breast exams, pelvic exams, and Pap tests. Treatment may be covered for women who have been diagnosed with cancer. Eligibility: 1. Must be women aged 35 to 64 years old. 2. Must be U.S. citizens or qualified residents living in Illinois. 3. Younger women may also be eligible depending on certain factors.

Healthy Women

800-226-0768

Healthy Women offers benefits to help promote women’s health in Illinois. Benefits of the program include family planning, screening and medicine for sexually transmitted diseases, physical exams, mammograms, Pap tests, multivitamins, and more. Eligibility: 1. Must be a woman aged 19 to 44 years old. 2. Must be a U.S. citizen or a qualified resident living in Illinois. 3. Must have Social Security number with income not exceeding 200% FPL. 4. Must have lost health insurance from the Illinois Department of Healthcare and Family Services (HFS).

Medicare

800-633-4227

This health care system is administered by the federal government and provides health insurance coverage to Americans aged 65 and above or those younger than 65 but have a disability or end-stage renal disease. Coverage has four parts: Part A: provides inpatient care in hospitals and rehabilitative centers. Part B: provides doctor and some preventive services and outpatient care. Part C: provides Medicare benefits through Medicare Advantage. Part D: provides prescription drug coverage. Eligibility: 1. Must be a U.S. citizen or permanent U.S. resident. 2. Must be 65 years or older, with you or your spouse having worked in a Medicare-covered employment for at least ten years; or have a qualified disability or end-stage renal disease, regardless of age.

Illinois Cares Rx

800-226-0768

Available as Illinois Care Rx Basic and Illinois Care Rx Plus, this program offers prescription drug assistance to residents with or without Medicare coverage. Illinois Cares Rx Basic coverage is limited to prescription drugs used to treat Alzheimers disease, arthritis, cancer, diabetes, glaucoma, heart disease and its related conditions, lung disease and smoking-related illnesses, multiple sclerosis, osteoporosis and Parkinsons disease. Illinois Cares Rx Plus covers most prescription drugs. Eligibility: 1. Must be a U.S. citizen or qualified residents living in Illinois. 2. Must be an individual with Medicare coverage, or an individual 65 years or older without Medicare, or an individual under 16 years having total disability. 3. Must satisfy income requirements.

Health Coverage Tax Credit

866-628-4282

Health Coverage Tax Credit covers up to 80% of premiums for qualified trade-impacted workers or TAA recipients. This is a federal tax credit created by Congress through the Trade Act of 2002 which aims to make health coverage more affordable and accessible for those who may not afford it. Benefits for HCTC plans include doctor visits, prescription drugs, inpatient and outpatient care, preventive care, medical care, mental health, and substance abuse care. Eligibility: 1. Must be 55 years or older and receiving pension from Pension Benefit Guaranty Corporation; or receiving Trade Adjustment Assitance. 2. Must have a qualified health insurance plan and must be paying for more than 50% of the premiums. 3. Must NOT be in prison, be listed as a dependent in tax returns, belong to certain state plans, be a recipient of 65% COBRA subsidy.

VA Medical Benefits Package

877-222-8387

The Veteran Affairs (VA) Medical Benefits provides standard health benefits plan to veterans enrolled in the program. Benefits are portable and can be accessed anywhere in the VA system. Benefits include preventive and primary care, and a full range of outpatient and inpatient services. Eligibility 1. Must have veteran status.

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