How Am I Protected?

 In Illinois, as in many other states, your health insurance options are somewhat dependent on your health status.  Even if you are sick, however, the laws protect you in the following ways.

  • Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more, because of your health status. This is called nondiscrimination.
  • All group health plans in Illinois must limit exclusion of pre-existing conditions. There are rules about what counts as a pre-existing condition and how long you must wait before a new group health plan will begin to pay for care for that condition. Generally, if you join a new group health plan, your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage.
  • Your health insurance cannot be canceled because you get sick. Most health insurance is guaranteed renewable.
  • If you are a small employer buying a group health plan, you cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group. All fully insured health plans for small employers must be sold on a guaranteed-issue basis.
  • If you leave your job, you may be able to remain in your old group health plan for a certain length of time. This is called COBRA or state continuation coverage. It can help when you are between jobs or waiting for a new health plan to cover your pre-existing condition. There are limits on what you can be charged for this coverage.
  • If you lose your group health plan and meet other qualifications, you will be HIPAA eligible. If so, you can buy an individual health insurance policy from the Illinois Comprehensive Health Insurance Plan (CHIP). You will not face a new pre-existing condition exclusion period. There are limits on what you can be charged for a CHIP policy.
  • If you have had difficulty obtaining affordable individual health insurance because of your health condition or if you have one of 31 presumptive medical conditions, you may also be eligible for a CHIP policy. In this case you may face a new pre-existing condition exclusion period.
  • If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The Illinois Medicaid program offers free or subsidized health coverage for pregnant women, families with children, elderly, and disabled individuals with very low incomes. In addition, some women who are diagnosed with breast or cervical cancer may be eligible for medical care through Medicaid.
  • If your children are 18 years old or younger and meet certain financial qualifications, you may be able to buy insurance for them or receive assistance paying for private health insurance through the Illinois KidCare Program.
  • If you have lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program then you may be eligible for a federal income tax credit to help pay for new health coverage. This credit is called the Health Coverage Tax Credit (HCTC), and it is equal to 65% of the cost of qualified health coverage, including COBRA, and a specific policy offered through the Illinois Comprehensive Health Insurance Plan (CHIP).
  • If you are a retiree aged 55-65 receiving pension benefits from Pension Benefit Guarantee Corporation (PBGC), then you may also be eligible for the HCTC.

AddThis Social Bookmark Button