How Am I Protected?

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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. (see Group Health Plans)

· 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. (see Group Health Plans)

· Your health insurance cannot be canceled because you get sick. Most health insurance is guaranteed renewable. (see Individual Health Plans for Individual Coverage, and Small Employer or Self-Employed Person for Small Group Coverage)

· If your son or daughter is in college and covered as a dependent under your group, but cannot maintain student status due to illness, he or she may still be able to remain covered as your dependent for up to one year. (see Group Health Plans)

· 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. (see Individual Health Plans)

· If you lost your group health plan because of involuntary termination of employment that occurred between September 1, 2008 and December 31, 2009, you may be eligible for a federal tax credit that can help you pay for your COBRA or state continuation coverage premiums for up to nine months. (see Individual Health Plans)

· 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 state high-risk pool, 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. (see Individual Health Plans)

· 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. There are limits on what you can be charged for a CHIP policy. (see Individual Health Plans)

· If you lose your fully insured group health plan and meet other qualifications, you may be eligible to buy a conversion policy. You will not face a new pre-existing condition exclusion period. (see Individual Health Plans)

· When you apply for an individual health insurance policy, insurance companies may not turn you down, charge you more or impose a pre-existing condition exclusion period because of your genetic information. In addition, insurance companies are not allowed to even ask about your genetic tests or family history when you apply for coverage. (see Individual Health Plans)

· 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. (see Small Employer or Self-Employed Person)

· As a small employer, you may not be turned down or charged more because of the genetic information of a member of your group. In addition, insurance companies are not allowed to even ask about genetic tests or family history of people in your group when you apply for coverage. (see Small Employer or Self-Employed Person)

· 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. (see Financial Assistance)

· If your child is 18 years old or younger, does not have health insurance and meets other qualifications, you may be able to buy insurance for them or receive assistance paying for private health insurance through the Illinois All Kids Program. (see Financial Assistance)

· If you believe that you may be at risk for cancer, you may be eligible for free screening and treatment. The Illinois Breast and Cervical Cancer Program (IBCCP) provides qualified women with free breast and cervical cancer screening. In addition, women diagnosed with cancer through this program may be eligible for medical care through the Illinois Medicaid program. (see Financial Assistance)

· If you 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 80% of the cost of qualified health coverage, including COBRA, and a specific policy offered through the Illinois Comprehensive Health Insurance Plan (CHIP). (see Financial Assistance)

· 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. (see Financial Assistance)


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