Understanding Individual Health Insurance
The need to purchase a health insurance plan of your own tends to make you one of the unwanted children of the medical insurance marketplace...The employees of smaller firms unable or unwilling to offer health benefits, the self-employed, those of us who are lingering between jobs, the recently divorced or widowed, young adults moving off of their parents's health plans or early retirees -- all need to buy an individual or family policy and are entering into a peril-fraught marketplace where good advice and reasonable prices are scarce.
Are There Any Insurance Options for Me?
Natiaonally there are not too many health carriers interested in offering their products to individuals such as those described above, and their reasons for that are fairly straightforward. With employer paid plans, the premiums of the healthier tend to cover the claims of the ill. But, with individual health plans, there are no alternate revenue streams and as a direct result, many health insurers claim that even a high premium won't cover their costs if you fall ill or have an accident.
Many carriers try to avoid writing individual health policies. That doesn't mean that there aren't good deals to be found, but just as with any other marketplace, effective comparison shopping will be essential.
What options do I have in Illinois?
If you live in Illinois you are fortunate because there are a wide variety of carriers offering individual policies to the self employed and uninsured. UniCare, BCBSIL, World, Humana, Celtic, John Alden, Assurant, Time, and Aetna all offer solid choices for the individual, or self employed consumer. Look carefully at the ratings of the company, be sure they have an "A-" rating or higher. Having a B+ carrier or lower doesn't mean the health plan or company is in trouble, but it could mean they are a prime takeover target whose plans may be discontinued in the future which could leave you in the lurch.
Companies can't terminate you, but they can terminate themselves, and that can you leave you uninsured. The collapse of Conseco Health left many people with pre ex out in the cold only a few years ago, make sure your provider is going to around for the long haul.
What to Look Out for When Getting and Staying Insured
- Coverage for Pre-Existing Illnesses: The majority of individual policies must be medically underwritten. What that means is providers will take a closer than average look at your medical records, turning you down if you have a condition posing too much risk. 12 months restrictions for pre ex are standard for carriers in Illinois.
It's not odd that most insurers would deny coverage to anyone with a serious condition, but if you are faced with the sort of provider who also turns down applicants suffering from ailments as minor as ear infections, you may want to look elsewhere.
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If you can't get coverage the Chips plan sponsored by the State of Illinois and administered currently by BCBSIL is a good option.
- Gaps in the Regulations: There are a small number of insurance carriers who offer health plans that appear to be group benefits when they are not. These providers arrange for a policy under what's known as a group discretionary trust in an under-regulated state. These carriers then offer their semi-bogus health plans in other states. If you're faced with business practiced in such a fashion, keep looking. You cannot join an association just to get group health insurance...remember that. Stay away from Association comapnies from out of state who promise group benefits, it is a scam, they do not offer true group insurance, they offer memebership in an association which allows you to buy their health insurance.
- The Flaws in the System: Back in 1996, the passage of Health Insurance Portability and Accountability Act mandated that every state provide a source of last resort for you to buy into a health plan. Unfortunately, the law really didn't really solve many of healthcare's basic problems, and in fact, left the marketplace more or less unchanged. HIPAA did lay out minimum standards for coverage, but it didn't ensure that you would have access to a health plan regardless of your health status.
The resulting hodgepodge of insurance regulations vary from state to state and have left behind a definite need for unbiased sources from which to gather both independent health insurance quotes and health plan information.
We are experts in Illinois health insurance with 18 years of experience providing consumers with quality Illinois health insurance. We have the answers for your questions.
If you have more questions please give us a call at 800-391-7469.
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