The Pre-Existing Conditions Conundrum

There are times that finding an Illinois health insurance plan suitable for a pre-existing health condition is difficult, if not next to impossible. What do people do about that?

The first thing to understand when dealing with Illinois health insurance is what the definition of a pre-existing health condition happens to be. To simplify a sometimes long and drawn out description, a pre-existing condition is one where a person has seen a doctor and has been diagnosed with a “condition or illness,” and has been treated prior to applying for Illinois health insurance.

The tricky situation then becomes the fact that many Illinois health insurance companies use the application questionnaires to implement an exclusion period to defend themselves against people with pre-existing health conditions. It is often used as a loophole to deny insurance, rider it or accept it, but with a higher premium.

The conundrum in Illinois is that if a person is looking for individual Illinois health insurance and they have a pre-existing condition, the insurance company can turn them down unless the person happens to be eligible for an Illinois Health Insurance Portability and Accountability Act, HIPAA. Without getting too technical, HIPAA protects Illinois health coverage for workers and their families if they change or lose their jobs and provides protection for those with pre-existing medical conditions by limiting their exclusion period.
While it’s a good thing to have that law in place to protect people who need Illinois health insurance, the unfortunate thing is that the law hasn’t gotten rid of the ability of insurance companies to deny health insurance to those with pre-existing health conditions or even excluding medical conditions. What this boils down to is that there’s only guarantee issue in State sponsored plans and in insurance company funded plans. If an applicant for Illinois health insurance meets six HIPAA criteria, they are eligible for guaranteed issue HIPAA. In a pinch, this may be the only route those with major pre-existing health conditions are able to take.

Illinois health insurance companies all tend to handle pre-existing health conditions differently, so it’s best to do some serious research online and in person to find out what company and policy will be applicable. It’s a given that individual plans have more exclusions and are more expensive than group plans. When in doubt, ask a local insurance agent what is available and what the requirements are to apply.

Some of the most important insurance companies in the state of Illinois handle pre-existing conditions a little bit differently, because of this it is important to do some research and actually shop around for a policy before deciding to apply. Individual plans have more exclusions than group plans and that is why they are quite a bit less expensive, because they are more restrictive.

To learn more about Illinois health insurance, Illinois health insurance quotes, Illinois group health insurance or to get an Illinois health insurance quotes, visit Focusinsgroup.com

How to Get Competitive Health Insurance in Illinois

Getting competitive health insurance in Illinois is a whole lot easier that you might think.

How easy is easy? Really, it is a lot easier to get competitive health insurance quotes in Illinois by doing smart surfing online and finding a site that offers side-by-side competitive quotes. Not just a few things side-by-side, but a site that offers customers the best bang for their buck.

Keep in mind that not all the things one sees on an online insurance website are always applicable to your particular situation. For instance, you may find a totally outstanding quote and note that it is the “preferred” rate. That means you have to meet certain criteria in order to be eligible for that particular Illinois health insurance policy. This is one of the major reasons you will want to talk to the agent who owns and runs the website you are surfing, to clarify any questions you might have about the quotes you will receive.

Sometimes just reading quotes side-by-side online, or side-by-side comparisons made by an expert health insurance broker after you have provided your information makes sense and sometimes there are unanswered questions that can be cleared up by an insurance expert. Always take the time to carefully compare the health insurance plans you see online, paying particular attention to two things – what is included in the plan and what the price happens to be.

There are various choices of health insurance plans that may be tailor-made to suit your circumstances with some tweaking. You will definitely have a wide variety of carriers to choose from when you find an Illinois health insurance website with up-to-date information.

You might be wondering why you have a good chance of finding a “deal” on Medicare supplements. This happens because each private insurance carrier has the option to offer Medicare (if they do offer Medicare, as not all insurers do) at a rate they choose. So it makes a lot of sense to have a health insurance expert provide you with side-by-side comparisons after providing your information. Of course you will want to make sure that the Medicare supplements you want will dovetail with the Medicare plan you ultimately choose.

If at any time you have questions while getting your competitive Illinois health insurance quotes, reach for the phone and make that personal call to the expert. It goes without saying that you only want the best in Illinois health insurance for you and your family.

Randy Gillespie is with Illinois health insurance agency, Focus Insurance Group. To learn more about Illinois health insurance, Illinois health insurance quotes, Illinois group health insurance or to get an Illinois health insurance quotes, visit Focusinsgroup.com

Keeping Networks Is a Good Thing

Sometimes, the more things change, the more they remain the same. This seems especially true when talking about Illinois health insurance.

It wasn’t too long ago that Blue Cross and Blue Shield of Illinois told their members that one of their hospitals, St. John’s, was making the decision to discontinue its status as a Medicare Select contracting network hospital. That decision, which caused a lot of pandemonium, was supposed to kick-in on the 17th of June, 2009.

Of course the implications for a decision like this that affected Illinois health insurance echoed far and wide, with the major complaint, aside from what people would do to replace the service they were getting, was having to change to another type of plan that was more expensive. An agreement was ironed out where Blue Cross Blue Shield helped people who’d lost their original Illinois health insurance plans to get reinstated and credited for premium increases that arose due to changing plans.

This kind of thing raises the very specter of changes coming to the health care system over the next few years. And along with the changes come the questions of whether or not the changes will be beneficial. This is one of the toughest questions to answer with any degree of certainty.

It would involve having a crystal ball and a system that would address everyone’s medical needs; a system that would be affordable and accessible to all. Comprehensive health care reform is supposedly coming, and likely won’t come any too soon given the current state of the health system. In the meantime we muddle along with what works the best at any given time, and that includes Medicare Select.

Medicare Select is basically an Illinois health insurance Medicare supplemental insurance plan that provides you with choices. They also have the advantage of being priced at an even more reasonable level than the usual versions of Medigap insurance policies. The one major difference that you might want to be aware of is that Medicare Select acts like a managed care plan. That simply means that you’d have to use doctors and hospitals that are in an Illinois health insurance network. In addition, your insurance company will only pay full benefits if you got your medical care from a preferred health provider who is, once again, a part of the insurance company’s designated network.

Let’s take a quick look at an example. If you go to see a preferred provider physician, Medicare pays the approved charges. Your supplemental insurer pays the full benefits under your policy. However, if you choose to use services outside the plan network, the plan may deny the claim entirely or only pick up a very limited portion.

So really, there are three things you need to know and remember about a Medicare Select plan. The first thing is that it is considered to be an Illinois health insurance supplemental product, just about the same as Medigap insurance. In other words, when you buy a Medicare Select policy, you’re getting a standard Medigap plan. And, as we already pointed out (but it’s worth mentioning again) pretty much the only difference between a standard Medigap policy and a Medicare Select policy is that the Select policies are managed care plans. To get full benefits from the Select plans, you will need to use designated hospitals, clinics and even certain doctors. This will explain why these plans are priced lower than similar Medigap policies.

Something else you also need to know about Medicare Select plans is that they are typically only offered in larger cities in Illinois. If you live outside a large city, you may have other options. To find out what those options are, contact an expert Illinois insurance agent in your area.

Randy Gillespie is with Illinois health insurance agency, Focus Insurance Group. To learn more about Illinois health insurance, Illinois health insurance quotes, Illinois group health insurance or to get an Illinois health insurance quotes, visit Focusinsgroup.com