Illinois is one of 35 states that offer plans for people with chronic illnesses who can’t get coverage in the individual health insurance market.
It’s the Illinois Comprehensive Health Insurance Plan, commonly known as ICHIP.
I asked Michael McRaith, secretary of the state’s Department of Professional and Financial Regulation, to explain how it works. He told me the program was established almost 20 years ago to serve as the “health insurance carrier of last resort” for Illinoisans.
For people losing their jobs and health-care coverage, it’s an option worth knowing about.
ICHIP runs two programs: a traditional pool and a HIPAA pool, McRaith said.
The traditional pool is for people who have tried but failed to get medical coverage elsewhere. Also, it’s open to anyone with 31 serious and presumably uninsurable medical conditions, including AIDS, cystic fibrosis, juvenile diabetes, leukemia, multiple sclerosis and Parkinson’s disease.
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The traditional pool is funded by premium payments and state funding (almost $20 million in fiscal 2008). By law, premiums can’t exceed 150 percent of those charged in the conventional insurance market. Charges vary depending on age, sex, location and the plan’s design — but not health status.
Only U.S. citizens or lawful residents qualify, and lifetime benefits are limited to $2.5 million. No one has reached that limit yet, McRaith said.
Like several other states, Illinois restricts the number of people who can enroll in the traditional ICHIP pool; the cap is set at 5,950 people. That’s a way of restricting the program’s size and limiting the state’s financial exposure.
High premiums also serve that purpose: Many people with serious chronic illnesses can’t afford the monthly expense. For them, the promise of an “insurer of last resort” is too costly to be of help.
I asked McRaith to run some numbers for me. For an ICHIP plan with a $500 deductible — the most common type members selected — a single, 35-year-old Chicago woman would pay $597 a month for coverage through the traditional pool. A 50-year-old woman would pay $923 a month; a 62-year-old man, $1,466.
A deductible is the amount a member pays out of pocket before insurance coverage kicks in.
Double the deductible to $1,000 and the first woman would pay $544 a month, the 50-year-old woman, $866; and the 62-year-old man, $1,370. Rates are slightly lower for residents of Cook County, excluding Chicago.
For more information, check out ICHIP’s Web site, or call 800-962-8384. For information about eligibility, call 866-851-2751.
On Tuesday I’ll write about the second ICHIP pool, the HIPAA plan. This is an option for people who had employer-sponsored health insurance but lost it because they became seriously ill and stopped working or because they left a job and exhausted their COBRA coverage.