If your state high risk pool cancelled your policy you do have options.

If you have a preexisting condition such as Cancer, Heart Disease or Diabetes or your build falls outside what is considered acceptable underwriting guidelines and you have received a policy termination letter from your state High Risk Health Insurance Pool like this one from the Illinois ICHIP – Illinois Comprehensive Health Insurance Plan. Know that you should apply now for a guaranteed issue (you can not be denied coverage) replacement plan with an effective date of 1/1/2014.

Since State High Risk Health Insurance Pools are already ‘maximum rated’ due to the fact that our state risk pools cover those with severe preexisting conditions, your premium should be less than what you are paying now most especially if your household MAGI – Modified Adjusted Gross Income – (income after deductions and after retirement contributions) is less than:

$46,960 for an individual
$62,040 for a couple
$78,120 for a family of three
$94,200 for a family of four
$110,280 for a family of five
$126,360 for a family of six

Since Blue Cross Blue Shield of Illinois is the administrator for our ICHIP program you have been using Blue Cross Blue Shield of Illinois providers whilst insured with ICHIP. If you wish to stay with BCBSIL providers click the logo below and apply for coverage with Blue Cross Blue Shield of Illinois, a Division of Health Care Services Corporation. Find the right health insurance plan for you by exploring all of the options, save the plans that fit your needs in your Shopping Cart and return to apply for coverage when you are ready. Don’t forget, the last day for the Patient Protection and Affordable Care Act (PPACA) “Open Enrollment” is February 15, 2014.

 

If you have received a policy termination letter from another State High Risk Health Insurance Pool. Yes, that’s right we had state based High Risk Health Insurance Pools which provided guaranteed issue coverage to individuals with preexisting conditions in 34 other states long before Obamacare. You can shop for all plans on (subsidized) and off (unsubsidized) the “Health Insurance Exchange Marketplace” in all 50 states by clicking the banner below. Remember that all Qualified Health Plans (excluding Temporary plans) sold on and off  the exchange will be guaranteed issue between the two national “Open Enrollment” periods beginning 1/1/14 – 3/31/14 and again during the recently delayed new second “Open Enrollment” period of  11/15/14 – 01/15/15.

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Please note: Outside of these two national “Open Enrollment” periods you will not be able to obtain guaranteed issue coverage for a preexisting condition as an individual or family applicant and you will be denied coverage unless your situation is deemed a “Special Enrollment”.

In addition to increasing your lifetime coverage to an unlimited coverage amount for each insured member and the addition of four more of these ten “Essential Health Benefits“. You already have 6 of them on your policy. However, now you get to pay for Maternity coverage, “Substance Abuse Disorder Services” and Pediatric Dental, whether you want that or not.

You will also have ‘first dollar’ coverage (no deductible or co pay required) for the following Preventative Care services and exams on all policies sold after 1/1/2014. You do not have any these benefits currently provided on your existing High Risk Health Insurance Pool coverage:

15 Covered Preventive Services for Adults:
  1. Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
  2. Alcohol Misuse screening and counseling
  3. Aspirin use for men and women of certain ages
  4. Blood Pressure screening for all adults
  5. Cholesterol screening for adults of certain ages or at higher risk
  6. Colorectal Cancer screening for adults over 50
  7. Depression screening for adults
  8. Type 2 Diabetes screening for adults with high blood pressure
  9. Diet counseling for adults at higher risk for chronic disease
  10. HIV screening for all adults at higher risk
  11. Immunization vaccines for adults–doses, recommended ages, and recommended populations vary:
  12. Obesity screening and counseling for all adults
  13. Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
  14. Tobacco Use screening for all adults and cessation interventions for tobacco users
  15. Syphilis screening for all adults at higher risk

22 Covered Preventive Services for Women, Including Pregnant Women

  1. Anemia screening on a routine basis for pregnant women
  2. Bacteriuria urinary tract or other infection screening for pregnant women
  3. BRCA counseling about genetic testing for women at higher risk
  4. Breast Cancer Mammography screenings every 1 to 2 years for women over 40
  5. Breast Cancer Chemoprevention counseling for women at higher risk
  6. Breastfeeding comprehensive support and counseling from trained providers, as well as access to breastfeeding supplies, for pregnant and nursing women*
  7. Cervical Cancer screening for sexually active women
  8. Chlamydia Infection screening for younger women and other women at higher risk
  9. Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, including abortifacient drugs – some religious organizations are now exempt from this mandate
  10. Domestic and interpersonal violence screening and counseling for all women*
  11. Folic Acid supplements for women who may become pregnant
  12. Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
  13. Gonorrhea screening for all women at higher risk
  14. Hepatitis B screening for pregnant women at their first prenatal visit
  15. Human Immunodeficiency Virus (HIV) screening and counseling for sexually active women*
  16. Human Papillomavirus (HPV) DNA Test: high risk HPV DNA testing every three years for women with normal cytology results who are 30 or older
  17. Osteoporosis screening for women over age 60 depending on risk factors
  18. Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  19. Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
  20. Sexually Transmitted Infections (STI) counseling for sexually active women
  21. Syphilis screening for all pregnant women or other women at increased risk
  22. Well-woman visits to obtain recommended preventive services

26 Covered Preventive Services for Children

  1. Alcohol and Drug Use assessments for adolescents
  2. Autism screening for children at 18 and 24 months
  3. Behavioral assessments for children of all ages
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  4. Blood Pressure screening for children
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  5. Cervical Dysplasia screening for sexually active females
  6. Congenital Hypothyroidism screening for newborns
  7. Depression screening for adolescents
  8. Developmental screening for children under age 3, and surveillance throughout childhood
  9. Dyslipidemia screening for children at higher risk of lipid disorders
    Ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  10. Fluoride Chemoprevention supplements for children without fluoride in their water source
  11. Gonorrhea preventive medication for the eyes of all newborns
  12. Hearing screening for all newborns
  13. Height, Weight and Body Mass Index measurements for children
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  14. Hematocrit or Hemoglobin screening for children
  15. Hemoglobinopathies or sickle cell screening for newborns
  16. HIV screening for adolescents at higher risk
  17. Immunization vaccines for children from birth to age 18 —doses, recommended ages, and recommended populations vary:
  18. Iron supplements for children ages 6 to 12 months at risk for anemia
  19. Lead screening for children at risk of exposure
  20. Medical History for all children throughout development
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  21. Obesity screening and counseling
  22. Oral Health risk assessment for young children
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years.
  23. Phenylketonuria (PKU) screening for this genetic disorder in newborns
  24. Sexually Transmitted Infection (STI) prevention counseling and screening for adolescents at higher risk
  25. Tuberculin testing for children at higher risk of tuberculosis
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  26. Vision screening for all children
    Source:
    https://www.healthcare.gov/what-are-my-preventive-care-benefits
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5 Comments

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5 responses to “If your state high risk pool cancelled your policy you do have options.

  1. Pingback: Champion News | If your state high risk pool cancelled your policy you do have options.

  2. Jeannette Clark

    The first thoroughly detailed, lucid tutorial I’ve seen for this category of healthcare … Heck, for any category of healthcare. Thank you, and please keep them coming.

  3. Proff Van Gogh

    Hey guys!….please read this email!…I’m a bit short on time…hence…please forgive my “grammatical errors”….however!… smile!…I’m not writing for publication….

    …rather….I’m over the top frustrated/infuriated with what’s going on…and STILL on HOLD with BC/BS for now OVER TWO HOURS!!!!!….’last “real person” was that nasty black woman who spoke Ebonics as explained in my email to Melissa!…

    …and NOW!…does John really have to “authorize” BC/BS to speak with me?!…is this each and every time I call customer service???!!….

    (….in the process of downing a second bottle of Captain Morgan’s Spice Rum…100% proof!?!!??!!…smile….not really…but sure is tempting!…I’ve been dealing with BC/BS since 11:00 today!!!!!!!….and I’m NOT being paid for my time?!…. smile!…)

    …any ideas?!…or a simple answer to my question???….that is….do we have to meet the individual $3,000 deductible before we are covered for doctor visits with a $55 co-pay?!…this question should NOT be that hard!…

    …also…I would LOVE to report this nasty “Michelle”…if she can’t handled the job…then QUIT!….

    …”mom”…j… 🙂

    • Hey there! No, John can sign a form that Blue Cross will provide to him upon his request that will permanently authorizes you to speak to Blue Cross at any time regarding your policy. Those pesky HIPAA privacy laws do have a work around.

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