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Q: Qualifying for individual health insurance in Illinois ( Answered 4 out of 5 stars,   1 Comment )
Question  
Subject: Qualifying for individual health insurance in Illinois
Category: Health > Conditions and Diseases
Asked by: ironmike-ga
List Price: $5.00
Posted: 27 Apr 2003 07:43 PDT
Expires: 27 May 2003 07:43 PDT
Question ID: 196127
I'm a 39 y.o.single
non-smoker,male
in good physical shape.My current daily medications are
Paxil,20mg.,Aciphex,40mg
Advair/Discus inhaler 2x daily,and Synthroid.175.I have been on all of
these medications for over a year,but consider Advair/D and Aciphex
temporary.I was layed off and fell behind on a Cobra payment,so it was
cancelled.Will I be turned down due to pre-existing conditions if I
apply for individual health insurance,and if I believe part of my
daily meds are temporary,what will happen if I do not disclose them on
the insurance app?Lay-people are suggesting I leave the meds off the
application?I live in a West suburb of Chicago,IL.What are my options
as my medications cost nearly $600 month?
Answer  
Subject: Re: Qualifying for individual health insurance in Illinois
Answered By: wonko-ga on 24 May 2003 14:06 PDT
Rated:4 out of 5 stars
 
Hi ironMike,

First of all, I would strongly encourage you to contact one or more
independent insurance agents and explain your situation to them.  They
can give you some idea as to what might happen with your application
for insurance in terms of coverage, rates, and exclusions.

As far as leaving information about medications off the application,
here is the deal: if you leave off any pertinent information from your
application, and the insurance company finds out, they will most
likely immediately cancel your coverage and demand reimbursement of
any benefits paid.  And, they have access to a nationwide database
that is pretty comprehensive regarding a person's health history,
which means they are likely to discover your omission during
application process anyway. So, it is not a good idea to omit
medications you are currently taking from your application.

However, just because you have a pre-existing condition does not mean
you cannot obtain individual health insurance.  You are just going to
have to pay more than a person without pre-existing conditions.  You
may be accepted by a traditional insurer.  If not, at least in
Illinois, you would probably have to join a waiting list for the
state's high-risk pool since you let your COBRA coverage expire,
although you may be able to sneak in if less than 90 days have passed
since you dropped COBRA.  I would certainly look into trying to make
back payments to reestablish my COBRA coverage if at all possible
since there is no way to know how long you might have to wait to
receive coverage through the high-risk pool.

"Illinois residents can generally qualify for Traditional CHIP, unless
otherwise ineligible under Section 7 of the CHIP Act, if they meet one
of the following criteria:

If they have applied for individual health insurance and have been
rejected because of a preexisting condition;

If they have an individual policy that is substantially similar to
CHIP which costs them  more than they would pay for CHIP coverage; or

If they have one of 31 presumptive medical conditions, i.e.,
conditions presumed to result in automatic rejection by an insurance
company. "

"The Traditional CHIP (Section 7) enrollment is capped at 5,950
participants.  The Board continues to accept and process applications
for coverage under the Traditional CHIP (Section 7) pool.  Applicants
who qualify may be placed on a waiting list in the order of the date
on which their application is found to be complete and meet all of the
eligibility requirements.  As additional enrollment opportunities
become available, applicants will then be contacted in the order in
which they appear on the waiting list.  Therefore, anyone seeking
coverage under either Plan 2 or 3 (Section 7) should apply as soon as
possible."

http://www.chip.state.il.us/chip.htm
There is a link "see if you qualify" which would tell you if you have
to join the waiting list or not.

By far your best bet is to find another employer who offers health
insurance coverage.  Worst case, your pre-existing conditions wouldn't
be covered for your first year of employment, but then would be. 
Furthermore, you would reestablish your creditable insurance coverage
history, which would allow you to join the CHIP plan if you lost your
job again without having to wait.

I hope you find the above information helpful.

Wonko
ironmike-ga rated this answer:4 out of 5 stars and gave an additional tip of: $5.00
Wonko,
     Thanks for your elaborate response.Yes,honesty is the best
policy,and you've provided me with options I had not thought
of,although I've never heard of Cobra being reinstated.

Comments  
Subject: Re: Qualifying for individual health insurance in Illinois
From: badabing-ga on 30 Apr 2003 13:59 PDT
 
http://info.insure.com/health/hipaa.html

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