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Illinois Comprehensive Health Insurance Plan
Pat Quinn, Governor
Andrew Boron, Chairman of the Board of Directors
Melissa Hansen, Executive Director
A State health insurance program for Illinois residents

+ Administrators
Blue Access for Members (Medical)
Catamaran (Pharmacy Benefit Manager)

THE CHIP PLANS

The Traditional plan is a Preferred Provider Organization (PPO) plan available only to eligible persons who qualify for coverage because they have been denied major medical coverage due to their health by private insurers and are not eligible for Medicare. To receive maximum benefits under the plan, a designated PPO provider must be used. The Traditional Plan has five standard deductible options to choose from: $500, $1,000, $1,500, $2,500 and $5,000.

The Traditional plan also has deductible options available to persons who qualify for coverage under Section 7 and who are interested in purchasing a plan that qualifies as a High Deductible Health Plan (HDHP) that can be used in conjunction with a federally approved Health Savings Account (HSA). All covered services and supplies, including prescription drugs, are subject to a deductible which must be satisfied before the plan will pay any benefits. The Traditional Plan has three HDHP deductible options to choose from: $1,300, $2,000 and $5,200. These Traditional Plan HDHD deductible options are subject to change, based on the federal requirements for minimum and maximum deductibles for HDHP Plans.

Back Federal Eligibility

Federally eligible individuals in the individual market are those who, at the time they seek individual coverage, satisfy all of the following criteria:

  1. they must have accrued a total of 18 or more months of prior creditable coverage; they have no more than a 90 day break between periods of creditable coverage;
  2. their most recent creditable coverage must have been provided under a group health plan, governmental plan or church plan;
  3. they must not be eligible for group health coverage, Medicare or Medicaid, and must not have any other health insurance coverage;
  4. their most recent coverage must not have been terminated due to nonpayment of premium or fraud; and,
  5. if offered continuation of coverage under federal COBRA requirements or state continuation laws, they must have elected and exhausted such continuation coverage.
Back HIPAA Plans

The HIPAA plan is a Preferred Provider Organization (PPO) plan available only to federally eligible individuals who qualify for coverage because they have had prior creditable coverage and meet the other HIPAA requirements. To received maximum benefits under the plan, a designated PPO provider must be used. The HIPAA plan has five deductible options to choose from: $500, $1,000, $1,500, $2,500 and $5,000.

The HIPAA Plan also has deductible options available to persons who qualify for coverage and who are interested in purchasing a plan that qualifies as High Deductible Health Plan (HDHP) that can be used in conjunction with a federally approved Health Savings Account (HSA). All covered services and supplies, including prescription drugs, are subject to a deductible which must be satisfied before the plan will pay any benefits. The HIPAA-HDHP Plan, has three HDHP deductible options: $1,300, $2,000 and $5,200. The deductible options for the HIPAA Plan that qualifies as HDHP are subject to change, based on the federal requirements for minimum and maximum deductibles for HDHP plans.

Back

"Presumptive" Conditions

A person having one of these medical conditions is presumed to be uninsurable, and is not required to receive a rejection letter for health reasons from an insurance company before applying for CHIP as a non-federally eligible person under Section 7 of the CHIP Act. In such cases, applicants for CHIP may instead submit a letter from their attending physician identifying one of these medical conditions for which they are being treated.

Medical conditions that do not require a notice of rejection or refusal to issue individual health insurance for health reasons from an insurer:

Acquired Immune Deficiency Syndrome Lupus Erythematosus Disseminate
(AIDS) or Aids Related Complex (ARC) Metastatic Cancer
Angina Pectoris Multiple or Disseminated Sclerosis
Arteriosclerosis Obliterans Muscular Atrophy or Dystrophy
Cerebrovascular Accident (Stroke) Myasthenia Gravis
Chemical Dependency Myotonia
Cirrhosis of the Liver Paraplegia or Quadriplegia
Coronary Insufficiency Parkinson's Disease
Coronary Occlusion Poliomyelitis
Cystic Fibrosis Polycystic Kidney
Friedreich's Ataxia Severe Traumatic Brain Injury
Hemophilia (Classical) Sickle Cell Anemia
Hodgkin's Disease Silicosis Pneumoconiosis (Black Lung)
Huntington's Chorea Syringomyelia
Juvenile Diabetes Wilson's Disease
Kidney Failure Requiring Dialysis  
Leukemia
Back Traditional Plan Enrollment

Enrollment in the Traditional program is currently capped at 5,950 participants.

If the program is ever at capacity when application is made, applicants who qualify may be placed on a waiting list as of the date their application is complete and all of the eligibility requirements are met. 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 the Traditional Plan should apply as soon as possible.

At present, the program is not at capacity.

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Tel 217-782-6333 | Toll Free (Illinois only) 866-851-2751 | TTY 855-691-7156
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