Illinois CHIP insurance coverage

Many people feel that to get Illinois health insurance with a pre-existing health condition is virtually impossible without going to the Illinois CHIP program. In some cases this might be true. But is it true in all cases? Maybe not! It will depend on the pre-existing health condition that you have.

Each health insurance carrier that solicits sales in Illinois, whether it is Blue Cross Blue Shield, Humana, Health Alliance or United Health Care, underwrites a little differently for each health condition based on their own actuarial tables and claims experience. A lot of times what it boils down too, is what that condition cost them in the past? That is why many different health insurance carriers only approve the application with a rider or exclusion attached to it. When a health insurance carrier does this it simply means they are not willing to take the risk for the amount of premium they receive in return.

If a carrier approves your application but is putting a rider on your health condition that doesn't mean you have to accept it, you can refuse to take it. In choosing not to though the carrier will simply withdraw their offer for coverage. That's a decision that you would need to decide for yourself. Considering whether the risk of taking that rider is worth the benefit of the having a lower premium.

What if you had a complete hip replacement 3 years ago and you have never seen a doctor for it since.

• Would having coverage for your hip be important to you?

I would certainly think so, who wouldn't want to have it covered. Almost every carrier in this state would refuse to offer you coverage without a rider or exclusion on your hip. So one would think the only way to have your hip covered would be to go onto the state run CHIP program. Not true! If you were to fill out an application with Health Alliance, which is only available to Illinois residents your hip would be covered without a rider or exclusion.

That is why it is critical to go with an agent or agency that specializes in health insurance. They will be the ones that can give you advice as to what you're best options are.

Randy Gillespie is the owner of Focus Insurance Group, get expert help from an agent specializing in Illinois Health Insurance