On January 28, 2021, C.M.S. announced a 90 day Special Enrollment period due to COVID-19 which begins on February 15, 2021 and ends on May 15, 2021. During this Special Enrollment period you can purchase ACA-qualified (Obamacare) health insurance on a guaranteed issue basis (no preexisting condition exclusions and no health questions). To determine if you qualify for an APTC – Advance Premium Tax Credit – (Obamacare subsidy) SCROLL DOWN THIS PAGE.
All ACA-qualified (Obamacare) health insurance policies must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible. Click “See The List” below. Be sure to click on “For all Adults”, “For Women” and “For Children” to see entire list.
COVID-19 Special Enrollment period begins on February 15, 2021 and ends on May 15, 2021
On January 28, 2021, C.M.S. announced a 90 day Special Enrollment period due to COVID-19 which begins on February 15, 2021 and ends on May 15, 2021. During this Special Enrollment period you can purchase ACA-qualified (Obamacare) health insurance on a guaranteed issue basis (no preexisting condition exclusions and no health questions) even though the annual Open Enrollment period ended on December 15, 2020. If you qualify for an A.P.T.C. – Advance Premium Tax Credit (“Obamacare subsidy”) please click “Shop for ACA-qualified (Obamacare) plans” below. You will then be able to pick a plan, get your subsidy and finish the entire process much faster than working solely with Healthcare.gov. You can also purchase ACA-qualified plans without a subsidy using the same link if you do not qualify for an Advance Premium Tax Credit.
Determining your eligibility for one or more federal subsidies
Depending on what you expect your 2021 total household MAGI – Modified Adjusted Gross Income (after deductions but before taxes) to be, you may qualify for an APTC – Advance Premium Tax Credit (federal subsidy) to lower your premiums. You may also qualify for the CSR – Cost Sharing Reduction – subsidy to lower your deductible if you purchase a Silver plan. If you believe your 2021 total household MAGI will be lower than:
$51,520 for an individual
$69,680 for a couple
$87,840 for a family of three
$106,000 for a family of four
$124,160 for a family of five
$142,320 for a family of six
you will qualify for an Advance Premium Tax Credit (Federal subsidy) which will substantially reduce your insurance premium.
The Biden administration is considering increasing the APTC eligibility threshold to 600% of F.P.L. as it is now in California.
Please note: If you expect that your M.A.G.I. – Modified Adjusted Gross Income will be lower than 138% of the Federal Poverty Level, you will be eligible for Medicaid and as such will not be able to qualify for subsidized private health insurance. You can purchase private health insurance even if you qualify for Medicaid but you must do so at full price without a Federal subsidy.
Click the chart below to determine the current Federal Poverty Level and percentages above it.
Please also note: If you qualify for a federal health insurance subsidy and your state has expanded SCHIP – State Children’s Health Insurance Plan – you may not be able to insure your children on your policy. Healthcare.gov will instead send a referral to your state’s SCHIP program. In Illinois, that program is entitled “All Kids Covered“. You may wish at that juncture to purchase private health insurance at full price for your children instead if you cannot find a Pediatrician who will accept “All Kids Covered”.
Short Term insurance is unsafe to buy in Illinois until July 1st of each year.
On October 12, 2017 President Donald Trump signed this Executive Order designed to restore consumer choice in the non ACA-qualified Short Term health insurance marketplace. Short Term health insurance is the only kind of non ACA (Affordable Care Act) qualified health insurance available in the individual marketplace. Short Term health insurance is considered major medical health insurance but it is not ACA-qualified. As such, Short Term health insurance does not cover preexisting conditions and you do have to answer health questions in order to qualify. As of October 2, 2018, President Trump’s Executive Order became the new Federal regulation and as such non ACA-qualified Short Term policies that keep you consistently insured for up to 360 days became once again available for all Americans to purchase. However, states retain the right to accept or reject the Trump restoration of non ACA-qualified Short Term health insurance policies.
Wisconsin, Indiana, Texas, Arizona and 23 other state regulators have accepted the Trump restoration. So, their residents can still purchase non ACA-qualified Short Term health insurance for up to 12 months at a time with the option to purchase from the same insurance carrier for up to 3 years. Short Term health insurance is safe to purchase in these states.
SHORT TERM HEALTH INSURANCE IS NOW UNSAFE TO PURCHASE IN ILLINOIS WITHOUT PROPER PLANNING
From October 2, 2018 to December 14, 2018 Illinois residents were able to purchase non ACA-qualified Short Term health insurance policies for up to 360 days thanks to Illinois Governor Rauner’s VETO of HB2624 which was the Illinois Democrat led attempt to block the Trump restoration of non ACA-qualified Short Term health insurance policies. Unfortunately, after Rauner lost his reelection bid, Illinois Democrat Senator Antonio Munoz began working to undermine President Trump’s much needed restoration of non ACA-qualified Short Term health insurance policies. Munoz’s effort was unfortunately successful and as of December 14, 2018 Illinois residents can now only purchase Short Term health insurance for a maximum policy term of 180 days.
This action by Illinois Democrats has once again left Illinois consumers who do not qualify for Federal health insurance subsidies with no other safe option but to purchase ACA-qualified health insurance at a premium that is not only not “affordable” but now exceeds their mortgage payments. A non ACA-qualified Short Term policy that lasts for only 180 days exposes consumers to unique and significant risk by potentially leaving them uninsurable in the middle of the year if at the end of the first 180 day Short Term policy, they are at that juncture too sick to qualify for another 180 day Short Term policy.
As of January 1, 2014, Americans can only purchase Individual ACA-qualified (Obamacare) health insurance policies that cover preexisting conditions during a short “open enrollment” window between November 1st and December 15th of each calendar year. So, a consumer whose Short Term policy ends in 180 days could be left without the ability to obtain health insurance that covers preexisting conditions again until January 1st of the following year. This could happen if they were to develop a medical condition that would render them unable to qualify for another Short Term policy. There is a way to ensure that small business owners have access to health insurance that covers preexisting conditions at any time throughout the year. This can be accomplished by purchasing group insurance.
PLEASE NOTE: Since Group health insurance is available all year long and it covers preexisting conditions. It is absolutely essential for Illinois residents who plan on continuing to purchase Short Term health insurance (after January 1, 2020) to ensure they have the proper business structure in place in order to be able to purchase group health insurance at any time. This way, when a six month Short Term policy ends (at the end of June for example) you will be able to purchase group health insurance if at that juncture you or a family member becomes too sick to qualify for another Short Term policy. Since Short Term policies do not cover preexisting conditions, it is extremely important to have your company properly structured ahead of time so that you can purchase group health insurance at any time should you need coverage for preexisting conditions. As few as two people can purchase group health insurance, even husband and wife teams who have no employees. To learn how to structure your small business in order to ensure you have coverage for preexisting conditions at any time throughout the year, please call us directly at (630) 582-1043. Or, click “Contact” above to email us.
Below is more information about United Healthcare’s Short Term health insurance policies:
United Healthcare’s non ACA-qualified Short Term health insurance policies are the most comprehensive non ACA-qualified Short Term health insurance policies in the industry. Unlike other non ACA-qualified policies, these policies cover outpatient prescription drugs and your health plan deductible is waived for Urgent Care visits and the “Short Term Medical Copay” plan waives the health plan deductible and only requires a $50 co pay for three outpatient doctor office sick visits each year. United Healthcare also covers each insured member to $2,000,000. United Healthcare’s Short Term policies also include their national “Choice” PPO network which include in network access to Chicago’s Teaching hospitals such as Northwestern Memorial, University of Chicago, Rush university medical center and the Lurie Children’s hospital. You can search for in network PPO providers within United Healthcare’s Choice PPO by clicking here. United Healthcare’s best designed plan is their “Plus Elite” plan which provides 100% coverage after the deductible has been satisfied. It also provides a “first dollar” (no deductible required) benefit for outpatient Urgent Care visits. To view their new non ACA-qualified Short Term health insurance brochure click here. For quotes and to apply online click United Healthcare logo below:
Another unfortunate consequence of this new legislation enacted by Illinois Democrats is that Illinois consumers can no longer purchase another 6 month Short Term health insurance policy from the same insurer (after their initial 6 month Short Term policy ends) without a 60 day coverage gap between policies. This means that those who have a United Healthcare Short Term policy now must purchase their second 6 month Short Term policy from a different insurance company. The second best priced and best designed Short Term health insurance carrier in Illinois is National General insurance company publicly traded on the NASDAQ stock exchange under the ticker symbol NGHC. National General’s Short Term policies also include a national PPO network. That network is Aetna’s Open Choice PPO network. It also includes in network access to Chicago’s Teaching hospitals including Northwestern Memorial, University of Chicago, Rush university medical center and the Lurie Children’s hospital. You can search for in network providers PPO providers within Aetna’s Open Choice PPO network by clicking here. After entering your zip code, choose “Open Choice PPO” on the next page under “Choose a plan”. You can then begin your network search. To view their new non ACA-qualified Short Term health insurance brochure click here. For quotes and to apply online click the National General Accident & Health logo below:
PLEASE NOTE: There are two other health insurance carriers offering Short Term health insurance policies in the state of Illinois. They are Independence American via IHC – Independence Holding Group and “Pivot Health” products via Companion Life insurance company. These carrier’s offer Indemnity policies on a Short Term basis. Indemnity policies do not include a PPO contract. These Indemnity policies pay reasonable and customary charges only. Without a PPO contract included with your policy, a medical provider can balance bill you for charges above the reasonable and customary amount. For this reason we do not recommend purchasing Short Term Indemnity policies from Independence American or Companion Life.
Please also note: Non ACA-qualified Short Term health insurance plans are not required to cover certain “Essential Health Benefits” that are covered with ACA-Qualified plans. These benefits are:
1.) Maternity and newborn care
2.) Mental health and substance use disorder services
3.) ACA mandated Preventive care benefits. However, routine mammograms, birth control and cancer screenings ARE COVERED with non ACA-qualified Short Term health insurance policies in states like Illinois where these Preventive care benefits are mandated.
4.) Pediatric Services (including both oral care and vision care).
The ACA (Obamacare) Individual Mandate was REPEALED by congress on 12/20/17. The Tax Cuts and Jobs Act of 2017 zeroed out the Individual Mandate as of January 1, 2019.
On January 28, 2021, C.M.S. announced a 90 day Special Enrollment period due to COVID-19 which begins on February 15, 2021 and ends on May 15, 2021. During this Special Enrollment period you can purchase ACA-qualified (Obamacare) health insurance on a guaranteed issue basis (no preexisting condition exclusions and no health questions) even though the annual Open Enrollment period ended on December 15, 2020. To shop for 2021 ACA (Obamacare) Individual and Family health insurance policies from Blue Cross Blue Shield of Illinois, please click the logo to the left. New improvements for 2021 include the addition of the entire Northwestern Medical Group. Northwestern will not accept the HMO plans.
Medicare Supplemental coverage
If you’re over 65 or nearing that age and are looking for information and multiple free quotes on plans that will cover your Medicare deductibles and other out of pocket expenses. Visit our Medicare Supplement page