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ADAP to the Rescue!

If you have private health insurance or Medicare, there are important changes in the Illinois AIDS Drug Assistance Program (ADAP) that may help you with some of your drug costs. Additionally, ADAP may make it possible for some people to afford comprehensive health insurance coverage under the new Illinois Pre-Existing Condition Insurance Plan (IPXP). First and foremost: The income eligibility limit for Illinois ADAP is 500% of federal poverty. That means for 2011, your annual income must be less $54, 450 in order for you to enroll in any of ADAP’s programs. So let’s dig in and explain. For folks with private insurance: ADAP used to pay drug copays for people with private health insurance, but only if the copays were more than 20% of the drug costs or if a drug’s individual copay was more than $100. But...

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Health Care Reform Takes Effect Today … Sort Of

So you’ve probably heard lots of news stories telling you that many of the most important aspects of the Affordable Care Act going into effect today. For example, insurers can no longer deny insurance for children with pre-exisiting conditions. And insurers can’t put life-time caps on the benefits in their plans. That’s not quite the whole story. In fact, for any particular insurance plan these changes will go into effect on the date of the new plan year, on or after September 23, 2010. That means that the changes happen the next time your insurance plan renews. So for example, if your current insurance plan has a million dollar lifetime cap, that cap doesn’t disappear today. It disappears when your plan is up for renewal. The cap stays in place until that time. There, hope that clears things...

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New Insurance Option in Illinois

One big piece of health insurance reform is now in place in Illinois: a new high-risk insurance pool for Illinoisans who are otherwise uninsurable. The new plan goes by the sub-euphonious moniker, Illinois Pre-Existing Condition Insurance Plan, or IPXP. We can’t fathom why the program’s acronym isn’t IPCIP, or even IPXCP, but who are we to question the wisdom of government bureaucrats? EIEIO. Anyway, to qualify for IPXP a person has to have been uninsured for at least six months, have a pre-existing condition, be a U.S. citizen or legal resident, and be unable to obtain health insurance from any other source. The premiums are considerably lower than Illinois’s other high-risk insurance pool, ICHIP. But unfortunately folks currently enrolled in ICHIP are not eligible for IPXP — which is a bit like being barred from buying a cheaper toaster...

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Wrapping Our Brains Around Health Care Reform

Quick! According to the new, massive health care reform law, when must employers begin to report the value of employees’ health insurance benefits on their W-2s? When will Health and Human Services establish a process to review unreasonable insurance premium increases? When must insurance companies start selling individual insurance policies to anyone, regardless of pres-existing condition? If you know the answers to any of these questions, you are a bigger wonk than us. But if you’d like a concise timeline for the implementation of the various aspects of health care reform, click on this lovely link and read to your wonky heart’s...

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More Health Insurance Reform Specifics

Yesterday’s Chicago Tribune featured an interesting interview with Michael McRaith, director of the Illinois Department of Insurance, about the effects of the new health insurance laws on Illinoisans. Here’s something McRaith said that jumped out out at us: “Effective immediately, the secretary of (the U.S. Department of) Health and Human Services, in conjunction with the states, has authority to review and challenge unreasonable health insurance rate increases. Right now, insurance companies report premium increases in the individual market, but we (in Illinois) do not have the authority to approve or deny rate changes. In the small-employer market, we don’t even get informed of rate increases or premiums charged. We will establish a protocol (for reporting data) as soon as possible. … It is absolutely certain that if there is an unreasonable rate increase, we will examine that and we...

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President Obama signed health insurance reform into law just a few minutes ago. Here are some important highlights from the new law. Effective in 2010: Employment-based and individual insurance policies will have to end pre-exisiting condition exclusions for children. Individual and group plans will not be able to rescind coverage except in cases of fraud or intentional misrepresentation. Policies can have annual caps on benefits only if allowed by the secretary of Health and Human Services. Children up to age 26 can stay on their parents insurance (yeah, yeah, we know that 26-year-olds aren’t children, but you get the point). Small employers (under 25 employees, average salary under $50,000) who offer insurance get a tax credit. A new national high-risk insurance pool will be available to people with pre-existing medical conditions who have been uninsured for at least six...

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