Illinois Health Insurance Company Review
It is estimated that about 12,831,970 people live in Illinois, an increase of 3.3% from the year 2000. Recently the Governor of Illinois, Mr. Rod R. Blagojevich announceD that his administration will fight against the high uninsured ratio by allowing more money to go towards health care information security and for quality health care for all Illinois residents. With the increase in population many health care companies have begun campaigns to attract potential customers to them knowing that almost anyone in today’s society would be attracted to cheap and excellent health insurance coverage. Below you will find seven of the top health insurance companies in the state of Illinois, the plans that they offer and the history of each company.
UniCare of Illinois
This Company is a national organization focused on the delivery of quality health care products for their members. The company is one of the nation’s largest publicly traded managed care companies and has an estimated 13 million members throughout the United States. They offer a portfolio of health, life, pharmacy, dental and disability products that are directed to satisfy each member and their specific needs. Founded in the year 1995, UniCare (Affiliated Company of WellPoint Inc) knows that customers and employers want to save money and be well covered at the same time. Because of this they created products that combine the low-cost part of the equation and that best cover their members. They offer HMO and PPO plans for both members and business groups and they are rated with an A- by A.M. Best which lets customers know that they have very strong financial strength ratings. The plans offered within this state are divided into three categories, each with different deductibles and services offered to the customer:
a. UniCare Saver 2000: This plan is perfect for those who want low monthly premiums and not very high out of pocket costs when using the services. You will have a deductible of $2,000 with an out of pocket maximum of $3,000. For families the deductible and out of pocket maximum double. Preventive care under this plan is not covered and it only gives you 2 doctor visits a year for which you will have to pay $30 each (if you decide to go for a third visit you will be charged 100%. Everything else, (in network) will require you to pay a 30% co-insurance; this is for services such as adult preventive care, inpatient hospital service, outpatient medical care, and lab tests. Prescription drugs are divided into generic drugs (you will pay a $10 copay) and brand name (you have a $200 deductible, and then you will pay a $25 copay). You can also go out of network for an additional of $1000 in deductible and a co-insurance of 40% instead.
b. HSA Compatible Plan: As the name says all the plans under this category give you the option of making the coverage compatible with your Health Savings Account. With these plans you have deductible options of $1,100, $2,600 and $5,000 with family deductibles doubling the ones said above. For most of the services you will have to pay a 20% co-insurance and under this plan you will be covered for the three tiers of prescription coverage (generic, brand name and specialty) but you will have a $100 deductible and you will pay $10, $30 and $50 for each tier respectively. You will also have the option of going out of network for more expensive prices.
c. Fit Plans: This plan’s focus is more on the Health Maintenance Organization (HMO) kind of approach to health care. You will have the option of two plans ($500 and $1,000) individual deductibles in which you will be responsible to pay a 20% co-insurance when you use selected services. You will also have the option of choosing deductibles of $2,000, $3,000 and $5,000 with a co-insurance of 30%. For doctor visits in all of these plans you will be asked to pay a $30 cost and prescription drugs are divided into the three tiers (generic, brand name and specialty) with prices of $20, $60 and $100 respectively.
BCBS of Illinois
Blue Cross and Blue Shield is a company made up of 39 independent, community based and locally operated Blue Cross and Blue Shield companies. The company was started in the year 1929 in the state of Texas as a non-profit health insurance for teachers and then after this it spread out to the United States. Today Blue Cross and Blue shield serves in all 50 states, the District of Columbia and Puerto Rico and their brands are registered in more than 170 countries! About 90 percent of hospitals and 80 percent of physicians nationwide have contracts with BCBS and the number keeps growing. Blue Cross Blue Shield of Illinois however, was started during the Great Depression (1936) when a group of Chicago business leaders decided to form a company called Hospital Service Corporation. Today Blue Cross Blue Shield of Illinois covers about 6.5 million people within the state and their numbers keep growing. They offer a variety of plans because they have to satisfy a diverse group of customers. Below you will see the plans they offer with the rates you should expect to pay.
a. Select Blue and Select Blue Advantage: This plan has a provider network that includes about 90% of physicians in Illinois and more than 2,000 hospitals. They offer you a variety of individual deductibles ($0, $250, $500, $1,000, $2,500 and $5,000. For office visits you will have to pay a $20 copay and for most services your co-insurance would be completely covered by the company or you will have to pay a 20% co-insurance. This is based on the deductible option that you select. Prescription coverage is only available for the people that selected deductibles of $0, $250 and $500; and they would have to pay nothing for generic, 35% co-insurance for brand name and 50% for specialty.
b. Blue Value and Blue Value Advantage: With this plan you will have a choice of deductibles from $250, $500, $1,000, $2,500 and $5,000. Your out of pocket limit would be $1,000 or $3,000 depending on the choice that you select and the co-insurance for most services will be paid in full by the health insurance company or you will have to pay 20%. For prescription drugs you will have to pay a 20% co-insurance regardless of the tier the drug is found under or the deductible option you select.
c. Blue Choice Select and Blue Choice Value: This plan is a Point of Service plan that allows you to stay in network and choose a primary care physician that manages your health care, or you can go out of network and visit any specialist and any doctor of your choice. They have deductible options of $250, $500, $1,000, $1,750, $2,500 and $5,000 with the deductible for out of network coverage doubling. You will have a co-insurance of 20% in network and 50% out of network depending on which side you choose. For prescription drug coverage if you have a $250 and $500 deductible you will be able to pay a $10 copayment for generic, 35% co-insurance for brand name and 50% for specialty, but if you have other deductibles you will end up paying 20% co-insurance. For Blue Choice Value it is important to know that if not offers prescription drug coverage, other than that the rates are the same.
d. Basic Blue Plan: With this plan you will have the choice of three deductibles: $500, $1,000 and $1,200. You will be covered with a 20% co-insurance for all of the services including outpatient care, inpatient surgery and other care, doctor visits, etc. The only thing about this plant that might throw a lot of people off is that it does not offer prescription coverage and that for emergency room fees you will have to pay a $125 copayment first.
e. Blue Edge Individual HSA: This plan is a Health Savings Account compatible plan that allows people to save some money when electing to use their health care. You will have the choice of $1,100, $1,750 and $2,600 deductible options with the family deductible options doubling these. Depending on your deductible option you will have all the services covered after you meet your deductible or you will only have to pay a 20% co-insurance when using the services. If you choose to go to a non-service provider, your co-insurance will rise from 0% to 20% and from 20% to 40% respectively.
f. Blue Edge Individual HSA 500: This plan is very simple. It is a Health Savings Account compatible plan and you only have a $5,000 deductible option. If you choose to stay in network you will be completely covered by the insurance company for any of the selected services that they offer. If you decide to go out of network however you will be required to pay a 20% co-insurance.
Golden Rule United Healthcare of Illinois
“Follow the Golden Rule and you will find great insurance” is this company’s motto. They were founded in the year 1940 by Michael and Mary Rooney. The couple founded the company in the city of Lawrence, Illinois; however the main office of this company can be found in Indianapolis, Indiana ever since the 1970’s. The most important event in the history of this company was when they were bought by United Healthgroup Inc. in 2003 for the sum of $500 million. Ever since that year the company has been known as one of the most important subsidiaries to United Healthgroup Inc. and can now be found in 28 out of the 50 states of the nation. Golden Rule Insurance has exceeded their expectations through these three years they have worked under the United Healthgroup Company and are proud of their outstanding service. It is exactly the customer service part of Golden Rule that brings the company to the top of the health care industry. They process about 94% of claims within 10 days or less and they also offer discounts of 35%-45% for their members thanks to their nationwide network of doctors and hospitals. One of the biggest providers in the state of Illinois, they offer many plans to fit their diverse number of customers. Below you will find a description of each plan with some of the rates you should expect to pay.
a. Plan 100: With this plan you have the following choices on deductibles: $1500, $2500, $3500 or $5000. They will pay 100% of the co-insurances on services once you have paid the deductible and the rate is locked for 12 months. For preventive care services (Doctor Visits, Child Immunizations and Mammograms) you wont have to pay anything once you meet your deductible, the same goes for outpatient services (doctor visits, prescription drugs and lab tests such as X-rays). The only thing you would have to pay is an emergency room fee of $100 if you don’t get admitted into the hospital in case of going for an emergency. For inpatient services everything is covered 100% once you meet your deductible. It is important to note that since everything is paid for once you meet that deductible; the monthly rates might be a little higher than other plans.
b. Plan 80: This plan is much the same as the 100 plan. You will be able to choose between $1500, $2500, $3500 and $5000 deductibles and the rate will be locked for 12 months. The difference comes in the co-insurance payments once your deductible is reached. With this plan you will have to pay 20% to $3000. This means that the company will pay 80% of the co-insurance and up to $12000, then everything is covered. For preventive services such as doctor visits, immunizations and mammograms you should expect to say 20%. For outpatient services such as doctor visits, prescription drugs, CAT scans and MRI’s you should also expect to pay 20% co-insurance. The emergency room fee is different because if you decide to go you will have to pay 20% co-insurance plus $100 more if you are not admitted. Inpatient services such as surgeries you also will be required to pay 20% of the total cost once your deductible has been met.
c. Saver 80: This plan is a little different that the two plans we have seen and is the plan with the lowest monthly premium because is the one that charges you more when you use the services. You have deductible choices of $500, $1000, $1500, $2500, $3500 and $5000 and just like the other two your rate will be locked for 12 months. Most preventive care is not covered and you will have to pay 20% co-insurance for preventive tests such as mammograms and Pap Smears. Outpatient Services are also much different under this plan. If you decide to go for a doctor visit you will have to pay full price, in other words you are not covered. Outpatient drug prescriptions are not covered, however a discount card is sent over the mail for members of this plan. Everything else is 20% co-insurance, except that with the emergency room fee you will have to pay $500 if you are not admitted. All inpatient services are 20% co-insurance as well.
d. Copay Select: This plan is a copay based plan instead of a co-insurance one. What this means is that you will have to pay a particular amount for most of the services instead of a percentage. With Copay Select you will be able to choose from $500, $1000, $1500, $2500 and $5000 in deductibles and your rate would be locked in for 12 months. For preventive care office visits and outpatient doctor visits you will have to pay $35 dollars. The prescription drugs under this plan are divided into tiers (generic, brand name and specialty) and you will have to pay $15, $30 and $60 accordingly. You will have to pay a 20% co-insurance in all the other outpatient services as well as inpatient care. Emergency room fee if you are not admitted is $100.
e. Copay Saver: This is another copay plan offered by Golden Rule Health. The plan only allows the member to choose from a $2500 and a $5000 deductible. Most Preventive care is not covered and only tests such as mammograms in which you would have to pay 20% are covered. For outpatient services you will have to pay $35 for a maximum of 2 visits per year, although you can purchase more. The prescription drug tier would $15 for generic with brand name and specialty drugs not covered and everything else would be a 20% co-insurance. The emergency room fee if you are not admitted is $500 and inpatient services are covered if you pay 20% co-insurance.
f. HSA 100: These plans are compatible with health savings accounts. Deductibles for this plan are $1100, $1850, $2850, $3500 and $5000 for an individual and for a family those deductibles double. The rate is locked in for 12 months and after you reach your deductible you won’t have to pay for a single thing. Everything under preventive care, outpatient services and inpatient care is covered 100%. No need for copayments or co-insurances, not even if you go to the emergency room and are not admitted.
g. HSA Saver: This is another plan compatible with a health savings account. Deductibles for this plan are the same as the other one: $1100, $1850, $2850, $3500 and $5000 for individual and those are doubled for family. Within preventive care you are only covered 100% for tests, other than that you are not covered. Outpatient care is quite different from the other Health Saving Account plan. You will not be covered for doctor visits and for prescription coverage you will only be given a discount card. If you don’t get admitted to the emergency room when you go, then a fee of $250 will be implemented. Impatient care stays the same and you will be covered 100% for anything within this category.
Aetna of Illinois
This Company was founded in the year 1850 in the state of Connecticut as annuity fund to sell life insurance; the company has continuously kept growing and giving more and more people an opportunity for low-cost, excellent health plans. Today, Aetna has an estimated 15.8 million medical members, 13 million dental members and 10.6 million pharmacy members. They have over 793,000 health care professionals affiliated to them, 462,000 primary care doctors and physicians and 4,716 hospitals. This was also the first insurance company to offer a consumer-directed health plan and it continues to lead the way with its diversity of plans and coverage. Aetna insurance company offers major medical plans in the state of Illinois and one preventive and hospital care plan.
a. IL PPO: These plans have deductible options of $500, $1,000, $1,500 $2,500 and $5,000. Your co-insurance will be 20% after you meet the deductible and your out of pocket maximum is based on your deductible. For an office visit to your primary care physician or any non-specialist doctor would be $20, while if you go for a specialist visit you would pay $30. For any other service you will be subject to 20% co-insurance, although prescription drugs are a little bit different. You will have a $250 deductible and after you meet it you will pay $15 for generic, $25 for brand name and $40 for specialty. If you decide to go out of network your deductible will double and your co-insurance would be 50%.
b. IL High Deductible 3000 Plan: This is Health Savings Account compatible plan with deductibles of $3,000 and $6,000. It is easy to describe this plan because after you meet your deductible everything will be covered by your health insurance company (inpatient and outpatient care, doctor’s visits, preventive care, etc). If you go out of network then you will have a 50% co-insurance.
c. IL High Deductible 5000 Plan: This is another Health Savings Account compatible plan with deductibles of $5,000 and $10,000. This is another plan that if you meet your deductible you will be covered 100% by the insurance company. If you go out of network you should expect to pay a 50% co-insurance.
d. Preventive and Hospital Care 1250: These plan has a deductible of $1,250 with the deductible for families being double that. You will not have your office visits covered and you will pay a 20% co-insurance for all the services. Pharmacy is not covered and if you want to go out of network you should expect your deductible to double and your co-insurance to be 50%.
e. Preventive Hospital Care 3000: This is a Health Savings Account compatible plan with deductibles of $3,000 and $6,000. Doctor visits and prescription medications are not covered; every other service covered is subject to a 20% co-insurance in network and a 50% co-insurance out of network. You should also expect your deductible to double if you go out of network.
Celtic of Illinois
One of the most prominent health insurance companies in the state is Celtic Health Insurance. The company was founded in the year 1978 in the city of Chicago, Illinois. They started the career in the health care industry providing group and individual health plans along with life insurance. After realizing that they could not focus on those three types of insurance, they decided to stick with individual health insurance plans. Today they are one of the top health insurance companies for individual plans with over 900,000 members and they are licensed in 49 out of the 50 U.S. states (all states except for Hawaii).
a. CeltiCare II Select PPO Plan: This plan is a physician and hospital PPO plan for members between the ages of 6 months and 64 ½ years old. The calendar year deductibles for these plans are $500, $1000, $1500, $2500 and $5000, with out-of-pocket maximums of $2500, $3000, $3500, $4500 and $7000 respectively. You have a maximum of six visits to the doctor per calendar year; each of them will be $15. If you happen to go for a seventh visit you will pay full price and that money will be discounted from your deductible. Laboratory fees and x-rays are paid 100% unless they go past $200, then you will have to pay full price subject to deductible. Prescription drugs are divided into three tiers, but before you get the actual prices you will be subject to a $500 deductible. After this deductible you will pay $20 for generic, $40 for brand name and $75 for specialty. You will have to pay $250 in addition to your yearly deductible if you go to the emergency room; however the fee is cancelled if you are admitted. Lastly, for inpatient care your hospital is covered up to 4 times in a calendar year. It is important to note that you have the choice to go out of network, but you will have a $1500 annual deductible.
b. CeltiCare II “Any Doc” PPO Plan: This plan is an any physician-hospital PPO for member between the ages of 6 months to 64 ½ years old. The annual plan deductibles for this plan include $500, $1000, $1500, $2500 and $5000 with out-of-pocket maximums of $2500, $3000, $3500, $4500 and $7000 respectively. You will have six visits to the doctor per calendar year and each of them will be $35. In the case that you want to go for a seventh visit you will have to be subject to your deductible (pay full price). Labs and X-rays are the same as the previous plan and are paid 100% until you exceed 200. The prescription drugs are $20 generic, $40 brand name and $75 specialty and emergency room fees are $250 if you are not admitted. Inpatient care is covered up to 4 visits per year and if you go out of network you will have another $1500 deductible.
c. CeltiCare II Managed Indemnity Plan: This plan has no network requirements meaning that you can go anywhere you want and the cost for your services will be the same. The age requirements for this plan are the same as the other (between 6 months and 64 ½ years old). Deductibles for this plan are as follows: $500, $1000, $1500, $2500 and $5000 with out-of-pocket maximums of $2500, $3000, $3500, $4500 and $7000. Outpatient and Preventive office visits will cost you full price and prescription coverage is divided into three with generic drugs being $20, Brand name medications $40 and specialty medications are $75. Inpatient care is covered up to 4 visits per year and the emergency room fee is $250 if you are not admitted to the hospital.
d. Celtic Basic Health Plan: This plan operates within the physical and hospital PPO network and is available for people between the ages of 6 months and 64 ½ years old. Deductibles offered are $1500, $2500 and $5000, but an additional $1500 in deductible will be added if you want to go out of network. You will have 2 doctor visits per year for the cost of $30 each and then you pay full price until meeting deductible. Labs and x-rays are also charged full price until you meet the deductible and you will also have to pay a fee of $250 every time you go to the emergency room if you are not admitted. For hospital care you will have to pay a $500 deductible per admission and you will have to pay $1000 deductible on prescription medications. It is also important to mention that the drugs are divided into the frequent three tiers and you will pay $25 for generic, a 35% co-insurance for brand name and 50% co-insurance for specialty. This plan also offers preventive care, rehabilitation services and home health care.
e. CelticSaver HSA Health Plan: These plan operates in two different networks, a managed indemnity and a PPO with the age of members between 18 and 64 ½ year of age. Deductibles for individuals under this plan are $1500, $2600 and $5000 with the family deductible being doubled. Non-preventive office visits are covered after the deductible is met as well as prescription medications. The emergency room fee is that of $250 if you are not admitted and the plan includes preventive eye care up to $50 dollars, psychiatric care up to $2500 per person and manipulative theory up to $500 per calendar year. Inpatient intensive hospital care is covered up to 4 visits per calendar year and the plan also included home health care for those people that need it.
Humana One of Illinois
A great option for those people living in the state of Arizona can be Humana Health. Best known for being the official health care provider sponsoring the PGA Tour, Humana is one of the largest health insurance providers in the United States. The company itself was found in the year 1961 in Louisville, Kentucky within the nursing home industry. The founders of the company were two successful lawyers by the names of David A. Jones and Wendell Cherry and four of their friends who together invested $1000 each in order to start this now extremely large Illinois health insurance company.
a. Autograph Total HSA: With this plan you are can choose from the following individual deductibles: $2,000, $3,000, $4,000 or $5,200 with the family deductibles being $4,000, $6,000, $8,000 and $10,400. Once you meet your plan’s deductible every service will be covered in its entirety by Humana. If you choose to go out of network the deductibles double and you will have to pay a 30% co-insurance for every single service. This plan as its name shows is Health Savings Account compatible. It is important to note that this plan does not include prescription drug coverage.
b. Autograph Total plus Rx/HSA: These plans are Health Savings Account compatible and you can choose from deductibles of $1,500, $2,500, $3,500 and $5,000 for individuals. The family deductibles are $3,000, $5,000, $7,000 and $10,000. After you meet your deductible you will be covered 100% for any service except for mental health which you would have to pay a 50% co-insurance. This plan also covers you for prescription medications, unlike the one right above it. If you choose to go out of network you will be subject to pay higher deductibles and 30% co-insurance for the covered services.
c. Autograph Share 80 Plus Rx: With this plan you will have the choice of $5,000 or $6,000 individual deductible and $10,000 or $12,000 for a family. For the first six visits to a doctor you will have to pay $35 (Primary Care Physician) and $50 (Specialist) and then you will be subject to a 20% co-insurance. Inpatient and Outpatient hospital care will be 20% co-insurance after you meet the deductible and emergency room visits cost you $75 before you meet your deductible (20% co-insurance after that). For prescription medications you will have a $1000 deductible and after it you will pay $15 or $35 depending on the tier. You can go out of network if you so preferred, but you will have to pay a higher deductible and a higher co-insurance.
d. Autograph Share 70 Plus Rx: You will have the option of a $2,500 or $5,000 for individual and $5,000 or $10,000 for families. The out-of-pocket maximum is $3,000 and $6,000 for individual and family respectively. For all the services you will have to pay 30% co-insurance after you meet your deductible and prescription medications will have a $1000 deductible. After you meet that deductible you will pay $15, $40 and $65 respectively depending on which tier the medication falls.
e. Portrait Share 80/1000 and 80/2500 plus Rx: If you happen to join this plan you will have an individual deductible of $1,000 and a family deductible of $2,000 with an out-of-pocket maximum of $2,000 for individual and $4,000 for family. You can also choose another deductible option of $2,500 for individual and $5,000 for family if you so decide. For primary care physician visits you will pay $30, while specialist visits go up to $50. Inpatient and outpatient surgical care would be 20% co-insurance after you meet your deductible and emergency room visits are also 20% after you pay a $75 copay and your deductible. Prescriptions are divided into three tiers for which you will pay $5, $35 and $55 respectively after you meet a $500 deductible. You also have the chance of going out of network for a higher deductible and co-insurance price.
f. Monogram Total plus Rx: This plan only allows you to choose from a $7,500 deductible for individuals and $15,000 for family. After you meet your deductible you will be covered 100% for every service except prescription coverage. Prescription medications include another $1000 deductible and it’s divided into three levels for which the customer will pay $15, $40 and $65 respectively. If you decide to go out of network you will be subject to a $15,000 individual and a $30,000 family deductible. Also, you will have to pay 25% and 30% co-insurances depending on the service.
Sound of Illinois
Started in the year 2006 by Unicare Life and Health Insurance to address the health insurance needs of people between the ages of 19 and 29. This plan was started in the states of Texas and Illinois and because the health insurance is designed for the young adults, premiums start as low as $68 a month depending on the plan selected, medical history, age and the place where the applicant lives. They are available for every resident of the state of Illinois that wants to apply. Below there will be a brief description of the three plans being offered and what they rates are for each of them.
a. The Cruiser: The general rate for this plan would be in between the prices of $101 to 147 per month. You will have a deductible of $1,500 and pay for unlimited doctor visits at the price of $40 a visit. After you meet the deductible you will not have to pay a single penny out of your pocket because you will be covered 100% by Sound Insurance. The only thing you will have to pay for is emergency room visits if you are not admitted, they can cost you $150.
b. The Curb Jumper: The general rate for this plan would be in between the prices of $78 to $116 per month. You will have a $3,000 annual deductible with a $40 copay for doctor’s visits. You will be covered 100% by Sound insurance company after you meet the deductible and for emergency room visits you will have to pay a $150 fee.
c. The Gravity Bender: The general rate for this plan would be between the prices of $68 to $103 per month. Your deductible will be $5,000 and you will be paying a $40 copay once again. After you meet the deductible everything will be covered and you won’t have to pay anything; only for not-admitted emergency room visits which you would pay $150 for the fees.
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