The Affordable Care Act (ACA) has provided individuals and families with several ways to access health insurance. These include Marketplace (also known as the Health Insurance Exchange plans), Medicaid, private policies through an insurance agency or employer, among others.
According to your situation, you may qualify for advance premium tax credits or cost-sharing reductions. This means you’ll pay less monthly for your policy.
Low out-of-pocket maximums
If you’re searching for an affordable health insurance plan, Illinois has some of the lowest out-of-pocket maximums in the country. These low limits give you predictability when it comes to costs and keep medical expenses under control so that you can reap all of its benefits.
An out-of-pocket maximum is the most you will pay out of pocket during a policy period (typically a year). Deductibles, coinsurance and copays all count toward this limit.
Selecting a plan with a high out-of-pocket maximum can result in higher monthly premiums, but you may qualify for cost sharing reduction subsidies. Illinois’ lowest Silver plans are eligible for these subsidies and can help reduce your out-of-pocket healthcare expenses.
Comparing the average premiums of Silver plans across Illinois will help you determine which plan is most affordable for your needs and budget. For instance, a 40-year-old woman enrolling in a Silver plan with a $4,000 deductible and $4,400 out-of-pocket maximum will pay an average monthly premium of $533 from 2023 until 2024.
Coverage for pre-existing conditions
Thankfully, the Affordable Care Act prohibits health insurance companies from charging more or denying coverage based on a preexisting condition. Furthermore, once you buy a plan on an exchange site, the law requires it to cover your medical needs.
However, it is still essential to search for a plan that won’t increase your out-of-pocket expenses. This is especially relevant for those with chronic diseases or health conditions requiring regular treatment.
Illinois residents have access to insurance through the Healthcare Marketplace, the state’s health insurance exchange. Here, they can compare plans and premiums across different metal tiers and age groups.
For a 40-year-old male, the average cost of health insurance for a policy is $533 per month. You have several options when selecting your plan: higher-cost Gold or Platinum with lower deductibles and out-of-pocket maximums can save on monthly premiums by opting for these higher plans.
Coverage for children up to age 14
The federal government funds Medicaid and the Children’s Health Insurance Program (CHIP). These programs assist low-income people in accessing medical care. They cover doctor visits, hospital services, prescription drugs, and dental work.
Illinois’ All Kids program provides coverage to eligible children and parents with incomes up to 213% of the Federal Poverty Level (FPL), as well as pregnant women.
Families earning between $44,100 and $90,000 can qualify for FamilyCare, a plan which offers comprehensive medical, dental, vision and prescription drug coverage to all members.
The state’s new All Kids program seeks to reduce the number of uninsured children in California by providing comprehensive insurance options for families with limited incomes. It will pre-register and enroll up to 50,000 kids during its initial year, with additional enrollments anticipated over five years.
Coverage for pregnant women
To guarantee you and your baby access affordable healthcare during pregnancy and childbirth, consider getting coverage through Medicare, Medicaid or the Children’s Health Insurance Program (CHIP). There are multiple options for obtaining this type of coverage including Medicare, Medicaid or CHIP.
Prenatal health insurance can be an invaluable asset to both you and your baby, providing them with essential medical services without worrying about hefty bills in the future. Not only does it make it simpler to access necessary health care during your pregnancy, but it may also protect against future medical bills that could prove expensive in the future.
In Illinois, pregnancy-related Medicaid coverage is provided to women whose incomes fall below 133% of the federal poverty level for up to 60 days postpartum. Unfortunately, some postpartum individuals do not maintain coverage after this period – especially in nonexpansion states – which estimates suggest costs to the Medicaid program at least $2.5 billion annually.
