What Do Most Illinois Health Insurance Plans Leave Out? PDF Print E-mail
Written by Mike Novelli   
Sunday, 22 August 2010 16:46
With the dawn of the Patient Protection and Affordable Care Act (PPACA) phasing in new health plan requirements; many consumers remain miffed by what the terms of these new policies actually cover. Aside from the premiums, physician visits, and other standard medical co-payments, consumers tend to overlook what a basic Illinois health insurance plan covers. Whether it's Blue Cross Blue Shield, Humana or Aetna, many Illinois health insurance policies have a litany of exclusions that consumer should note.
by MikeNovelli


With the dawn of the Patient Protection and Affordable Care Act (PPACA) phasing in new health plan requirements; many consumers remain miffed by what the terms of these new policies actually cover. Aside from the premiums, physician visits, and other standard medical co-payments, consumers tend to overlook what a basic Illinois health insurance plan covers. Whether it's Blue Cross Blue Shield, Humana or Aetna, many Illinois health insurance policies have a litany of exclusions that consumer should note.

Maternity. Depending on the medical policy, some Illinois health insurance policies do not include delivery charges or hospitalization for newborn conception. As certain policies extend care for midwives and OB/GYN care, new families are often left to flip the expense of hospitalization costs.

Injuries or ailments incurred by illegal actions. Don't count on any Illinois health insurance policy to cover the cost of any emergency care - hospital admission, resultant of drinking and driving, overdose of an illegal substance or even a failed suicide attempt. Also, accidents that are the outcome of a dangerous activity, such as jumping out of an airplane, bungee jumping or propelling off of a rooftop are often deemed excluded benefits.

Sexual reproductive enhancements. In the realm of sexual performance, reconstruction and transformation, most Illinois health insurance plans do not cover the cost of sexual transformation. While most health plans cover medications prescribed by one's physician, diagnostic and surgical procedures for sexual dysfunction are predominantly excluded benefits.

According to one's health scenario, it's vital to develop a checklist of medical service prerequisites. During the shopping process, evaluate the cost of finding medical insurance. Remember to calculate any out-of-pocket exclusions to the premiums with all required medical services included in the cost.

Prescribed medications home health care or hospice care. In recent years, certain Illinois health insurance policies may or may not include prescription and home health care. In an effort to keep health plans economical, some plans are strictly for prescribed medications. Correspondingly, some Illinois health insurance plans cover home health care, and custodial care. After the PPACA is in place, the law mandates that Americans will have to set aside funds for such services.

Even though the Patient Protection and Affordable Care Act will soon require that preventative medical services are free of fees, Illinoisans should still confirm which health benefits are included in each policy. While some plans offered via Humana One, Blue Cross Blue Shield features plans with preventative care benefits, not all health plans have revised their terms of service.

President of Illinois Life and Health.com Michael Novelli forewarns Illinoisans to peruse more than the policy's premiums. Frequently, consumers obsess over monthly rates and are astonished when they discover that medical services such as maternal care are not a covered benefit.

DISCLAIMER: This article is provided as information only and is not to be taken as financial advice.

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