Illinois Comprehensive Health Insurance Plan

Illinois is one of 35 states that offer special plans for people with chronic illnesses who can’t get medical coverage from private health insurers.

It’s the Illinois Comprehensive Health Insurance Plan, commonly known as ICHIP.

I asked Michael McRaith, secretary of the state’s Department of Professional and Financial Regulation, to explain how it works. He told me the program was established almost 20 years ago to serve as the “health insurance carrier of last resort” for Illinoisans.

For people losing their jobs and health care coverage, it’s an option worth knowing about.

ICHIP runs two programs: a traditional pool and a HIPAA pool, McRaith said.

The traditional pool is for people who have tried and failed to get medical coverage elsewhere. Also, it’s open to anyone with 31 serious, presumably uninsurable medical conditions, including AIDS, cystic fibrosis, juvenile diabetes, leukemia, multiple sclerosis and Parkinson’s disease.

The traditional pool is funded by premium payments and by state funding (almost $20 million in fiscal 2008). By law, premiums can’t exceed 150 percent of those charged in the conventional insurance market. Charges vary depending on someone’s age, sex, location and the plan design—but not by health status.

Lifetime benefits are limited to $2.5 million. No one has reached that limit yet, McRaith said. Only U.S. citizens or lawful residents qualify.

Like several other states, Illinois restricts the number of people who can enroll in the traditional ICHIP pool; the cap here is set at 5,950 individuals. That’s a way of restricting the program’s size and limiting the state’s financial exposure.

High premiums also serve that purpose: Many people with serious chronic illnesses simply can’t afford the monthly expense. For them, the promise of an “insurer of last resort” is just too costly to be of help.

As of January, 4,986 people were enrolled in ICHIP's traditional plan.

I asked McRaith to run some numbers for me. For an ICHIP traditional plan with a $500 deductible —the most common type selected by members—a single, 35-year-old Chicago woman would pay $597 a month for coverage. A 50-year-old woman would pay $923 a month; a 62-year-old man, $1,466.

A deductible is the amount that a member pays out of pocket before insurance coverage kicks in.
Double the deductible to $1,000, and the first woman would pay $544 a month, the 50-year-old woman $866 and the 62-year-old man $1,370. Rates are slightly lower for residents of Cook County, excluding Chicago.

For more information about the traditional plan, call 1-800-962-8384 for general information. For information about eligibility, call 1-866-851-2751.