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Individuals &

More than 1.5 million people in Illinois who were uninsured in 2013 are now are guaranteed access to affordable, quality health insurance coverage. Consumers now need to understand how to navigate the healthcare system and the new health insurance marketplace in order to access coverage, and make use of the healthcare protections and benefits now available.


 Q:   I underestimated my 2014 income for premium tax credits. I'm not able to pay the IRS back by April 15. Will I have an additional penalty?

 A:   No.  You will not have to pay a fine if you don't already owe the IRS money and report the amount of premium tax credits owed in your 2014 tax return.You can file for an extension to pay back the IRS. This release from the IRS explains who will be waived from the penalty and this article from Forbes clarifies the information.

 Q:   Can people with SHOP coverage delay Medicare Part B enrollment without the penalty?

 A:   Yes. A person with SHOP coverage is the viewed the same as a person with an employer group health plan. The same enrollment rules apply. People must enroll in Medicare Part B within 8 months of retirement or their SHOP coverage ending, whatever comes first. This question and answer from addresses concerns Medicare beneficiaries may have about the marketplace.

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Managed Long Term Services and Supports

Starting July, 2016 managed care organizations will be responsible for coordinating long-term services and supports for people who live in a nursing facility or receive home and community-based services through a Medicaid waiver program. This April 2016 fact sheet from Health & Disability Advocates informs consumers about the change.

New Observation Status Rules

Starting August 2016, hospitals are required to let people know if they are an outpatient on observation status. This April 2016 fact sheet from Health & Disability Advocates prepares patients for the changes.

Illinois Health Policy Update

Get the latest with this April 2016 brief from Health & Disability Advocates.

Network Adequacy Analysis

This December 2015 report from the Aids Foundation of Chicago analyzes Illinois silver-level Marketplace plans’ coverage of HIV and the Hepatitis C Virus treatment. The trend has been for Marketplace plans to limit coverage of necessary treatments for this population.

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