Your Source for Health Reform

Individuals &
Families

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.


YOUR QUESTIONS ANSWERED

 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 Healthcare.gov addresses concerns Medicare beneficiaries may have about the marketplace.

More questions answered - Ask your own question


RESOURCES FOR YOU

Land of Lincoln Health insurance coverage will end for consumers as of October 1, 2016.  Land of Lincoln is no longer offering health plans for individuals on the Federal Health Insurance Marketplace (HealthCare.gov). Land of Lincoln has also stopped offering health plans for employer groups. Please note: it is very important that until October 1, 2016, consumers and employers must continue paying premiums. 

Below is an excerpt from the Land of Lincoln Health website instructing consumers and employer groups on coverage options:

IL Department of Insurance Director Dowling has been working with the Centers for Medicare and Medicaid Services (“CMS”) for purposes of having a special enrollment period opened in order to allow individual insureds an opportunity to obtain replacement coverage during 2016 on the Federal Health Insurance Marketplace (HealthCare.gov). CMS will provide Land of Lincoln individual insureds with a special enrollment period (“SEP”) due to a loss of Minimum Essential Coverage (MEC).

Under this SEP,individual insureds have two options:

  1. Individuals may report their upcoming loss of MEC to the Marketplace from August 2, 2016 through September 30, 2016 and enroll in a new plan for coverage commencing on October 1, 2016; or
  2. Individuals may report their recent loss of MEC to the Marketplace from October 1, 2016 through November 29, 2016 and enroll in a new plan for coverage commencing on the first day of the following month.

It is important that individual insureds take note that if they enroll in a new plan on the Federal Health Insurance Marketplace prior to their loss of MEC they will have no gap in coverage or any financial assistance they’re receiving, but that if they wait until after they’ve lost MEC to enroll in a new plan there will be a gap in their health insurance coverage and any financial assistance they’re eligible for.

Employer groups should work with their agent or broker to explore their options. If you are an employer group that enrolled in a Land of Lincoln plan on the open market, please work with your agent or broker. Questions for Small Business Health Options Program (“SHOP”) customers can be directed to the call center for the SHOP Marketplace,which is part of HealthCare.gov, at 1-800-706-7893 (TTY711) Mon-Fri, 9 a.m. to 7 p.m. (ET). Agents and brokers may also use this number.

IT IS IMPORTANT THAT LAND OF LINCOLN INSUREDS CONTINUE TO RECEIVE HEALTHCARE SERVICES WITHOUT INTERRUPTION FROM LAND OF LINCOLN PROVIDERS. PROVIDERS WILL BE PAID FOR SERVICES DELIVERED TO LAND OF LINCOLN INSUREDS UNDER THEIR PROVIDER AGREEMENTS. CLAIMS FOR SERVICES SHOULD BE SUBMITTED AS USUAL FOR PAYMENT. PROVIDERS SHOULD NOT REFUSE SERVICE TO INSUREDS.

If you are denied services from a Land of Lincoln provider, please notify the Illinois Department of Insurance. Please call the Consumer Assistance Hotline at (866) 445-5364, and then submit your complaint in writing. Complaints may be submitted in the following ways:

Keep your originals and send only copies of information. For a printed copy of the Department’s complaint form, contact the Consumer Assistance Hotline at (866) 445-5364.

When your complaint is received, a file number will be assigned and you will be sent written notification of that number. Please refer to the complaint file number when you call or write to the Department.

To read the entire Land of Lincoln Health notice, visit their website and read their alert.

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.


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