At Focus Insurance Group, we keep your best interest at heart, focusing on YOUR needs.
We take pride in our collaborative approach, providing you the information and tools you need to make the best decision for your family. We work for YOU, not the insurance carriers.
Illinois Health Insurance FAQ
Below is a list of frequently asked questions. Click on a link to view the answer or scrool through to browse questions and answers.
Can I get a better deal through a different agency?
Can I be singled out for rate increases or cancellation?
Will my rates ever go up?
What is an HSA plan?
What is Co-Insurance?
Which doctors and hospitals can I use?
What if I have pre-existing conditions?
Is it important to disclose all of my health information?
When am I considered a smoker?
What can I do if I have been declined by several companies?
I own my own business. Can I get Small Group Insurance?
Once accepted, how long am I obligated to keep the insurance?
How long does it take to get approved?
What is a HIPAA policy?
Can I get a better deal through a different agency?
Absolutely not, insurance premiums are the same for every agent, regardless of how much business each agent does with the insurance company. The main consideration is whether or not the agent will take care of your individual needs. We pride ourselves on excellent customer service. A good agent will act as a "buffer" between you and the insurance company. You should only have to make a quick phone call to your agent in order to resolve any dispute that arises.Back to top
Can I be singled out for rate increases or cancellation?
Absolutely not, after you are accepted, your rates will increase with everyone else's in your age group or class, regardless of your claim history. Additionally, you can not be cancelled due to claim history. Once you have been approved, the insurance company will take very good care of you. This is a good reason to choose a reputable company with a solid track record for paying claims. Both American Community and Blue Cross will take care of you in sickness and in health.Back to top
Will my rates ever go up?
Most insurance companies have annual rate increases. Some insurance companies increase their rates more often than others. American Community, for example, locks in your rate for 12 months. Also, by working with a broker, we can re-shop your insurance at any time, providing the best coverage at the best price.Back to top
What is an HSA plan?
The HSA (Health Savings Account) plans are especially suited for self employed individuals or families. This plan can be very beneficial. Beginning in 2007, the maximum HSA contribution is not limited to the annual deductible under the high deductible health plan. Prior to 2007, your annual HSA deposit could never exceed your insurance plan’s deductible, unless you were 55 or older and were making “catch-up” contributions. Since 2007 you are no longer limited in the annual deductible. In 2009 individuals can put in a maximum of $3,000 and families $5,950. This way you can use pre-tax dollars to meet your deductible instead of after tax dollars. If you don't use your HSA funds to meet any medical expense, it rolls over to the next year automatically. With most carriers you are responsible for all expenses until your deductible has been met. At that time, most carriers cover 100% for the remainder of the year. For further information and regulations click on the following link. (HSA Road Rules for Consumers) &(HSA Road Rules for Employers)
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What is Co-Insurance?
Co-insurance is the percentage split expense between the carrier and the customer after the deductible has been met. This comes in different levels, with a typical range up to $20,000. A typical example of co-insurance would be an 80/20 split between the carrier and the customer with a limit of $5,000 or $10,000.For example: If you have an 80/20 split with a limit of $5,000, that means once you've met your deductible, the carrier would cover 80% of the eligible expenses and the customer would carry 20% for an out of pocket expense of $1,000 plus your deductible.
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Which doctors and hospitals can I use?
With every Health Insurance Company you will have a specific network that is considered in network. That leaves all other doctors out of network. Always check to see if a provider is in network before you see him or her. This will save you money, as out of network costs are much higher. Some carriers have their own network, but most carriers use a network that is strong in that area. If you are unsure if a specific doctor or hospital is in network, please check before you go. You can do this in various ways. Most people use the internet. Typical networks have a web site where you can check doctor or hospital participation.HEALTHLINK: http://www.healthlink.com
PHCS: http://www.phcs.com
NPPN: http://www.nppn.com
BCBS of IL: http://www.bcbsil.com
BCBS of MO: http://www.anthem.com
If you are unsure of which network you have please check your policy certificate. Always ask your agent about network participation in your area before you apply for coverage.
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What if I have pre-existing conditions?
Insurance companies handle pre-existing conditions in different ways. Depending on the condition it can be either ridered for a specific time, rated up, excluded or declined. A pre-existing condition is usually anything that you have seen the doctor for or have been treated for within the last 12 months prior to the proposed effective date. Agents have no control over this. It is important to consult your agent if you have any conditions at all.Back to top
Is it important to disclose all of my health information?
Absolutely, an Insurance policy is only good if you fill it out honestly and to the best of your ability. The insurance company will find any inconsistencies when your medical records are reviewed. If you fail to disclose a condition on your application, you can be legally liable for fraud, and your policy can be cancelled.Back to top
When am I considered a smoker?
You are considered a smoker unless you quit over 12 months prior to applying for health insurance. It's better to pay the higher rates for one year and then reapply after a year as a non-smoker in order to get a lower premium.Back to top
What can I do if I have been declined by several companies?
Depending on your circumstances, you might qualify for the states high risk pool. Most states have this available for otherwise uninsurable people. Please contact your agent to discuss your options.Back to top
I own my own business. Can I get Small Group Insurance?
The qualifications and rules for Group Health Insurance are a bit different with each carrier. Please call to discuss all the Small Group rules for your specific state.Back to top
Once accepted, how long am I obligated to keep the insurance?
We wouldn't offer a plan that makes you keep the insurance for a specified period of time, and we wouldn't recommend taking a plan that does. All of our products can be cancelled at any time, and there is never a contractual obligation to continue coverage.Back to top
How long does it take to get approved?
This varies widely based upon previous credible coverage, how long it takes your doctor to get records to the insurance company, etc. We estimate it will take approximately 30 days to get approved from the date of submission. This is not a guarantee, however.Back to top
What is a HIPAA policy?
HIPAA policies are generally for people with serious health conditions that wouldn't normally qualify for an individual health plan. In order to qualify for a HIPAA plan you must not have had a break in credible coverage for more than 60 days and you must have exhausted your COBRA coverage. HIPAA plans are more expensive, but you do have guaranteed acceptance by the insurance company.
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