The Associated Press August 20, 2010, 8:24AM ET

Illinois to enroll uninsured in new high-risk pool

Illinois residents who've been uninsured at least six months can on Friday start applying for a new federally funded health insurance program for people with medical problems.

Enrollment will be first-come, first-served for eligible people who fill out their applications correctly.

David Zoltan, 33, who has diabetes, planned to be among the first in an expected rush of applicants Friday morning. Applications were to be taken starting at 10 a.m.

"I was laid off from a great job because of the economy," Zoltan said. "Since that time I've been uninsured, and a diabetic without insurance is probably in one of the scariest positions you can possibly imagine."

The federal government has set aside $196 million for Illinois, enough to cover claims for an estimated 4,000 to 6,000 people. Many thousands more might be eligible -- as many as 218,000 people, according to a 2008 U.S. Government Accountability Office report.

Monthly premiums will be reasonable: $111 to $653 depending on a person's age, where they live and whether they use tobacco. Federal law requires that monthly premiums be no more expensive than similar coverage in Illinois.

How many people will be covered depends on the severity of their medical problems, said Illinois Department of Insurance Director Michael McRaith.

"If we have several thousand people who are in the midst of a fight against cancer, or similarly serious and expensive treatments, we'll be able to enroll fewer people," McRaith said. On the other hand, if enrollees are mostly people with lower medical costs, more people can be included, he said.

McRaith said the online enrollment system will be able to process a high volume of applications. Coverage will begin on Sept. 1 for the first successful applicants.

"Although the program cannot cover every uninsured Illinoisan, it will provide important relief for many of those who have had the hardest time buying affordable health care coverage," said AARP Illinois Senior State Director Bob Gallo in a statement.

The lowest premiums will be paid by younger, nonsmokers living in counties where medical costs are lower. For example, a 30-year-old nonsmoker living in Quincy would pay $111 a month. A 62-year-old smoker living in Chicago would pay $653 a month.

Oldest enrollees can be charged no more than four times what the youngest enrollees are charged, according to federal requirements.

Gov. Pat Quinn announced details Thursday in Chicago. The program will provide coverage until Jan. 1, 2014, when the new federal law will bar insurers from denying coverage to people with pre-existing conditions.

Only legal residents and those who've been uninsured for at least six months will be eligible. Applicants must be able to show they've had trouble getting insurance because of a pre-existing medical condition.

Forms can be filled out and submitted online at the insurance department's website, http://www.insurance.illinois.gov, or printed from the site and mailed. They also can be turned in at insurance department offices in Chicago and Springfield, or to the Health Alliance Medical Plans Inc. office in Urbana.

Health Alliance Medical Plans was chosen by the state to administer the program. McRaith said the for-profit health insurer, founded by Carle Clinic Association, was the low bidder.

Zoltan was diligent about getting his paperwork ready to apply for the program, and he appeared with the governor at Thursday's announcement. But he said his efforts still don't guarantee he'll be enrolled.

Currently, his health care is paid for by charity care from Northwestern Memorial Physicians Group and assistance programs from several pharmaceutical companies.

"I've been very lucky to have some very talented nurses who've been willing to fight for me every step of the way," Zoltan said. "They've cobbled together a health care program for me right now."


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