On July 1, 2013, operation of the Illinois Pre-Existing Condition Insurance Plan (IPXP) is transitioning to the federally run Pre-Existing Condition Insurance Plan (PCIP). Members should watch for a letter from the federal government that includes the PCIP Enrollment Form (shown below). PCIP coverage runs through December 2013.
IPXP/PCIP Information and Resources:
PCIP Enrollment Transition FAQ
PCIP Transition of Care
PCIP Prosthetic Preauthorization Form
PCIP Spinal Surgery Preauthorization Form
PCIP Durable Medical Equipment Preauthorization Form
PCIP Benefits Summary
IPXP (State of Illinois) Notification Letter
PCIP Enrollment Form
Enrollment Suspension FAQ
Answers to frequently asked questions about IPXP enrollment suspension.
Benefit Plan Highlights
Information about what IPXP covers.
Find A HealthLink Network Provider
For residents of Alexander, Bond, Calhoun, Clinton, Cook, DuPage, Hardin, Jersey, Kane, Kendall, Lake, Madison, Massac, McHenry, Monroe, Pope, Pulaski, St. Clair and Will counties.
Find A Health Alliance Network Provider
For those who do not reside in the HealthLink counties above.
Some of the coverage highlights of IPXP include:
- Preexisting conditions are covered.
- Choice of four calendar year deductibles: $500, $1,000, $2,000 or $5,000.
- PPO coverage.
- Prescription drugs covered without a deductible (except for the $5,000 deductible plan) with an out-of-pocket maximum of $1,600 per calendar year. Services other than prescription drugs subject to calendar year deductible.
- Coinsurance for all services is 20% with the $500, $1,000 and $2,000 deductible plan (for non-preferred PPO providers coinsurance is 40%). With the $5,000 deductible plan, there’s no coinsurance after the deductible is met (for non-preferred PPO providers coinsurance is 20%).
- Calendar year out-of-pocket limits: Out-of-pocket expenses are limited each calendar year for major medical expenses.
|For the $500 deductible plan: $2,850.|
|For the $1,000 deductible plan: $3,350.|
|For the $2,000 deductible plan: $4,350.|
|For the $5,000 deductible plan: $5,000.|
|For the $500 deductible plan: $5,000.|
|For the $1,000 deductible plan: $5,500.|
|For the $2,000 deductible plan: $6,500.|
|For the $5,000 deductible plan: $7,150.|