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State Shutters Land of Lincoln Health

ACA policyholders feel pinch

The state’s shutdown of its Affordable Care Act-approved Land of Lincoln Health has sent thousands of Illinoisans scrambling for new coverage. The company will cease operations by Oct. 1. Many of the nearly 50,000 policyholders who had signed up with this state-sanctioned insurer had counted on the coverage to manage chronic illnesses or other long-term treatment. Under a recently convened “special enrollment” period, they will now have until Oct. 1 to find another plan on the Illinois exchange to cover the last three months of the year.

These customers, who had heeded federal law and bought their insurance last year through the state’s health insurance exchange, will most likely have to pay higher premiums for that coverage, along with paying all deductibles and out-of-pocket costs again. In addition, the new policies will most likely include more limited networks of hospitals and doctors. Land of Lincoln had offered coverage through a significant network of providers including the University of Chicago Medicine and Northwestern Memorial Hospital. But now, many of those patients could be required to pay higher rates to remain with hospitals or physicians.

And there’s not much else these patients can do. The Illinois Department of Insurance (IDOI) doesn’t have the power to force insurers to allow policyholders to shift to new plans without recalculating deductibles and other out-of-pocket payments. Nor does the state have the funds to reimburse insurers for their losses. In the meantime IDOI Acting Director Anne Melissa Dowling has said she is looking at the possibility of finding financial or other means for Land of Lincoln policyholders who are facing these extra costs.

In a written statement addressing healthcare providers, Dowling said 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,” she stated. “Claims for services should be submitted as usual for payment. Providers should not refuse service to insureds.”

Dowling also offered the following information to Land of Lincoln policyholders:

Current insurance coverage with Land of Lincoln will terminate Sept. 30, 2016.

Through Sept. 30, policyholders may report their upcoming loss of coverage to the Federal Health Insurance Marketplace (1-800-318-2596) and enroll in a new plan for coverage starting on Oct. 1, 2016, and ending Dec. 31, 2016. Enrolling in a plan during this time will allow consumers to avoid a gap in coverage and any financial assistance they may be receiving.

Alternatively, there will also be a special enrollment period from Oct. 1, 2016, through Nov. 29, 2016, to enroll in a new plan for coverage starting on the first day of the following month. Enrolling in a plan during this time may result in a gap in coverage and financial assistance.

Policyholders who fail to enroll or obtain private health insurance coverage by Nov. 29 may not be able to enroll in coverage through the Federal Health Insurance Marketplace until the start of Open Enrollment starting Jan. 1, 2017.

Sources: Chicago Tribune, July 26 “Land of Lincoln Health and Obamacare”; Ill. Dept. of Insurance.

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