Health Insurance in Illinois for Individuals Under 65
Under 65 Health Insurance On or Off Exchange Policies
In the under 65 private market your employer CANNOT purchase a policy on your behalf. The monthly premium needs to be paid with after tax dollars.
The IRS has issued an FAQ that states that employer reimbursement of individual premiums on a tax-favored basis will trigger this excise tax. All three agencies have issued an additional FAQ that states that reimbursement of premiums for individual coverage on either a pre-tax or an after-tax basis is an impermissible employer payment plan. This prohibition applies whether the payment or reimbursement is through a Section 125 plan, a 105 plan or as compensation. Click here to read more.
- Off-exchange Policies
- On-Exchange Policies
- Long-Term Policies
- Short-Term Policies
Off-exchange or non-marketplace policies are health insurance polices that are purchased in the private market that are not subsidized by the Federal government.
On-exchange or marketplace place policies are those subsidized by the federal government. They include things like cost-sharing that reduces your deductible and advanced premium tax credits that help pay for your monthly premiums.
Long-Term insurance which can be purchased both on or off-exchange typically called comprehensive major medical coverage is a permanent insurance policy that has services like:
- Guaranteed for 12 months or longer
- Guaranteed renewable
- Meets the Affordable Care Act requirements, therefore, you would not have to pay a penalty.
- Essential Health Benefits include:
- Emergency Services
- Preventive Services
- Mental Health and Substance Abuse
- Prescription Drugs
- Labratory services
- Pediatric dental
Short-term insurance which cannot be purchased on-exchange and must be purchased off-exchange can protect you or your family against unexpected medical cost that could result from accidents or illnesses.
- Can be purchases for 1 – 11 months
- Not guaranteed renewable
- Does not meet Affordable Care Act requirements, therefore, you may have to pay a penalty.