Illinois Medigap: Important State Rules

Illinois Medicare Supplement (Medigap) plans work the same as in most other states, however, IL has installed regulations that give those from the Prairie State great Medigap options. Illinois now offers a Medigap Birthday rule and there is one IL provider that allows for guaranteed acceptance at any time of the year. There are also special Medigap plans in the Land of Lincoln that can offer reduced rates or extra benefits like dental, vision, and hearing.

Comparing Illinois Standard Medigap plans

**Medigap Plan G High Deductible is $2,800. Plan G PLUS in Illinois is available with extra benefits.

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Who can enroll in an Illinois Medigap plan?

In Illinois, each category has its own rules for who can enroll in a Medigap plan

65 and older: There is a six-month Medigap guaranteed acceptance period when you are first eligible for Medicare Part B. Outside of this enrollment, you can still apply but you will have to answer medical questions and could be charged more or denied. (Exception: Blue Cross Blue Shield IL guaranteed acceptance)

Under 65 and eligible due to a disability: In Illinois, Medigap insurance providers must offer at least one Medigap plan to anyone who is under 65 and has had Medicare for 24 months. These plans are NOT guaranteed issuance and they can cost a lot more than those for someone over 65.

Under 65 with ALS: If you are an Illinoisian who is under 65 with Amyotrophic Lateral Sclerosis (ALS), you are immediately able to choose a Medigap plan. Just like above, these plans are NOT guaranteed issuance and they can cost a lot more. Medigap providers must offer at least one plan for those under 65 with ALS.

If you try to enroll outside of your initial enrollment period, you may be required to answer medical questions and could be charged more or denied.

Illinois Medigap guaranteed issuance periods outside the initial enrollment

The following are a few scenarios where Illinois offers guaranteed issuance outside the initial enrollment period:

• Employer-based health coverage ends
• No longer live in the Medicare Advantage (HMO) plan area
• Turn 65, even though you qualified for Medicare before age 65
• Fraud was committed by your insurance provider
• Trial period I: Originally enrolled in Medicare Advantage when 1st eligible, but changed your mind in the 1st year
• Trial period II: Originally enrolled in Medigap, switched to Med Advantage, within your first year of enrollment decide to switch back to Medigap (Learn more about Trail Right Medigap switching)

What is BCBS Illinois Guaranteed Acceptance?

Blue Cross Blue Shield of Illinois, at the time of this publication, is offering guaranteed acceptance to ANYONE 65 or older. You do not have to answer medical questions unless you’re interested in a BCBS Illinois Secure plan. Get a BCBS Illinois quote.

Check our Medigap Switching Guide for more information on when/how to enroll in Medigap.

Illinois Medigap Birthday Rule for Switching

Switching Medigap plans often requires Medical underwriting before approval. This means those currently on a Medigap plan could be turned down when applying for a new plan even with the same company. The Illinois Medigap rule allows you to switch to certain plans as long as you make the change within 45 days of your birthday.

If you are 65-75 years of age and have an active Medigap plan, you have an annual 45-day annual open enrollment period that starts on your birthday according to IL General Assembly. During the Illinois Birthday Rule Medigap open enrollment period, those currently on a Medigap plan can choose any plan with equal or lesser benefits from their current provider. Your insurer cannot deny you coverage or charge you more because of your medical history during this switching period. Find Out About the Medigap Birthday Rule in Every State with Our Guide.

Save Money with Illinois Medigap SECURE

In Illinois, even if you qualify for guaranteed acceptance, you can apply for a Medigap SECURE plan (from certain companies) that can lower your rate by answering (and passing) certain medical questions. Basically, if you can show that you don’t have major medical issues, you can pay less for coverage. SECURE Plans that can be offered are Medigap Plan A, G, and N. So if you are fairly healthy, call us at 800-930-7956 and we can help you apply for Medigap Secure to save money!

Medigap with dental, vision, and hearing benefits

Most Medigap plans do not offer coverage for teeth cleanings, eyeglasses, or hearing aids. Blue Cross Blue Shield of Illinois, however, now offers Medigap G plus that includes additional benefits such as dental, vision, and hearing. Click here to learn more about Medigap G Plus with Vision, Hearing, and Dental coverage.

How much are Illinois Medigap plans?

This isn’t a simple question. As you can see, rates vary by gender, tobacco usage and age, company, and whether you have guaranteed issuance. Discounts and lower rates are available with Medigap SECURE. Click here to get your personalized IL Medigap quote.

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Can Tobacco-usage affect your Medigap cost in Illinois?

Yes, tobacco-usage can increase your Medigap premium.

The definition of a tobacco user can vary by provider but often it is considered to be someone who has used tobacco in the last six months. Religious usage is excluded.

Are IL Medigap premiums the same for men and women?

They are not the same. In Illinois, females are sometimes offered a lowered rate than males.

What are the Illinois Medigap discounts?

There are a few Medigap discounts available in Illinois:

• Medigap Secure: You may receive a discount by answering qualifying medical questions
• Autopay discount: You may receive a discount of $2 or $3 a month for setting up EFT
• Medigap Household discount: You may receive a discount of 0% to 15% a month off for you and your partner (call us to find out which one has the best discount).
• Roommate Discount: is a great choice because it’s easy to qualify for. Learn more in our article: “What is the Medigap Roommate Discount and How do I get it?“.

Excess Charges in IL

When it’s time to crunch the numbers, remember that some plans may cost more but also cover additional benefits like coverage for excess charges. Some doctors who don’t fully agree with Medicare’s prices may still accept the approved amount sometimes. If they don’t, doctors can legally charge you up to 15% extra. Read more here: How To Avoid Medicare Excess Charges.

Will I lose my IL Medigap plan if I move out of state?

If you have a traditional, standardized Medigap plan, you can keep your plan in most states when you move. There is a version of Medigap that uses a regional network called Medigap SELECT that may not be as portable. We rarely recommend Medigap SELECT due to its smaller network.

If, for some reason, you are required to disenroll from your current Medigap plan, you will NOT have to go through medical underwriting (answering questions about your medical history) due to a Medigap guaranteed issuance period in your new state.

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Next Steps

If you found this article informative about Illinois Medigap plans, consider working with one Senior65.com at 800-930-7956. We know how Medigap works in your state and our team cannot (and will not) charge you a fee for our services. No insurance provider or agent can sell you the same Medigap plan for less than we can.