“Though full details won’t be released until later this month, some information is starting to trickle out about what Illinois residents will and won’t find when they shop for health insurance on the state’s Affordable Care Act exchange.
Neither Northwestern Memorial Hospital nor its physician group, Northwestern Medical Group, will likely be in-network on any exchange plans, said Northwestern spokesman Christopher King. Rush University Medical Center in Chicago also doesn’t anticipate it will be in-network on any exchange plans, said Charles Jolie, a Rush spokesman. Also, Cigna, new to the state’s exchange next year, will offer individual and family HMO plans both on and off the exchange that include hospital systems Presence Health and Amita Health in their networks. That means people who pick Cigna plans will be able to go to hospitals and doctors in those systems for care.
The federal government is expected to release full, final details about all the plans that will be offered on the exchange by Nov. 1, when consumers may start officially shopping for insurance for next year.
Presence is the largest Illinois-based Catholic health system, with 11 hospitals stretching from Evanston to Urbana. Amita has nine hospitals in Hoffman Estates, Elk Grove Village, La Grange, Hinsdale, Glendale Heights and Bolingbrook.
The Cigna plan will be available to individuals in Cook, DuPage, Kane, Kankakee and Will counties. Cigna spokesman Phil Mann declined to provide information about premiums and deductibles for the plans.
“We worked to make it competitively priced and our objective was to make sure we were on the top end of affordability,” said Michael Phillips, president of Cigna’s Midwest market.
A spokeswoman for the state’s largest insurer, Blue Cross and Blue Shield of Illinois, declined to release details about its on-exchange and off-exchange plans ahead of the federal release of the data.
Hospital system Advocate Health Care, however, will be in-network for two of Blue Cross and Blue Shield’s HMO products on the exchange: BlueCare Direct and Blue Precision, said Advocate spokeswoman Lisa Lesniak.
NorthShore University HealthSystem also will be in-network for the Blue Precision HMO, said NorthShore spokesman Jim Anthony. Also, Northwestern Medicine’s hospitals in Winfield and Geneva will be in-network for the Blue Precision HMO as will its Regional Medical Group, and doctors from those entities can refer Blue Precision patients to specialists anywhere in the Northwestern Medicine system, King said.
Blue Cross and Blue Shield is the only insurer offering plans on the exchange in Lake and McHenry counties next year. It also plans to offer PPO plans across the state, and is the only insurer that will do so.
Many exchange consumers, however, were disheartened when Blue Cross and Blue Shield this year ceased offering its broadest PPO plan for individuals on the exchange, instead offering a smaller PPO network that didn’t include NorthShore hospitals or academic medical centers at Northwestern University and the University of Chicago.
Attempts to reach Celtic Insurance Co., which is offering individual plans on the exchange in Cook and DuPage counties, were unsuccessful.
In recent months, a number of insurers announced they won’t take part in the state’s exchange next year, including Aetna, its Coventry brand, UnitedHealthcare, UnitedHealthcare subsidiary Harken Health and Land of Lincoln.
Consumers shopping for companies still on the exchange can expect to dig deeper in their pockets for coverage. Rates will increase by an average of 44 percent for the lowest-priced bronze plans, 45 percent for the lowest-priced silver plans and 55 percent for the lowest-priced gold plans.
Most Illinoisans get health care coverage through their employers or government insurers Medicare and Medicaid. But more than 300,000 Illinois residents bought insurance through the exchange this year.