Getting health insurance in Illinois if previously treated for alcohol abuse

First off I want to commend anyone that has gone through treatment for alcohol abuse.  Like all addictions, I'm sure this is a hard one to fight.  I recently was working with a client here in Illinois that was looking for and individual health insurance plan with Blue Cross Blue Shield of Illinois.  BCBSIL has such a good presence in Illinois that this was the first place he wanted to apply to. Most every doctor and hospital take BSCBIL and they have the most members that here in Illinois they are a household name.

Since he just recently exhausted his 18 months of COBRA, I should have known that there might have been some kind of condition he was bringing up.  All he told me about at first was his cholesterol medication Crestor.  I wanted to make sure he had coverage as soon as possible so we looked at doing a SelectTemp plan that can be issued the very next day as long as none of the few questions are answered "yes".  Well one of the questions does ask "in the past 5 years has anyone been treated for alcohol abuse...."  This is where we stopped and he told me that he was treated a little over 2 years ago for alcoholism. 

Since every insurance carrier can underwrite differently, it was time to go shopping around and look for the best outcome.  Some times when there is a pre-existing condition an insurance company may instead of declining do an exclusion rider or rate increase or both.  BCBSIL and United Health Care are known for doing riders, Aetna rate increases and Humana both.

One of the hardest things about being a non-captive independent broker working with multiple carriers is that their underwriting guidelines are all different and not necessarily disclosed.  For example there is nothing in the BCBSIL guidelines for agents that talk about about alcohol abuse, Humana states after 5 years they would be considered (this is what BCBSIL said when I talked to them), Aetna's guideline is the most thorough and actually the most lenient.  They require 2 years since treatment, no alcohol intake, clean liver function tests and going to AA is okay. 

Aetna would do a rate increase.  At his age we are hoping for a moderate 40% increase.  The premium we were looking at was about 200 so he would be at 280 now.  This was much cheaper than his 500 a month he was paying for on COBRA and much less than the CHIP plan through the state of Illinois.

We are in underwriting right now, I've got my fingers crossed but I'm looking forward to a positive out come.

If you have a pre-ex condition you would like me to pre-screen, let me know.  Until every carrier is required to accept all conditions I will continue to do my best to find my clients coverage.  You can also run quotes at www.infinityhealthinsurance.com