Illinois Health Insurance

Be Prepared with the most Suitable Health Coverage for Future, Because you Never Know it

Best Health/Medical Insurance Plans Illinois

Illinois nicknamed as the Prairie State is marked by farmland, forests, rolling hills and wetlands.


Illinois state exchange offers a variety of health insurance plans from different coverage level, though the plan available varies from one county to another and the residents of the state need to search for the best health coverage. Illinois along with the federal government operates a partnership exchange. Get Covered Illinois is a state run platform which provide residents with a website, a person assistance and a help desk whereas the federal government provides a portal, which residents of Illinois use to enroll in coverage or to make changes in their plan. This health insurance marketplace for the U.S. state of the Illinois allows people to purchase health insurance at federally subsidized rates. Since its launch around 388,179 residents of Illinois have obtain health coverage through it.

Highlights and Updates

  • For 2020 coverage in Illinois open enrollment will run from November 1 to December 15, 2019.
  • Illinois residents with qualifying events can enroll during any time of the year.
  • In Illinois short-term health plans can be sold with initial terms of up to 364 days.
  • Get Covered Illinois is a partnership exchange of Illinois state with the federal government.
  • For the year 2020 insurers have proposed a modest change in the rate of health plans, where some plans have seen an increase and some have seen a decrease.
  • State-regulated plans in Illinois will provide more robust coverage of mammograms in 2020.
  • Enrollment for health plans in Illinois is down nearly 20% since 2016.
  • In 2019 and 2020 five insurers are offering plans in Illinois

Health Plans Available for Individuals & Families in Illinois

Individuals who are looking for affordable health insurance for themselves or their families in Illinois should look for Affordable Care Act under which several level of health insurance are available such as platinum, gold, silver and bronze level plans. Each option has different set of features and cost and individuals can pick the right plan based on their preference and budget. Platinum tiers plans charge maximum premiums but offer best cost-sharing benefits, as around 90% of the incurred health expenses are covered. Bronze is the least expensive health plan in terms of premium but covers only about 60% of the incurred health expenses. Different types of Individual and Family health insurance options available in Illinois include:

Fee-for-Service Plan

Fee-for-service plans are also known as Indemnity plans in which the insured is free to visit any doctor or specialist of their choice with no referrals required. The insured pay up front for the services and later on submit a claim to the company for reimbursement. The insured is required to pay an annual deductible before starting to receive the claims from the insurance company.

Health Maintenance Organization

HMO plans offer a wide range of medical services through a network of healthcare providers who agree to render medical services to the members. These plans are known to provide the most comprehensive range of preventive healthcare services compared to other types of plans. Members of the HMO plans are required to choose a primary care physician for receiving most of the healthcare needs. In case if they have to see a specialist then the members will need to obtain a referral from their primary care physician. This plan is ideal for individuals who are looking for lower premiums plans.

Preferred Provider Organization

PPO plans are the most popular plans in the Individual and Family health insurance segment. In these plans though the members are encouraged to visit the insurance company’s network of preferred doctors but they do not need to choose a primary care physician. However, in-network services are covered at a higher benefit level compared to out-of-network services. This type of plan is ideal for individuals who wish to have flexibility of choosing a health care provider of one’s choice.


A Point of Service plan comes with the qualities of both HMO and PPO plans. Though the benefits vary based on the fact that whether the insured received care in or out of the insurance company’s network providers. In POS plan also insured need to designate a primary care physician for receiving health care services and if there is any need of any specialist then the insured need to have referrals from their primary care physician. In this plan the insured can receive care from non-network health care providers but will have to bear greater out-of-pocket costs. The insured are responsible for co-payments, coinsurance and an annual deductible.

Health Savings Account

A health saving account is a tax-favored account that insured can use to pay for qualified medical expenses including dental and vision services. This plan is used in conjunction with a high-deductible HSA-compatible health plan that makes healthcare more affordable and allows individuals to save for retirement.

Dental Insurance

Affordable dental insurance plans in Illinois are an excellent options for individuals and families to save on dental care for themselves and their family. These plans are available at low monthly cost and will reduce the insured dental cost when they will visit the dentist. These plans provide discounts on dental procedures and there is no waiting period. The plans have low deductibles and offer various choices for benefits and the insured also have the option to see both network and outside network dentist. With these plans the insured not only receive affordable plans but also have access to high quality dentists in Illinois including general dentists, orthodontists and other dental specialists.

Short-term Plans in Illinois

A legislation was passed by the lawmakers in Illinois to have limited short-term health plans in Illinois but in August 2018 Governor Rauner vetoed it. Due to which the short-term health plans in Illinois is still sold with an initial term of up to 364 days that can be renewed for a total duration of up to 36 months. These are low cost health plans providing less coverage and are intended for individuals who are looking for temporary medical coverage before enrolling in a different health plan. Since, these plans do not comply with the Affordable Care Act’s standard of coverage and benefits so were not offered in the marketplace but due to an Executive Order and changes in Department of Health and Human Services regulations in 2017, these policies have changed and are being offered by few private insurance companies in some of the states.

Insurance Carrier in Illinois

The Illinois exchange has five participating insurers for the year 2019-2020, although not every carrier is available in every county.

  • Ambetter or Celtic Insurance Co. is available only in Cook County. There is an overall decrease in the number of members enrolled with the company. A 1.04% of decrease is observed in plans that include dental and vision coverage and a 0.01% decrease is seen in plans that don’t include dental and vision coverage.
  • Blue Cross Blue Shield of Illinois is the largest carrier that is available statewide and the company also has the largest network of doctor. There is an overall 0.02% decrease of members in their plans.
  • Health Alliance is available only in central and southern Illinois and the company has experience an overall rate decrease of 4.03%. The company has 35,929 members in the year 2019.
  • Cigna is available only in certain counties and has experience an average rate increase of 5.8%.

Gunderson is a new entrant in the Illinois health care market that has experience an overall average rate increase of 5.32 percent.

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