Illinois Health Insurance 2026

Illinois offers diverse health insurance options through Get Covered Illinois and private carriers, with plans ranging from budget-friendly Bronze coverage to comprehensive Platinum protection. Most residents qualify for premium tax credits that can significantly reduce monthly costs, over 90% of marketplace enrollees receive some level of financial assistance. Explore your coverage options below to find the right balance of benefits, provider access, and affordability for your household.

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Illinois Health Insurance Overview

For 2026, Illinois transitioned to Get Covered Illinois, a state-based marketplace that replaced HealthCare.gov for Illinois residents. Coverage is available during annual Open Enrollment and Special Enrollment Periods for qualifying life events. All marketplace plans include essential health benefits such as preventive care, prescription drugs, hospitalization, and emergency services.

Choosing the right Illinois health insurance requires understanding plan categories, network structures, and cost-sharing arrangements. Whether you need affordable coverage with subsidies or comprehensive PPO coverage with nationwide access, Illinois offers options for different healthcare needs and budgets.

Key Considerations When Choosing Coverage

Focus on three primary factors: your expected healthcare utilization, your monthly budget, and whether you have preferred doctors or specialists you want to continue seeing. These considerations drive most coverage decisions.

All Illinois marketplace plans include essential health benefits mandated by federal law, so core coverage remains consistent regardless of which plan you choose:

• Ambulatory patient services – Outpatient care without hospital admission
• Emergency services – Emergency room visits and urgent care
• Hospitalization – Inpatient care, including surgery and overnight stays
• Maternity and newborn care – Prenatal, delivery, and postnatal services
• Mental health and substance abuse services – Behavioral health treatment and counseling
• Prescription drugs – Formulary-based medication coverage with tiered copays
• Rehabilitative services and devices – Physical therapy and medical equipment
• Laboratory services – Diagnostic testing and blood work
• Preventive and wellness services – Annual checkups, screenings, and vaccines at no cost
• Pediatric services – Dental and vision care for children

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Illinois Health Insurance Carriers for 2026

Seven insurance companies offer marketplace coverage in Illinois for 2026, down from eleven in 2025. Several carriers exited the market, and some remaining carriers have geographic or plan-type limitations.

Active Carriers

Carriers That Exited (December 2025)

If you had coverage through Aetna, Health Alliance, or Quartz in 2025, you’ll need to select a new plan for 2026. Cook County residents should note that Cigna is not available in that area, and those seeking Bronze plans should be aware that Celtic only offers Silver, Gold, and Platinum tiers.

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Understanding Plan Categories: Metal Tiers

Illinois marketplace plans are organized into four metal tiers—Bronze, Silver, Gold, and Platinum—based on actuarial value. These tiers indicate how costs are shared between you and the insurance carrier, not the quality of coverage provided.

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Plan Network Structures

Beyond metal tiers, Illinois plans differ in network design and provider access requirements. Understanding these structures helps match coverage to your doctor preferences and care coordination needs.

Choosing the Right Network Type

• Select HMO if: You have established local providers and prefer lower premiums
• Select PPO if: You need maximum flexibility or travel frequently
• Select EPO if: You want no referrals but can stay within network
• Select POS if: You want coordinated care with occasional out-of-network access

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Illinois Health Insurance Costs

Health insurance premiums in Illinois vary based on age, location, household size, and tobacco use. Understanding all cost components—premiums, deductibles, copayments, and out-of-pocket maximums—helps determine true coverage affordability.

Primary Cost Factors

Review lowest-cost Illinois options to understand the relationship between premiums and cost-sharing while maintaining adequate coverage.

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Premium Tax Credits and Financial Assistance

Illinois residents with household incomes between 100% and 400% of the Federal Poverty Level may qualify for premium tax credits, substantially reducing monthly insurance costs. These subsidies are advance-applied, lowering premiums immediately rather than requiring tax-time reconciliation.

2026 Income Limits (Based on 2025 FPL)

• 1 Person: $15,650 (100% FPL) to $62,600 (400% FPL)
• 2 People: $21,150 to $84,600
• 3 People: $26,650 to $106,600
• 4 People: $32,150 to $128,600

Note: Illinois Medicaid covers adults up to 138% FPL ($21,597 individual). Children qualify up to 318% FPL through All Kids. Subsidy amounts depend on income, household size, and local plan costs. Professional specialists ensure accurate subsidy calculations and optimal affordable coverage selection.

Cost-Sharing Reductions (CSR)

Households earning below 250% of the Federal Poverty Level qualify for additional cost-sharing reductions when selecting Silver plans. CSR benefits lower deductibles, copayments, and out-of-pocket maximums beyond premium subsidies, providing enhanced value for qualifying households. Learn more about affordable coverage options.

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Family Health Insurance Coverage

Family coverage in Illinois accommodates multiple household members under unified policies, addressing diverse age-specific healthcare needs from pediatric care to adult preventive services.

All Illinois marketplace plans include pediatric dental and vision coverage as essential health benefits. Family policies feature both individual and aggregate deductibles, with specialized cost-sharing structures requiring careful review to understand actual financial obligations.

Learn more about Illinois family coverage options and enrollment approaches for households of all sizes.

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Enrollment Periods and Deadlines

Illinois marketplace enrollment operates during specific annual windows with limited mid-year access through qualifying life events. Understanding enrollment timing prevents coverage gaps and ensures timely protection.

Annual Open Enrollment

For 2026 coverage, Open Enrollment ran November 1, 2025, through January 15, 2026. Coverage generally begins January 1 for December enrollments or February 1 for January enrollments.

Special Enrollment Periods

Qualifying life events—including job loss, marriage, childbirth, or relocation—trigger 60-day Special Enrollment Periods for marketplace access outside Open Enrollment. Documentation requirements apply to verify qualifying events and enable mid-year enrollment.