State of Illinois Health Insurance 2026
Your guide to marketplace, All Kids, and Medicaid enrollment—what you need and how to apply.
Government Coverage Options in Illinois
Multiple coverage pathways exist for residents based on income, household size, and circumstances. Understanding which programs you qualify for—and how to apply correctly—prevents delays and ensures coverage starts when you need it.
⚠️ 2026 Enrollment Changes
Get Covered Illinois now handles marketplace enrollment (previously HealthCare.gov). Enhanced subsidies expired December 31, 2025—assistance is now limited to incomes below 400% FPL. The subsidy cliff has returned: earning $1 over the limit means losing all premium assistance.
Medicaid
Comprehensive coverage at no cost for qualifying low-income residents. Covers adults, children, pregnant women, seniors, and people with disabilities.
All Kids (CHIP)
Low-cost children’s coverage for those who don’t qualify for Medicaid. Premiums range from $0-$80/month based on income.
Marketplace Plans
Private plans with premium subsidies for qualifying incomes. Multiple carriers and metal tiers available through Get Covered Illinois.
Cost-Sharing Reductions
Enhanced Silver plans with lower deductibles and copays. Only available through marketplace enrollment, not direct from carriers.
For detailed information about financial assistance amounts, see our affordability guide.
How to Apply: Step-by-Step
The application process varies slightly by program, but follows the same general pathway. Gathering documents before you start prevents delays and incomplete applications.
Gather Required Documents
Collect proof of income (pay stubs, tax returns), identity documents (driver’s license, birth certificates), Social Security numbers for all household members, and proof of residency. Having everything ready prevents application delays.
Determine Your Program Pathway
Based on your income and household size, you’ll be directed to the appropriate program. Medicaid and All Kids applications go through the Department of Healthcare and Family Services. Marketplace applications go through Get Covered Illinois.
Complete the Application
Apply online, by phone, or with in-person assistance. Answer all questions accurately—inconsistencies trigger verification requests that delay approval. We can help you complete applications correctly the first time.
Respond to Verification Requests
If additional documentation is needed, respond promptly. Missing deadlines can result in application denial or coverage delays. Keep copies of everything you submit.
Receive Determination and Enroll
Once approved, you’ll receive enrollment instructions. For marketplace plans, you must actively select a plan and pay your first premium to activate coverage.
Documentation You’ll Need
Having the right documents ready before starting your application significantly speeds up the process. Requirements vary slightly by program, but most need the items below.
Application Document Checklist
Self-Employment Documentation
Self-employed applicants need additional documentation: profit/loss statements, 1099 forms, business expense records, and projected annual income estimates. Income verification for self-employment takes longer—apply early to avoid coverage gaps.
Need Help With Your Application?
We guide you through document preparation, program selection, and application completion. Avoid common mistakes that delay coverage.
Get Application Help Call: 888-215-4045Enrollment Timing: When You Can Apply
Not all programs follow the same enrollment schedule. Understanding when you can apply—and when coverage actually starts—helps you plan and avoid gaps.
Medicaid
Apply any time of year. No enrollment windows or deadlines to worry about.
All Kids (CHIP)
Apply any time. Children can be added to coverage throughout the year.
Marketplace (Open Enrollment)
Annual enrollment window for subsidized private plans.
Special Enrollment Period
60-day window after qualifying life events (job loss, marriage, birth, moving).
When Coverage Actually Starts
| Program | Application Timing | Coverage Effective Date |
|---|---|---|
| Medicaid | Any time | Can be retroactive 3 months |
| All Kids | Any time | Month of approval |
| Marketplace (by Dec 15) | Open enrollment | January 1 |
| Marketplace (Dec 16 – Jan 15) | Open enrollment | February 1 |
| Special Enrollment | Within 60 days of event | 1st of month after plan selection |
Life Changes and Program Transitions
Life changes can shift your eligibility between programs. Knowing what triggers a transition—and how to handle it—prevents coverage gaps.
Child Turns 19
Ages out of All Kids. May qualify for Medicaid or marketplace coverage.
Income Change
May shift eligibility between Medicaid and marketplace. Report changes within 30 days.
New Baby
60-day special enrollment. Baby covered from birth if added promptly.
Marriage
Combined household income may change eligibility. 60-day special enrollment window.
Moving
New county may have different plan options. 60-day special enrollment if moving to new coverage area.
Job Loss
Loss of employer coverage triggers 60-day special enrollment. May now qualify for subsidies.
Annual Renewal and Redetermination
Medicaid and All Kids require annual renewal. You’ll receive a renewal notice—respond by the deadline to avoid coverage termination. Marketplace plans auto-renew, but you should actively review and re-enroll each year to ensure you have the best plan for your current situation. Income changes during the year should be reported promptly to avoid tax reconciliation surprises.
For more on PPO plan options if you’re transitioning to marketplace coverage, or household coverage strategies for families navigating program changes together.
Navigating a Coverage Transition?
Life changes don’t have to mean coverage gaps. We help you understand your options and transition smoothly between programs.
Get Transition Help Call: 888-215-40452026 Income Eligibility Reference
Program eligibility is based on income as a percentage of the Federal Poverty Level (FPL). These are the 2025 FPL guidelines used for 2026 coverage eligibility.
| Household Size | 138% FPL (Medicaid) | 250% FPL (CSR) | 400% FPL (Subsidy Cliff) |
|---|---|---|---|
| 1 Person | $21,597 | $39,125 | $62,600 |
| 2 People | $29,187 | $52,875 | $84,600 |
| 3 People | $36,777 | $66,625 | $106,600 |
| 4 People | $44,367 | $80,375 | $128,600 |
| 5 People | $51,957 | $94,125 | $150,600 |
For detailed subsidy calculations and savings examples, see our affordability programs guide.
Official Resources
Access official government resources for program information and direct enrollment.
Get Covered Illinois: The official marketplace at getcovered.illinois.gov handles subsidized private plan enrollment.
Medicaid & All Kids: The Department of Healthcare and Family Services at illinois.gov/hfs administers Medicaid and children’s coverage programs.
Related Illinois Health Insurance Resources
Review plan types, major carriers, and key enrollment details for Illinois shoppers.
Compare Your OptionsCheck pricing across marketplace choices and major coverage paths based on your situation.
Top Picks by ValueSee which plans tend to stand out for benefits, networks, and overall cost efficiency.
Lower Your Monthly CostUnderstand how subsidies and cost-sharing reductions can reduce premiums and care costs.
Lowest-Cost RoutesExplore budget-focused coverage paths and tradeoffs so you can keep costs predictable.
Marketplace Enrollment HelpGet a clear view of enrollment steps, deadlines, and how subsidies apply in Illinois.
Get Help Navigating Your Illinois Options
Government programs can be confusing. We help you determine which programs you qualify for, gather the right documents, and complete applications correctly. Whether you need Medicaid, All Kids, or marketplace coverage with subsidies, we guide you through the process.
Start Your Application Call 888-215-4045Licensed in Illinois • Program navigation specialists • Same coverage, guided enrollment
Independent Broker Notice
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