Health Insurance in Illinois

Medicaid in Illinois

Illinois expanded Medicaid effective January 1, 2014. The expansion covers adults aged 19 to 64 earning up to 138% FPL (about $20,783 for a single person in 2026). Over 700,000 adults gained coverage through the expansion, and total Medicaid enrollment in Illinois exceeds 3.5 million people, about 28% of the state's population.

Illinois Medicaid uses managed care organizations (MCOs) for most enrollees. The largest MCOs include Meridian Health Plan, Molina Healthcare, Blue Cross Blue Shield of Illinois, and CountyCare (a Cook County program). Enrollees choose an MCO and receive care through that plan's network.

Illinois's uninsured rate is about 6%, close to the national average. Roughly 750,000 residents remain uninsured, with higher uninsured rates in southern Illinois and among immigrant communities.

What plans cost in 2026

Illinois marketplace premiums vary widely by region. In the Chicago metro area, a 40-year-old can find benchmark Silver plans around $400 to $500 per month before subsidies. Competition among multiple carriers keeps Chicago-area premiums relatively affordable. Downstate, premiums tend to be higher due to fewer carriers and higher per-capita healthcare costs in some rural areas.

Illinois had over 350,000 marketplace enrollees for 2025, making it one of the largest FFM states by enrollment. The expiration of enhanced subsidies for 2026 will affect a significant number of these enrollees. Those above 400% FPL ($63,440 for an individual) lose all subsidy eligibility, and those between 250% and 400% FPL will see their credits reduced.

Carriers in Illinois (2026)

Illinois has relatively strong carrier competition, particularly in the northern part of the state. Key marketplace carriers include:

• Blue Cross and Blue Shield of Illinois is the largest insurer in the state, offering plans in most counties. BCBSIL has the broadest provider network, including major systems like Northwestern Medicine, Advocate Aurora Health, and AMITA Health. In many downstate counties, BCBS is the only marketplace option.
• Ambetter from Meridian (a Centene subsidiary) offers lower-premium plans across much of Illinois. Meridian is one of the largest Medicaid managed care plans in the state and leverages that provider network for its marketplace plans. Networks are narrower than BCBS but premiums are often the lowest available.
• Molina Healthcare offers plans in the Chicago metro and select downstate counties. Like Meridian, Molina has roots in Medicaid managed care and offers competitively priced plans with moderate networks.
• Oscar Health is available in the Chicago metro area, offering tech-forward plans with virtual care integration. Oscar's network focuses on Chicago-area providers.
• Cigna offers plans in select Illinois counties, primarily in the Chicago area and some northern Illinois regions.

In Cook County (Chicago), you may see five or more carriers competing. In rural southern Illinois counties, you may find only BCBS. Always check what is available in your specific county and ZIP code.

Key regions

Chicago metro (Cook, DuPage, Lake, Will, Kane counties)

The Chicago area has the best carrier competition in the state. Northwestern Memorial Hospital, Rush University Medical Center, and the University of Chicago Medical Center are world-class academic medical centers. Advocate Aurora Health and Endeavor Health are large community health systems. The density of providers means most plans have reasonable in-network options, but check your specific doctors and hospitals before enrolling. Not all carriers include all major academic centers.

Rockford and northern Illinois

Winnebago County (Rockford) typically has two to three carrier options. Mercyhealth and SwedishAmerican (now part of UW Health) are the primary hospital systems. Northern Illinois is somewhat of a transition zone between Chicago's competitive market and the more limited downstate options.

Springfield and central Illinois

HSHS St. John's Hospital and Memorial Medical Center are the major Springfield facilities. SIU School of Medicine provides academic medical care. Central Illinois typically has two to three carrier options, with BCBS being the most common. Premiums tend to be moderate.

Southern Illinois

The southernmost part of the state faces challenges similar to rural areas throughout the Midwest: hospital closures, physician shortages, and limited carrier choice. SIH (Southern Illinois Healthcare) operates hospitals in Carbondale and Herrin. Many residents have only one marketplace carrier (typically BCBS). Some residents in the Metro East area (near St. Louis) may access Missouri providers if their plan allows it.

Estimate your subsidy

Illinois-specific things to know

The urban-rural divide is significant. Illinois is almost two different states when it comes to healthcare access. Chicago residents have world-class hospitals and multiple insurance options. Rural downstate residents may drive an hour or more for basic specialty care and have only one marketplace carrier. If you live downstate, focus on which plan has the providers you need in-network, not just the lowest premium.

Get IL is the state enrollment program. Illinois runs a state-funded enrollment assistance program called Get Covered Illinois, which provides free help from certified navigators and application counselors. They can help you understand your options, apply for subsidies, and enroll through HealthCare.gov.

Illinois has strong consumer protections. The Illinois Department of Insurance reviews rate increases and enforces network adequacy standards. If you have trouble accessing in-network care or believe your plan is not meeting its obligations, the department can investigate complaints.

Resources

• HealthCare.gov for marketplace enrollment (Illinois uses the federal marketplace)
• Illinois Department of Healthcare and Family Services for Medicaid eligibility and enrollment
• Get Covered Illinois for free enrollment assistance and consumer resources