Health insurance in Illinois

As is the case in other jurisdictions, health insurance in Illinois is a need for all families. With that in mind, here are the finest health insurance companies in Illinois.

Health insurance, among other things, covers medical expenses incurred as a result of an accident, illness, or injury.

Individuals can obtain this type of coverage in return for monthly or yearly premium payments for a certain length of time.

Health insurance is a sort of insurance that assists you in paying for medical expenses. Your health insurance may pay a portion of the cost of any hospitalizations, specialist visits, prescription medications, or lab tests that you require.

While there is no longer a financial penalty for not having health insurance, it is probably not the best idea to go too long without coverage.

Accidents and illnesses may strike at any time – and if you don’t have insurance, you’ll be responsible for the entire expense.

Health insurance is often obtained through an employer or a government scheme such as Medicare or Medicaid.

If you are not eligible for government-sponsored health insurance or via your work, you can acquire an independent health insurance policy through the Affordable Care Act (ACA) Marketplace. Create an account at to have access to the Marketplace.

When you begin looking for insurance, you may discover that each plan has a variety of pricing mentioned.

Terms you should know before purchasing health insurance in Illinois

Let’s take a deeper look at a few cost-related words that you should be familiar with before purchasing a plan:

  • Premium:

Your subscription is a monthly payment made to your insurance company in return for coverage. You must pay your premium monthly, even if you do not see a doctor during that month.

  • Deductible:

Your deductible is a predetermined cash amount that you must pay toward your insurance bills before your insurer begins to pay.

For instance, if you have a $1,000 deductible and a $2,000 hospital cost, your insurance will not begin to pay until you have paid off $1,000 of the bill.

  • Coinsurance:

Once your deductible is met, you are solely responsible for the coinsurance % of any medical bills you get.

The balance of your charge is covered by your insurance provider. For instance, suppose you have a plan with a 20% coinsurance rate and you get a $1,000 medical bill. You would pay 20% ($200) of this charge, and your policy would cover the balance of 80%.

  • Maximum out-of-pocket expense:

The out-of-pocket maximum is the most you will pay for health care in a given year. Once you reach your out-of-pocket maximum, your insurance will cover 100% of any further medical care expenditures.

In Illinois, the average cost of health insurance varies by family size.

The cost of health insurance coverage in Illinois is defined by the number of insured individuals and their ages.

If you add your kids to your health insurance plan, each child’s coverage will cost a set rate until the age of 14, at which point their premium will grow according to their age. If your spouse is covered under your health insurance plan, their premium is also decided by their age — just like it is for you.

The cost of health insurance for your family varies by plan, but the average monthly premium for a family of 4 in Illinois with a Silver plan is $1,444 per month, supposing two 40-year-old parents and one youngster. The addition of the first kid to a plan increases the monthly premium by an average of $333.

Including a spouse to your Silver insurance, on average, boosts your monthly premium by $556 in Illinois, assuming they are 40 years old. If you and your spouse are the same age, this practically doubles your monthly health insurance premium.

Different Types of Health Insurance

When shopping for health insurance, you may realize that a single insurance provider offers a variety of different plans. Consider many of the most prevalent types of insurance plans available on the Marketplace.

Health maintenance organization (HMO):

When you join an HMO plan, you will get information about doctors and medical care experts in your area who accept your insurance.

You must select a primary care physician from this list and remain within your network’s hospitals and specialists.

The sole exception to this rule is in the event of a life-threatening emergency. If you leave the network of your plan at any other time, you will be unable to use your benefits. HMO is one of the outstanding health insurance in Illinois.

Additionally, you will need a recommendation from your primary care physician to see a specialist. HMOs are the least expensive type of health insurance, but they allow you the least variety of choices in terms of coverage.

Preferred provider organization (PPO):

PPO plans provide you the freedom to visit any doctor or specialist you want, regardless of whether they are in your network.

Additionally, they enable you to see an expert without a referral from your primary care physician. PPO plans are more pricey than HMO plans, but they may be worth it if you want to keep seeing the same doctor.

Point-of-service (POS) plans:

Among the health insurance in Illinois, POS plans combine the benefits of an HMO with a PPO. You may see any doctor you choose with a POS plan but you will save money by keeping inside your network. Additionally, you often require a reference to consult a specialist.

What Is Covered By Health Insurance?

The ACA mandated that all health insurance providers cover a set of basic benefits. When shopping for long-term insurance, you may be confident that each option on the Marketplace covers at least some of the following medical treatments:

  • Ambulatory patient services refer to treatment and services provided outside of a hospital setting.
  • Hospitalization includes both overnight hospital stays and surgical procedures.
  • Prescription medicines for all main prescription drug classes – your coverage does not have to include every drug throughout every category.
  • Emergency services are available at every hospital in the United States, irrespective of whether it is a network hospital.
  • Rehabilitation and habilitative services encompass both the services and technologies necessary for regaining mental and physical function following an injury.
  • Inpatient and outpatient mental health services are available for those suffering from mental illness or drug addiction issues.
  • Laboratory services provide a variety of specialized tests used to identify certain medical disorders.
  • Routine laboratory testing, yearly examinations, and other sorts of preventative care are included in preventive care.
  • Maternity services cover all aspects of care and treatment required before, during, and after pregnancy. Additionally, it provides nursing support.
  • Pediatric care must cover all of the following services and treatments, as well as vision and dental coverage, for any children on your plan.
  • If you purchase your plan via the ACA Marketplace, your insurance company must also provide birth control. This coverage must encompass hormonal, physical, and emergency birth control techniques.

What Is Not Covered by Health Insurance?

Even the most comprehensive health insurance policies will not cover everything. The following are some of the most typical exclusions you’re likely to see on your insurance policy.

  • Adult eye and dental services: Under the Affordable Care Act, your health insurance provider is required to cover these services exclusively for children covered by your plan. Adult coverage often requires the purchase of a separate vision and dental plan.
  • Male contraceptives: The ACA mandates that only female birth control techniques be covered.
  • Cosmetic surgery: Reconstructive surgery is only covered by insurance if it is judged medically essential.
  • Vaccinations for travel: Your health insurance policy must cover the immunizations recommended by the Centers for Disease Control and Prevention. If you require additional vaccinations for travel, you will often have to pay for them yourself.
  • There is no government law for insurance companies to fund bariatric surgery, even if it is considered medically essential.

Best health insurance in Illinois

Now that you’re aware of how to obtain health insurance and what it covers, it’s time to pick a plan.

Let’s take a look at some of the finest health insurance providers available through the Illinois ACA Marketplace. In no particular order;

  1. Blue Cross Blue Shield 

Blue Cross Blue Shield of Illinois offers a variety of health insurance policies. It provides PPO and HMO coverage, as well as different tiers of each plan, allowing you to reconcile coverage and cost.

Its website clearly shows each prescription medicine covered by each plan, and you may search for pharmaceuticals by the plan to confirm that you are protected for your prescriptions. Blue Cross Blue Shield is our top pick for coverage in Illinois, with statewide coverage and a diverse plan selection.

  1. Bright Health Insurance Co. of Illinois;

Bright Health Group Inc operates in the healthcare industry. It is divided into two segmented companies:

NeueHealth and Bright HealthCare. It earns money via premiums, which include value-based provider revenue and fee-for-service provider revenue from customers and payors, as well as from investments.

Bright HealthCare insurance is suitable for people looking to save the cost of health care coverage by getting access to a narrower network of doctors and no out-of-network benefits.

Plans are frequently economical, and in certain cases, they may be the most cost-effective solutions available in a given location.

The insurer’s relationship with a limited number of physicians and healthcare facilities in each of the areas it serves, on the other hand, is a trade-off that must be made.

  1. HealthAlliance

Are you looking for the most cost-effective solution to safeguard your health? Consider a HealthAlliance insurance plan. Its most economical plans start at around $333 per month for non-smokers — more than $200 less than the state’s average plan.

HealthAlliance provides both HMO and POS plans, with many POS plans offering 0% coinsurance for the most popular health services.

Plans are accessible in the majority of Illinois, so there is a good possibility that you may discover affordable coverage close to home. Request a quotation from HealthAlliance if you’re seeking an affordable method to obtain coverage.

  1. Celtic Insurance

Celtic Insurance Firm is a financially sound, powerful, and devoted health care insurance company that specializes in high-quality individual health insurance.

We strive to deliver creative, consumer-oriented goods and services that are simple to understand, obtain, and utilize.

The plans provide critical coverage to clients of all ages while offering them autonomy over their treatment decisions.

There are several benefits and solutions available to fulfill the varied demands of residents in rural, suburban, and urban locations.

Individual health care plans are designed to safeguard individuals financially against the high expense of medical treatment.

The company’s medical products and services are designed to ensure that consumers have access to medically appropriate treatment by providing innovative, customer-focused products and services that are simple to understand, obtain, and utilize.

  1. Ambetter

Ambetter provides a variety of HMO plans throughout the state of Illinois. Obtaining coverage via Ambetter is a cinch. It is one of the top health insurance companies in Illinois.

To get started, you’ll need your Social Security number, details about your salary, current health insurance coverage, and some information about your employment.

Its online physician directory enables you to rapidly locate primary care physicians and specialists in your area that accept your Ambetter plan. Numerous insurers even waive copayments and coinsurance for preventative care.

  1. Cigna

Cigna’s coverage is provided in a limited number of counties in Illinois. However, its HMO plans are reasonably priced, and many plans offer no-cost preventative care. Cigna states that four out of five consumers who enroll in a plan obtain a premium assistance waiver.

Additionally, Cigna offers extremely inexpensive dental coverage, making it simple to add dental insurance to your health insurance policy with a few clicks. Additionally, Cigna provides 24-hour customer assistance, which might provide additional peace of mind if this is your first time purchasing an HMO insurance plan.

FAQs about the health insurance in Illinois

  • How much does health insurance cost on average in Illinois?

In Illinois, the average monthly cost of a Silver health insurance plan is $556. This monthly cost is more than 2% more than the national median of $541.

  • How can I obtain health insurance in the state of Illinois?

In Illinois, you would apply for health insurance through the federal health insurance market. You may browse and compare plans online or register for an account to apply.

You will learn if you are eligible for premium support or cost-sharing subsidies throughout the application process.

  • Which health insurance plan is the best in Illinois?

For the most affordable health insurance in Illinois, it is recommended to start with the Health Alliance Medical Plans Inc.’s 2022 POS 3000 Elite plan.

This is the least expensive Silver plan available in 53% of Illinois counties. If the Elite plan is not available in your location, the Blue Choice Preferred Silver PPO is the least expensive alternative for 20% of counties’ population.

  • What Medicare coverage alternatives do I have in Illinois?

As of August 2021, 2,294,413 citizens of Illinois were registered in Medicare. 87 percent of the state’s Medicare beneficiaries are 65 years or older, while the remaining 13% are under 65 but qualify for Medicare due to a disability.

  • Is it possible to acquire short-term health insurance in Illinois?

In 2018, Illinois approved laws limiting short-term health insurance to six months in duration and prohibiting renewals. The governor vetoed the measure, but lawmakers overrode him and the new restrictions took effect.


It is vital to recognize that not all health insurance companies in Illinois are represented equally, so do your homework and make sure you choose an insurer that operates with transparency, honesty, and a focus on civic responsibility.

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