Best Health Insurance in Illinois (2025)
Updated September 16, 2025 – No fluff, just facts for Illinois families, freelancers, and anyone shopping solo.
TL;DR - Updated Guide
If you don’t have employer coverage, you’ll shop on the ACA Marketplace. For 2025, Illinois used HealthCare.gov (Get Covered Illinois routes you there).
Open Enrollment for 2025 ran Nov 1, 2024 – Jan 15, 2025. Outside that window you generally need a Special Enrollment Period (SEP) (move, birth, loss of coverage, etc.).
Low‑income SEP (≤150% FPL) that allowed year‑round sign‑ups was discontinued in late August 2025. Other SEPs still exist.
Enhanced premium tax credits (bigger subsidies) remain in place through the 2025 plan year, which is why many Silver plans are still affordable.
Out‑of‑pocket max for 2025: $9,200 individual / $18,400 family (upper cap – many plans are lower).
2026 preview: Illinois will use a full state‑based marketplace (Get Covered Illinois) starting Nov 1, 2025 for 2026 coverage. Different website, same playbook.
What changed in Illinois for 2025
More choice, still local. Illinois has 11 on‑exchange insurers for 2025 (plan availability varies by county): Aetna (2 entities), Ambetter/Celtic, Cigna, Blue Cross & Blue Shield of Illinois (HCSC), Health Alliance, MercyCare HMO, Molina, Oscar, Quartz, and UnitedHealthcare of Illinois.
Chicagoland shake‑ups (2025):
Lake & McHenry (Rating Area 2): Cigna left; UnitedHealthcare added McHenry.
Will & Kendall & Kankakee (Rating Area 4): Aetna and Oscar expanded; Health Alliance (HAMP) left Kankakee.
Bottom line: Chicago‑area ZIPs still have the widest plan menus in the state, but networks changed. Always re‑check your doctors/hospitals.
Out‑of‑pocket caps dipped. 2025’s federal OOP maximums are lower than 2024, which slightly improves worst‑case protection.
Subsidies hold (for 2025). Enhanced premium tax credits continue this year. Many households above 400% FPL still qualify – the subsidy cliff is suspended through 2025.
SEP change. The special, year‑round SEP for households at ≤150% FPL was paused/discontinued in late August 2025. You can still qualify for standard SEPs (move, marriage, newborn, loss of coverage, etc.).
How to pick the best Illinois health plan for you
Think in this order:
Doctors & hospitals. If you have must‑keep providers, search the plan’s directory first. Chicago networks vary by system and by plan type.
Plan type (HMO vs PPO vs POS).
HMO: Lowest premiums, but you’ll pick a PCP and stay in‑network.
PPO/POS: More out‑of‑network flexibility; usually higher premiums. Popular with frequent travelers and folks juggling multiple specialists.
Metal tier & total cost.
Bronze: Lowest premium, higher deductibles – good for “rarely‑use” buyers.
Silver: The sweet spot if you’re subsidy‑eligible. If income ≤ 250% Federal Poverty Level, Cost‑Sharing Reductions (CSR) can shrink your deductible/copays a lot (CSR 73/87/94 variants).
Gold: Higher premiums, lower deductibles – good if you expect care.
Pro‑tip: Evaluate total annual cost = premium × 12 + (expected) out‑of‑pocket.
Prescriptions. Check the formulary (drug list) and tiers. Confirm your pharmacy is considered preferred (lower copays).
HSA‑eligible? If you want an HSA (Health Savings Account), choose an HSA‑qualified Bronze/Silver HDHP and confirm the plan’s HSA label.
rule‑of‑thumb, not one‑size‑fits‑all
“I just need the lowest monthly bill.” Try Bronze or Silver with CSR (if income ≤ 250% FPL). Bronze + healthy = fine; Silver + CSR = better protection.
“I see multiple specialists and want flexibility.” Consider PPO/POS designs where available.
“My doc is at a specific system.” Start with the provider directory. Chicago hospitals and groups can be in-network for some plans and not for others.
“Between jobs / COBRA offer in hand.” Compare COBRA to a Marketplace plan with subsidies; ACA often wins on price unless you need that exact COBRA network now.
Medicaid & All Kids (Illinois)
These programs run year‑round and may beat any Marketplace plan on cost:
ACA Adults (19–64): Income up to 138% FPL (includes 5% disregard).
All Kids (0–18): Income up to 318% FPL (tiers with low/no premiums).
Moms & Babies / postpartum: Up to 213% FPL, with 12 months postpartum coverage. If you’re near these limits, check eligibility before shopping Marketplace plans.
Open Enrollment & SEPs
Open Enrollment for 2025: Nov 1 – Jan 15.
Enroll by Dec 15 for Jan 1 effective dates; enroll by the January deadline for Feb 1.Special Enrollment Periods (year‑round): Life events (move, marriage, birth/adoption, loss of coverage, major income changes). Have documentation ready.
Low‑income SEP (≤150% FPL): Discontinued in late Aug 2025.
2026 preview (so you’re not blindsided)
Starting Nov 1, 2025, Illinois will enroll for 2026 coverage through a state‑based marketplace (Get Covered Illinois). Expect the same plan types and subsidies, just on the state’s platform instead of HealthCare.gov.
Ready to compare plans?
Simple. Quick. Easy. Head to blank‑insurance.com/health. We’ll:
Check your subsidy in minutes.
Filter plans by your doctors, hospitals, and meds.
Compare Bronze vs. Silver (with CSR) vs. Gold side‑by‑side.
Help with Medicaid/All Kids screening if you’re close to the income cutoffs.
Prefer a human? Request a callback and we’ll walk you through the whole thing, start to finish.
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