Best Health Insurance Plans in Illinois

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Located in the heart of the country, Illinois is also middle of the pack when it comes to healthcare. According to US News, Illinois has the 27th best health insurance coverage in the country.

Health Care Choices in Illinois

According to the Illinois Department of Insurance, you can get health insurance through multiple avenues:

  1. Employer-provided
    1. From your employer
    2. Through your spouse's employer
    3. Through COBRA
  2. Individual or family plans
    1. Through HealthCare.gov
    2. Directly from a health insurance company
  3. Government-assisted
    1. Medicare
    2. Medicaid

Where do most Illinoisans get their health insurance coverage?

Illinois Health Insurance Sources
Sources Percent
Employer-Provided 51%
Individual or family 8%
Medicaid 18%
Medicare 14%
Other Public Care 1%
Uninsured 7%
Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population

Seven percent of Illinois residents are uninsured. That’s below the national average of nine percent. This is good news for policyholders. A high percentage of uninsured residents leads to higher rates for insured people.

Illinois Health Insurance Costs and Rate Factors

Illinois residents spend an average of $8,262 on health insurance expenditures each year. That’s only a few hundred dollars more than the national average. What determines these costs? Prices differ depending on the person. Here are a few factors insurance companies consider:

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Body Mass Index

Insurers commonly look at your BMI while pricing your policy. This is because, statistically, a high BMI leads to a number of serious diseases. A high BMI increases your risk-level to your insurer, spiking your insurance costs.

In 2016, Illinois had a 31.6 percent obesity rate, the 18th highest rate in the country. Out of the many Illinois residents who used QuoteWizard to compare health insurance plans, 33 percent have a BMI in the obese range.

Tobacco Use

Due to the health risks from smoking, smokers tend to pay more for health insurance. About 15.8 percent of Illinois residents smoke according to a 2017 study. The state has the 18th lowest ranking in the country for tobacco use.

Age

According to HealthCare.gov, older people pay up to three times more for health insurance than young people do. IL residents who use QuoteWizard to shop for health insurance are, on average, 40 years old.

Plan Type

If you want more coverage, you're going to have to pay more in monthly premiums. Marketplace plans are sorted into metal tiers: bronze, silver, gold, and platinum.

So how much should you expect to pay for health insurance? These are the average costs for each plan type for a middle-aged Illinois resident:

Illinois Martketplace Plan Rates
Bronze Silver Gold
$345 $460 $529
Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier

In Illinois, jumping from a bronze plan to a gold plan will cost you around 53 percent more. Bronze plans cover only 60 percent of health care costs, whereas gold plans cover 80 percent of costs.

The lowest level of coverage is the catastrophic plan. It’s available to people under 30 or with certain exemptions. Though the catastrophic plan has low monthly premiums, it also comes with a $7,150 deductible. Buying a bronze or silver plan instead may save you money when you need to use your health insurance.

Location

The laws and regulations surrounding health insurance vary state to state. What does that mean? Your location plays a large role in how much you'll pay for health insurance.

Health insurance rates are generally community rated. That means if your neighbor files a lot of claims, your premiums could rise.

Living in a healthier state helps you get lower premiums. Illinois is ranked as the 27th healthiest state according to America's Health Rankings.

Illinois Health Insurance Companies

Illinois has several health insurance provider options. These companies offer both individual and family health care:

Specific plan types depend on where in the state you live. Check each company's website to find more information.

Illinois Health Insurance Laws

Due to the Affordable Care Act, insurance companies can't use these factors when pricing your policy:

Marketplace plans have out-of-pocket maximum limits. The 2018 out-of-pocket maximum is $7,350 for individual plans and $14,700 for family plans.

Illinois state law requires health insurance companies to offer at least some coverage for these services:

  • Infertility
  • Post-mastectomy care
  • Alcoholism and substance abuse
  • Cancer treatment- prescription drugs
  • Breast exams
  • Diabetes self-management
  • Cancer clinical trials
  • Organ transplants

There are additional services that companies must cover. Check out the full list and what limits apply here.

Medicare and Medicaid in Illinois

Medicare and Medicaid are both government programs that offer health care to many Americans. Medicare covers seniors while Medicaid assists low-income families and children.

Medicare

Medicare is a government-funded program that Illinois residents over 65 years can access. Medicare offers numerous options including parts A, B, C, D, and supplemental coverage plans. Illinois also offers qualifying residents a Medicare savings program:

Qualified Medicare Beneficiary (QMB)

  • Single person with a monthly income lower than $981.
  • Couple with a monthly income lower than $1,328.

Specified Low-Income Medicare Beneficiary (SLMB)

  • Single person with a monthly income lower than $1,176.
  • Couple with a monthly income lower than $1,592.

Qualified Individual–1 (QI-1)

  • Single person with a monthly income lower than $1,323.
  • Couple with a monthly income lower than $1,791.

Medicaid

Illinois Medicaid is an option for low-income families and children. These are the program requirements for Illinois households:

Illinois Medicaid Financial Requirements
Household Size Maximum Yearly Income
1 $16,643
2 $22,411
3 $28,180
4 $33,948
5 $39,716
6 $45,485
7 $51,253
8 $57,022

Illinois Office of the Insurance Commissioner

Website:
Homepage
Insurance Commissioner:
Anne Melissa Dowling
Insurance Hotline:
(217) 782 – 4515
Office Hours:
Monday - Friday
9:00 am to 5:00 pm
File a Consumer Insurance Complaint
Complaint Page

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