Medicaid in Illinois
Illinois expanded Medicaid effective January 1, 2014. The expansion covers adults aged 19 to 64 earning up to 138% FPL (about $22,025 for a single person under the guidelines used for 2027 coverage). 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.
Get Covered Illinois: where to enroll
Starting with 2026 coverage, Illinois moved off HealthCare.gov and began running its own exchange, Get Covered Illinois. If you live in Illinois, apply and enroll at GetCoveredIllinois.gov, not HealthCare.gov. It is the only place Illinois residents can get premium tax credits to lower their monthly payments.
Open Enrollment for 2027 runs from November 1, 2026, through January 15, 2027. Enroll by December 15 for coverage that starts January 1, or by January 15 for coverage that starts February 1. Get Covered Illinois has free help from certified navigators and brokers across the state, and a customer assistance center at 866-311-1119 (TTY: 711) with help in more than 250 languages.
What plans cost in 2027
The Illinois Department of Insurance reports a statewide weighted average rate increase of 14.1% for 2027 individual plans, before subsidies. That is down from 28.8% for 2026. Approved averages by insurer include 14.9% for Blue Cross and Blue Shield of Illinois, 9.2% for Celtic (Ambetter), 12.2% for MercyCare, and 12.4% for UnitedHealthcare. Your own change depends on your plan, age, and county.
Subsidies still do most of the work for most enrollees. According to Get Covered Illinois, 466,371 Illinoisans enrolled in marketplace plans for 2026, about 85% received premium tax credits, and those who got financial help paid an average of $140 a month.
The enhanced premium tax credits expired after 2025 and were not extended for 2027. If your household income is between 100% and 400% FPL ($15,960 to $63,840 for a single person), you still qualify for a tax credit. Above 400% FPL there is no subsidy, so you pay the full premium. Premiums also vary widely by region, and downstate premiums tend to be higher where there are fewer carriers.
Carriers in Illinois (2027)
Five insurers offer plans through Get Covered Illinois for 2027. Cigna and Molina are leaving the Illinois marketplace at the end of 2026, so their customers must choose a new plan during Open Enrollment to stay covered. The 2027 carriers:
- 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 and Advocate Health. In many downstate counties, BCBS is the only marketplace option. For 2027, MyBlue Plus Bronze customers in Cook, DuPage, Kane, Kankakee, St. Clair, and Will counties are being moved to Silver plans automatically, so check your renewal notice.
- Ambetter (Celtic Insurance Company, a Centene subsidiary) offers lower-premium plans across much of Illinois and is expanding to 20 new counties for 2027. Networks are narrower than BCBS but premiums are often among the lowest available.
- Oscar Health offers tech-forward plans with virtual care integration, with a network focused on Chicago-area providers.
- UnitedHealthcare sells marketplace plans in select Illinois counties.
- MercyCare HMO, the health plan tied to the Mercyhealth system, serves northern Illinois and is expanding to Stephenson County for 2027.
In Cook County (Chicago), you will see the most 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 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 a few carrier options, including MercyCare. 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.
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
Subsidy Estimator
Enter your info below to get a rough estimate of your monthly premium tax credit for a 2027 marketplace plan.
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.
Use Get Covered Illinois, not HealthCare.gov. Because Illinois runs its own exchange, you cannot buy an Illinois plan with financial help on HealthCare.gov. Get Covered Illinois also lets you preview 2027 plans and prices before you apply, and its navigators can help you understand your options and apply for subsidies.
Illinois has strong consumer protections. Since plan year 2026, individual and small group health insurance rate increases must be filed with the Illinois Department of Insurance for approval, and the department can modify or disapprove unreasonable increases. It also 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
- Get Covered Illinoisfor marketplace enrollment, plan shopping, and free enrollment help (Illinois's official marketplace)
- Illinois Department of Healthcare and Family Services for Medicaid eligibility and enrollment
- Illinois Department of Insurance for rate filings and consumer complaints