Illinois Health Insurance Guide 2025

Everything you need to know about health coverage in the Prairie State

Medicaid Expanded

Key Facts

Medicaid Status Expanded (2014)
Marketplace Federal (HealthCare.gov)
Open Enrollment Nov 1 - Jan 15
Uninsured Rate 6.2%

Medicaid in Illinois

Illinois expanded Medicaid in 2014, extending coverage to thousands of residents who previously fell into the coverage gap. The state's Medicaid program provides comprehensive health coverage for eligible low-income individuals and families.

Who Qualifies?

  • Adults ages 19-64 with income up to 138% FPL ($20,783/year for individuals)
  • Pregnant women with income up to 213% FPL
  • Children under 19 with income up to 147% FPL (All Kids program)
  • Seniors and people with disabilities meeting income requirements
Good news for Illinois residents: Medicaid expansion means adults without dependent children can qualify for coverage based on income alone, without needing to meet categorical requirements.

How to Apply

You can apply for Illinois Medicaid through:

  • Online at ABE.illinois.gov (Application for Benefits Eligibility)
  • By phone: 1-800-843-6154
  • In person at your local Department of Human Services office
  • Through a certified application counselor or navigator

Health Insurance Marketplace

Illinois uses the federal Health Insurance Marketplace at HealthCare.gov. This means Illinois residents shop for private health insurance plans alongside residents from other states using the federal exchange.

Available Plan Types

  • Bronze: Lower premiums, higher out-of-pocket costs (60% coverage)
  • Silver: Moderate premiums and costs (70% coverage) - best for subsidies
  • Gold: Higher premiums, lower out-of-pocket costs (80% coverage)
  • Platinum: Highest premiums, lowest out-of-pocket costs (90% coverage)

Enrollment Periods

Open Enrollment: November 1, 2024 - January 15, 2025

Outside of Open Enrollment, you may qualify for a Special Enrollment Period if you experience a qualifying life event such as:

  • Loss of other health coverage
  • Marriage or divorce
  • Having a baby or adopting a child
  • Moving to Illinois from another state

Average Costs in Illinois

Health insurance costs in Illinois vary based on your age, location, plan type, and tobacco use. Here are typical monthly premiums before subsidies:

Plan Type Individual (Age 40) Family of 4
Bronze $350 - $420 $1,100 - $1,400
Silver $450 - $550 $1,400 - $1,800
Gold $520 - $620 $1,600 - $2,000
Many pay much less: Premium tax credits can significantly reduce these costs. In 2024, over 80% of Illinois marketplace enrollees received subsidies, with an average monthly premium of around $120 after subsidies.

Frequently Asked Questions

Has Illinois expanded Medicaid?

Yes, Illinois expanded Medicaid in 2014 under the Affordable Care Act. Adults earning up to 138% of the federal poverty level ($20,783 for an individual in 2025) may qualify for Medicaid coverage.

What is the health insurance marketplace for Illinois?

Illinois uses the federal Health Insurance Marketplace at HealthCare.gov. Residents can shop for and enroll in qualified health plans during Open Enrollment or during a Special Enrollment Period if they qualify.

When is Open Enrollment for Illinois health insurance?

Open Enrollment for 2025 coverage runs from November 1, 2024 through January 15, 2025. To have coverage starting January 1, 2025, you must enroll by December 15, 2024.

How much does health insurance cost in Illinois?

The average monthly premium for a benchmark Silver plan in Illinois is approximately $450-550 before subsidies. Many Illinois residents qualify for premium tax credits that significantly reduce costs, with some paying less than $100 per month.

Need Help Finding Illinois Coverage?

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