Illinois runs a partnership exchange with the federal government. The state operates Get Covered Illinois, which has a website, in-person help, and a help desk, 1 but Illinois residents use the federally-run HealthCare.gov platform to enroll in Affordable Care Act (ACA) Marketplace health plans.
But starting in the fall of 2025, for coverage effective in 2026, Illinois will have its own state-run enrollment platform.
Use this guide to help you understand the Illinois Marketplace and choose the right health plan for you and your family. ACA Marketplace plans – or Obamacare or exchange – are affordable choices for many people. Enrolling on the exchange may make you eligible for financial assistance through an advance premium tax credit.
Hoping to improve your smile? Dental insurance may be a smart addition to your health coverage. Our guide explores dental coverage options in Illinois.
Learn about Illinois' Medicaid expansion, the state’s Medicaid enrollment and Medicaid eligibility.
Use our guide to learn about Medicare, Medicare Advantage, and Medigap coverage available in Illinois as well as the state’s Medicare supplement (Medigap) regulations.
Short-term health plans provide temporary health insurance for consumers who may find themselves without comprehensive coverage. Learn more about short-term plan availability in Illinois.
You can buy a health plan through the exchange if: 2
Qualification for financial assistance, including premium subsidies and cost-sharing reductions (CSR), depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area. This can vary based on where you live and your age. Moreover, to be eligible for financial aid for your Marketplace plan, you must:
In Illinois, open enrollment for ACA Marketplace individual and family health coverage is from November 1 through January 15. 7
You can sign up for an exchange plan — or make changes to your coverage — outside of open enrollment if you meet special enrollment period (SEP) requirements. 8 This generally means you must have a qualifying life event, such as losing your health insurance, getting married, or having a baby.
But some special enrollment periods don’t require a specific qualifying event. So if the open enrollment deadline has passed and you haven’t experienced a qualifying event, you may still be able to sign up for an ACA plan. For example:
For those who lose Medicaid or CHIP coverage between March 31, 2023 and November 30, 2024, an extended SEP allows you to enroll anytime during that window. 11
Illinois legislation (HB5142) was enacted in 2022 that created an easy enrollment program, which became available as of early 2023, when 2022 tax returns were being filed.
For the time being, Illinois cannot offer a special enrollment period for marketplace plans in conjunction with the easy enrollment program, because using the federally-run exchange means there cannot be state-specific SEP opportunities. That will change as of 2026, when Illinois is running its own exchange platform.
For now, Illinois residents can indicate on their state tax return whether they’d like their information to be shared with applicable state agencies (This is Step 12 on the 2023 Illinois state tax return).
If the person is found to be eligible for Medicaid or CHIP, the state can notify them and help them enroll, since those programs have year-round enrollment. 12
During the 2024 legislative session, Illinois lawmakers passed a bill (not yet signed into law as of late June 2024) that will create a special enrollment period triggered by pregnancy beginning in 2026, once Illinois is running its own Marketplace enrollment platform. 13
Here are the main ways to enroll in a Marketplace health plan in Illinois:
Individuals and families who enroll in Marketplace coverage in Illinois can take advantage of two different types of income-based financial assistance:
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Medicaid: Illinois residents may qualify for affordable Medicaid coverage if eligible.
Short-Term Health Insurance: For people who are not eligible for subsidies, Medicare, or Medicaid, short-term health insurance may offer a more budget-friendly option. However, Illinois enacted legislation in 2024 that calls for a ban on the sale of short-term health insurance in the state, starting in January 2025. 17
Twelve insurers are offering exchange plans in Illinois for 2024, up from 11 in 2023. 18
Aetna Life Insurance is the new insurer that joined the exchange in Illinois for 2024 (Aetna Health already offered plans; there are now two Aetna entities). The Illinois Department of Insurance also noted that as of 2024, SSM Health Plan changed its name to Medica Central Health Plan. 19
But one of the existing insurers (Medica, formerly WellFirst/SSM) is not listed among the carriers that have filed rates and plans for 2025. 20
Illinois has historically had very little transparency in terms of rate filing details for health plans, and state regulators have not had the authority to modify or reject rate changes proposed by insurers. But that will change as of the 2026 plan year (for rates filed in 2025), due to a new law that was enacted in 2023. 21
And for the 2025 plan year, the Illinois Department of Insurance has debuted a new summary page that contains an overview of the rate changes that insurers have filed, along with some of the filing details. 20 Although summary pages like this have long been displayed on many states’ insurance department websites, that was not the case in Illinois before 2024.
Illinois lawmakers have also enacted legislation that will call for a state-regulated factor that will be added to all silver-level plans starting in 2026. 22 This is also known as “premium alignment” and it should result in gold plans becoming relatively less expensive than silver plans, for people who aren’t eligible for cost-sharing reductions. Texas, New Mexico, and Pennsylvania all have similar protocols, and Vermont will join them in 2025.
Illinois’ individual/family market insurers have proposed the following average rate increases for 2025, 20 amounting to a semi-weighted average increase of 4.6% 23
Final rates will be announced before open enrollment begins in November 2024.
Source: Illinois Department of Insurance 20
For perspective, here’s how average individual/family health insurance premiums have changed in Illinois over the years (note that in Illinois, average rate changes have often been published based on rate changes for the lowest-cost plan at each metal level, rather than overall rate changes, which differs from how this information has typically been presented in other states. And weighted averages have not typically been available in Illinois, due to the lack of transparency in the rate filing process. This should change in future years, under the terms of the state’s new law.)
398,814 people signed up for private health coverage through the Illinois exchange during the open enrollment period for 2024 coverage, up from about 342,000 the year before. 34 This marked the highest enrollment Illinois has ever had; the previous record high came in 2016, when about 388,000 people enrolled. 35
Enrollment over time in the Illinois Marketplace is illustrated in the chart below. The increase in recent years is due in large part to the subsidy enhancements provided by the American Rescue Plan and Inflation Reduction Act. The increase for 2024 is also partially driven by the return to normal disenrollments for the Medicaid program, which was paused for three years during the pandemic. CMS reported that by March 2024, more than 99,000 Illinois residents had transitioned from Medicaid to a Marketplace plan during the “unwinding” of the pandemic-era continuous coverage rule. 36
Source: 2014, 37 2015, 38 2016, 35 2017, 39 2018, 40 2019, 41 2020, 42 2021, 43 2022, 44 2023, 45 2024 46
HealthCare.gov
Premium tax credits are available only through the ACA Marketplace.
Illinois Department of Insurance
The Illinois Department of Insurance regulates individual, small-group, and large-group health plans in the state (excluding self-insured ones). They also regulate brokers and agents selling private health insurance.
Illinois Senior Health Insurance Program (SHIP)
Contact them for assistance with Medicare questions.
Illinois Department of Healthcare and Family Services
A ssistance with Medicaid eligibility or enrollment in Illinois and with All Kids , the state’s Children’s Health Insurance Program, and Family Care , the state’s Medicaid coverage for parents with minor children.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
