ACA Marketplace Health Insurance in Illinois

Illinois runs its own marketplace, Get Covered Illinois. How it differs from HealthCare.gov states, where HealthChoice Illinois fits in, and what drives what you pay.

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Matthew T. Giberti Matthew T. Giberti Published October 2026 5 min read
Parents on a picnic blanket with their toddler in an Illinois city park, the downtown skyline beyond the trees

At a glance

Illinois runs its own marketplace, Get Covered Illinois (since 2026 coverage), you apply there, not at HealthCare.gov, and the state sets its own enrollment calendar.
HealthChoice Illinois was expanded January 2014, so adults up to 138% of the federal poverty level can qualify.
Premium tax credits lower the monthly bill for most enrollees, and Silver plans add cost sharing reductions if your income qualifies. The enhanced credits that ran from 2021 through 2025 have expired, so check your current estimate rather than last year’s.
Illinois left HealthCare.gov for 2026 coverage: Get Covered Illinois is now a full state based marketplace with its own website, call center and navigator network, and the state sets its own enrollment calendar (it ran to January 31 for 2026 plans).
Every plan is guaranteed issue and covers the ten essential health benefits; the Illinois Department of Insurance licenses the insurers that sell them.
Woman in a denim shirt comparing marketplace plans on a laptop at home

How the marketplace works in Illinois

Illinois chose to run its own marketplace, Get Covered Illinois, which has handled enrollment since the 2026 plan year. The federal premium tax credit rules still apply, but the state controls the enrollment calendar, outreach, the application experience and some plan standards. Insurers are licensed by the Illinois Department of Insurance.

The rules every Illinois marketplace plan has to follow:

enroll anyone who applies in an open window, no health questionnaire, no waiting periods for preexisting conditions;
pay for the ten essential health benefits, hospital stays, emergency care, prescriptions, maternity, mental health and preventive visits among them;
charge the same premium to everyone of the same age in the same Illinois rating area, adjusted only for tobacco use and the number of people covered.

That is what makes marketplace coverage the comprehensive option and minimum essential coverage under the ACA. Short term and fixed indemnity products sold in Illinois do not have to follow them; see our short term and fixed indemnity guides for Illinois before treating one as a substitute.

Medicaid in Illinois

Illinois expanded Medicaid January 2014. The program is called HealthChoice Illinois (Illinois Medicaid (HealthChoice Illinois)), and it covers most adults under 65 whose household income is at or below 138% of the federal poverty level, childless adults included. You can apply in any month.

The practical effect: if the marketplace application finds that your income is at or below the HealthChoice Illinois limit, it will not offer you a premium tax credit, it refers you to HealthChoice Illinois instead, usually at little or no cost. Marketplace subsidies pick up just above that line.

From 2027, expansion adults in Illinois will face federal work and reporting requirements under the 2025 reconciliation law. Expect notices from HealthChoice Illinois explaining what to document and when.

Not sure which plan fits?

A licensed agent compares your real options for your ZIP in plain English. No cost. No pressure.

What is different about Illinois

What a national explainer misses about Illinois:

Illinois left HealthCare.gov for 2026 coverage: Get Covered Illinois is now a full state based marketplace with its own website, call center and navigator network, and the state sets its own enrollment calendar (it ran to January 31 for 2026 plans).
Illinois banned the sale of short term, limited duration plans starting in 2025, so there is no underwritten short term alternative here, the realistic choices are a marketplace plan, Medicaid or employer coverage.
Consumer help: The Illinois Department of Insurance handles complaints about insurers and agents; the NAIC directory lists its contact details and license lookup.

Local guides for Illinois: Aurora · Chicago · Elgin · Joliet · Naperville · Peoria · Rockford · Springfield

Plan options in Illinois

Marketplace plans in Illinois are sorted into metal tiers. The tiers describe how you and the insurer split costs, not the quality of care or the network:

Catastrophic and Bronze, built for people who want a safety net against a hospital bill and expect to pay for routine care themselves.
Silver, the only tier where cost sharing reductions lower your deductible and copays if your income qualifies, and the tier subsidies are benchmarked to.
Gold, higher monthly cost, lower deductible; often the better buy if you fill prescriptions every month.
Platinum, the richest benefits and the highest premium, offered in only some Illinois counties.

Networks matter as much as tiers in Illinois: many marketplace plans are HMOs or EPOs with no out of network coverage except emergencies, so check that your doctors and hospital participate before you choose. Because we are carrier neutral, the recommendation is built on your doctors, your prescriptions and your budget, not on one insurer’s plan list.

How and when to enroll in Illinois

Enrollment happens at Get Covered Illinois, directly or with a licensed agent at no added cost. The calendar is what trips people up:

Open Enrollment starts November 1 on Get Covered Illinois. As a state run marketplace, Illinois sets its own closing date, which has run to January 31 in recent years, confirm the deadline on Get Covered Illinois each fall.
Special Enrollment Periods open a 60-day window any time of year after a qualifying event, losing other coverage, moving within or into Illinois, marriage, a new baby or adoption, or a change in subsidy eligibility. Get Covered Illinois has added its own enrollment paths, including one for pregnancy.
HealthChoice Illinois enrollment is open year round, there is no window to miss.

Miss the window without a qualifying event and the marketplace is closed until fall; that is the moment supplemental products get pitched hardest. If that is where you are, compare what is available in your ZIP code and ask us which path makes sense.

What it costs in Illinois

We do not quote premiums on this page, they depend on your household, but the price of a Illinois marketplace plan is built from a short list of inputs:

Household income, sets the premium tax credit, which for most Illinoisans outweighs every other factor.
Household size, counted with income for subsidies, and of course the number of people on the plan.
Age, older adults pay more, up to a 3-to-1 ratio.
Rating area within Illinois, the same insurer prices the same plan differently by county group.
Tobacco use and metal tier, a possible surcharge, and the trade-off between monthly cost and cost at the point of care.

The enhanced premium tax credits that applied from 2021 through 2025 have expired, so 2026 and 2027 estimates follow the original ACA schedule and many households are paying more than they did in 2025. Get a fresh estimate for your Illinois ZIP code, price Silver against Bronze and Gold, and have us check the arithmetic before you commit.

Matthew T. Giberti Matthew T. Giberti Licensed Insurance Producer · National Producer Number: 20698856 Licensed Insurance Producer · National Producer Number: 20698856 About Matthew →

ACA marketplace plans are comprehensive major medical coverage and are minimum essential coverage under the Affordable Care Act. Eligibility for premium tax credits, cost sharing reductions, and Medicaid depends on your income, household size, and other factors and is determined when you apply; this page is general information, not an eligibility determination.

GetHealthPlans.com® is operated by MTG Insurance Agency, an independent, carrier neutral brokerage. We do not issue insurance and are not a government agency or the health insurance marketplace. Regulatory details on this page reflect the marketplace and Medicaid status for Illinois as of the last reviewed date and can change; confirm current details at Get Covered Illinois before you enroll.