Paul Sanchez
Illinois offers a variety of health insurance plans, including Medicare, Medicaid, and Medicare Advantage. Medicare is a federal program for people 65 and older, as well as some younger people with disabilities. Medicaid is a joint federal and state program that provides coverage for low-income individuals and families, with Illinois offering Medicaid to those earning less than 138% of the federal poverty level. Medicare Advantage is an alternative to Medicare, sold by private insurance companies and sometimes offering additional benefits such as dental and vision coverage. To find the best Medicaid health insurance in Illinois, individuals should consider factors such as price and availability, and specific needs, such as Medicare Advantage potentially offering extra benefits that may be useful.
| Characteristics | Values |
|---|---|
| Best Health Insurance in Illinois | MercyCare Health Plans |
| Average Monthly Rate | $546 |
| Average Maximum Out-of-Pocket Cost | $7,767 |
| Denial Rate | 10% |
| Plan Types | Silver HMO, Gold HMO, Gold POS, Platinum POS, Gold PPO |
| Best Cheap Health Insurance in Illinois | Ambetter |
| Average Plan Rate | $572 |
| Average Maximum Out-of-Pocket Cost | $5,950 |
| Denial Rate | 10% |
| Plan Types | Silver HMO, Silver POS, Silver PPO |
| Medicaid Provider | Blue Cross and Blue Shield of Illinois |
| Medicaid Plan Types | Blue Cross Community Health Plans, Blue Cross Community MMAI (Medicare-Medicaid Plan) |
| Medicaid Eligibility | Individuals earning less than 138% of the federal poverty level |
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What You'll Learn
- MercyCare Health Plans: affordable, low out-of-pocket costs, low denial rate
- Ambetter: cheap, minimizes out-of-pocket costs, low denial rate
- Medicare Advantage: bundled alternative to Medicare with dental and vision coverage
- Medicaid eligibility: for individuals earning less than 138% of the federal poverty level
- Blue Cross Community Health Plans: contracted with Illinois to implement Medicaid
MercyCare Health Plans: affordable, low out-of-pocket costs, low denial rate
MercyCare Health Plans is the top-rated health insurance provider in Illinois, according to MoneyGeek. The company offers affordable plan options with low out-of-pocket costs and a low denial rate of 10%, which is lower than most of its competitors.
MercyCare Health Plans offers Silver HMO plans, which typically require choosing a primary care physician and getting referrals to see specialists. The average monthly rate for these plans is $546, and the average maximum out-of-pocket cost is $7,767.
One of MercyCare's Silver plans, the HMO Silver Option B, stands out for its lower out-of-pocket limit of $5,400, despite costing slightly more per month at $550. This plan could be a good option if the provider network suits your needs.
In addition to its low costs and denial rate, MercyCare Health Plans also provides mental health and substance use disorder services, including behavioral health treatment such as counseling and psychotherapy. Rehabilitative services and devices are also covered, helping individuals with injuries, disabilities, or chronic conditions to regain or improve their physical and mental skills.
MercyCare Health Plans are available directly through MercyCare or on the Marketplace, which allows individuals to compare different plans and find one that fits their budget and needs. However, it's important to note that the plans offered directly by MercyCare do not provide financial assistance in the form of reduced premiums or cost-sharing. To be eligible for these plans, individuals must reside in specific counties in Wisconsin or Illinois.
Overall, MercyCare Health Plans offers Illinois residents a strong combination of affordability, low out-of-pocket costs, and a low denial rate, making it a top choice for health insurance in the state.
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Ambetter: cheap, minimizes out-of-pocket costs, low denial rate
Ambetter is the best provider of cheap health insurance in Illinois, with a MoneyGeek score of 78 out of 100. Ambetter offers plans at lower rates compared to other providers, with its average plan rate at $485, and an average maximum out-of-pocket cost of $7,850. The company also has a low denial rate of 15%, meaning it approves claims more frequently than competitors.
Ambetter's Silver CSR plans are available at an average rate of $485 per month, with a maximum out-of-pocket cost of $6,513. The Silver level offers the most balanced cost-sharing, with a higher monthly premium than the Bronze level, but the plan will contribute more to your medical bills if you need care. Ambetter's top-rated plan offers lower out-of-pocket expenses for the same premium for people in different income brackets. For example, for those earning 201-250% of the Federal Poverty Level (FPL), the monthly cost is $464 with a maximum out-of-pocket cost of $4,600.
Ambetter also offers additional services to manage your health, such as vision and dental coverage, maternity health programs, and personalized help for managing chronic conditions. You can also earn rewards for taking charge of your health and get tax credits. The Ambetter Health mobile app allows you to conveniently manage your healthcare and access your Online Member Account from your smartphone.
Overall, Ambetter is a great option for those seeking cheap health insurance in Illinois, with its low rates, minimized out-of-pocket costs, and low denial rate.
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Medicare Advantage: bundled alternative to Medicare with dental and vision coverage
In Illinois, individuals earning less than 138% of the federal poverty level are eligible for Medicaid, a federal program that provides health coverage. Medicare, on the other hand, is a federal health insurance program for people 65 and older and some younger people with certain disabilities.
Medicare Advantage, also known as Part C, is a bundled alternative to original Medicare, offering additional benefits beyond what is typically covered by Parts A and B. These plans are sold by private insurance companies approved by Medicare and often include dental, vision, and prescription drug coverage.
In Illinois, several Medicare Advantage plans provide dental coverage, recognising its importance, especially as one's body ages. Seniors are more susceptible to tooth decay and gum disease, making regular dental visits a necessity. Some Medicare Advantage plans offer preventive services and procedures like checkups, cleanings, basic X-rays, fillings, bridges, and crowns.
Similarly, vision care is crucial, and some Medicare Advantage plans in Illinois may include vision insurance as part of their bundled services. Vision insurance typically covers eye exams, prescription eyewear, and other vision-related services.
When considering Medicare Advantage plans in Illinois, it is essential to review the specific details of the plans offered by different providers to understand the extent of dental and vision coverage included.
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Medicaid eligibility: for individuals earning less than 138% of the federal poverty level
Medicaid is a joint federal and state public health insurance program that provides coverage for low-income families and individuals. In Illinois, individuals earning less than 138% of the federal poverty level are eligible for this public health insurance plan.
Medicaid is an affordable health insurance alternative that can cover most, if not all, eligible medical expenses. Individuals covered by Medicaid in Illinois can choose either a fee-for-service plan or a managed care plan. As of 2022, more than 80% of Illinois Medicaid enrollees were covered under Medicaid managed care plans.
To be eligible for Medicaid in Illinois, you must be a U.S. citizen or fall within one of the qualified categories of non-citizens, such as refugees and persons lawfully present in the U.S. for over five years. Adults with income up to 138% of the federal poverty level are eligible, while children and pregnant women have higher income limits. For example, children who live in households with an income of up to 318% of the federal poverty level are eligible for Medicaid coverage. Women who have recently given birth with incomes up to 213% of the federal poverty level are also eligible for Medicaid coverage for up to 12 months after giving birth.
It is important to note that income limits for Medicaid eligibility in Illinois change annually, depending on the federal poverty level. As of 2025, MercyCare Health Plans is the top pick for the best health insurance in Illinois, with affordable plan options and low out-of-pocket costs.
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Blue Cross Community Health Plans: contracted with Illinois to implement Medicaid
In Illinois, Medicaid is a federal-state public health insurance program that provides coverage for low-income families and individuals. The state of Illinois has contracted with Blue Cross and Blue Shield of Illinois (BCBSIL) to implement Medicaid across all counties in the state. BCBSIL offers two plans under this program: Blue Cross Community Health Plans and Blue Cross Community MMAI (Medicare-Medicaid Plan).
Blue Cross Community Health Plans is a program developed and administered by BCBSIL to support the delivery of integrated and quality managed care services to enrollees. This includes seniors, persons with disabilities, families, children, and adults qualifying for the Illinois Department of Healthcare and Family Services Medical Program under the Affordable Care Act. The plan includes a network of independently contracted providers, such as physicians, hospitals, skilled nursing facilities, ancillary providers, and other healthcare providers, through which eligible members can obtain covered services. BCCHP also provides access to local providers, resources, and programs, as well as a member portal for easy access to health plan information.
Blue Cross Community MMAI, on the other hand, is a demonstration plan designed to serve individuals eligible for both Medicare and Medicaid. It combines Medicare and Medicaid funding under a blended payment agreement to provide integrated and comprehensive care to dual-eligible enrollees. MMAI aims to improve the accessibility and availability of care while maintaining the independence of its members.
While Blue Cross Community Health Plans is a strong option for Medicaid enrollees in Illinois, it is worth noting that other sources have named MercyCare Health Plans as the best health insurance in Illinois for 2025. MercyCare offers affordable plan options, low out-of-pocket costs, and a low denial rate of claims. Ambetter is also mentioned as the best provider of cheap health insurance in Illinois, with lower average plan costs and fewer denied claims.
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Frequently asked questions
Medicaid is a joint federal and state public health insurance program that provides coverage for low-income families and individuals.
According to MoneyGeek, the best health insurance in Illinois for 2025 is MercyCare Health Plans. This insurer offers affordable plan options, low out-of-pocket costs, and denies fewer claims than other insurers in Illinois.
Blue Cross and Blue Shield of Illinois offer two plans: Blue Cross Community Health Plans and Blue Cross Community MMAI (Medicare-Medicaid Plan). Other options include Aetna, Cigna, and Essence Healthcare, which offer 4.5-star plans.
When choosing a Medicaid health insurance plan, it is important to consider your individual needs and preferences. Factors to consider include the plan's costs, deductibles, copays, and whether your preferred medical providers participate in the plan's network.
Medicare is a federal health insurance program for people 65 and older, and some younger people with certain disabilities. Medicaid, on the other hand, is a joint federal and state program that provides coverage for low-income individuals and families, with eligibility based on income levels.
