Picking the Best ACA Health Plans in Illinois for 2023
As open enrollment for health coverage in 2023 begins on November 1, 2022, and runs through January 25, 2023, it is important to know what to look for in health coverage plans. This article will walk you through the best plans in Illinois based on this persona we used: a 30-year-old female who does not smoke and has no disability, making $70,000 a year. However, the best plans for you may vary from the ones we chose and listed below based on your personal profile.
What are the Best Plans on the Illinois Health Insurance Marketplace?
Illinois uses the federal Health Insurance Marketplace and does not have a separate state exchange. There are multiple health insurance companies on the marketplace for health plans in Illinois. Still, the three best-fit companies for our chosen persona are listed below. You can browse through plans using the comparison tool, which will list what is available to you based on your location, age, income, etc.
The three plan types listed are PPOs, POSs, and HMOs. You can find more information on the four main ACA health plan types later on in this article.
The table below displays the best plans on the federal Health Insurance Marketplace for a person of the profile described above. The table is sorted by metal tier and includes the plan name and type, monthly premium cost, and deductible amount.
With the profile listed above (30-year-old female making $70,000), this person would qualify for an estimated premium tax credit of $62 a month. It has been deducted from the original amount of the monthly premiums in the tables below. You may qualify for more or less tax credit based on your household factors.
Bronze Tier Plans
| Plan (Carrier+Name) | Monthly Premium | Deductible Amount | Plan Type |
|---|---|---|---|
| Blue Cross and Blue Shield of Illinois | $349.84 | $8,600 | Bronze PPO |
| Blue Cross and Blue Shield of Illinois | $366.91 | $9,100 | Bronze PPO |
| Blue Cross and Blue Shield of Illinois | $372.12 | $7,000 | Bronze PPO |
| Health Alliance | $373.28 | $8,000 | Bronze POS |
| Blue Cross and Blue Shield of Illinois | $381.94 | $7,000 | Bronze PPO |
| Health Alliance | $384.03 | $6,900 | Bronze POS |
| Health Alliance | $391.61 | $6,500 | Bronze POS |
| Health Alliance | $399.98 | $7,500 | Bronze POS |
| Blue Cross and Blue Shield of Illinois | $430.73 | $4,500 | Bronze PPO |
| Blue Cross and Blue Shield of Illinois | $432.97 | $7,500 | Bronze PPO |
| UnitedHealthcare | $556.03 | $9,100 | Bronze HMO |
| UnitedHealthcare | $574.52 | $9,100 | Bronze HMO |
| UnitedHealthcare | $577.28 | $7,250 | Bronze HMO |
| UnitedHealthcare | $594.68 | $6,700 | Bronze HMO |
| UnitedHealthcare | $597.20 | $7,500 | Bronze HMO |
| UnitedHealthcare | $601.54 | $7,500 | Bronze HMO |
Silver Tier Plans
| Plan (Carrier+Name) | Monthly Premium | Deductible Amount | Plan Type |
|---|---|---|---|
| Health Alliance | $495.18 | $7,250 | Silver POS |
| Blue Cross and Blue Shield of Illinois | $495.96 | $2,250 | Silver PPO |
| Health Alliance | $499.55 | $5,800 | Silver POS |
| Blue Cross and Blue Shield of Illinois | $499.91 | $5,800 | Silver PPO |
| Health Alliance | $509.98 | $3,000 | Silver POS |
| Health Alliance | $511.32 | $7,000 | Silver POS |
| Health Alliance | $522.33 | $4,200 | Silver POS |
| United Healthcare | $700.11 | $4,100 | Silver HMO |
| United Healthcare | $707.62 | $3,000 | Silver HMO |
| United Healthcare | $711.54 | $3,450 | Silver HMO |
| United Healthcare | $715.58 | $2,000 | Silver HMO |
| United Healthcare | $716.76 | $5,800 | Silver HMO |
| United Healthcare | $725.86 | $1,500 | Silver HMO |
| United Healthcare | $746.05 | $2,000 | Silver HMO |
Gold Tier Plans
| Plan (Carrier+Name) | Monthly Premium | Deductible Amount | Plan Type |
|---|---|---|---|
| Health Alliance | $511.90 | $2,000 | Gold POS |
| Health Alliance | $541.17 | $2,500 | Gold POS |
| Health Alliance | $568.70 | $1,000 | Gold POS |
| Blue Cross and Blue Shield of Illinois | $580.87 | $2,000 | Gold PPO |
| Blue Cross and Blue Shield of Illinois | $596.62 | $750 | Gold PPO |
| UnitedHealthcare | $842.13 | $1,800 | Gold HMO |
| UnitedHealthcare | $857.74 | $2,000 | Gold HMO |
| UnitedHealthcare | $844.21 | $1,200 | Gold HMO |
| UnitedHealthcare | $926.53 | $1,200 | Gold HMO |
What are the types of health plans?
The three types of plans listed above are PPOs, POSs, and HMOs. The table below outlines the four types of plans you may come across while browsing the marketplace.
Types of Health Insurance Plans
| Health Maintenance Organization (HMO) | This plan typically has lower premiums and out-of-pocket costs, and flexibility in choosing providers. You will have to pay completely out-of-pocket for out-of-network providers. |
|---|---|
| Point of Service Plan (POS) | This plan usually has higher premiums because they cover out-of-network providers and have a higher cost for in-network care. |
| Preferred Provider Organization (PPO) | This plan allows you to freely choose physicians out-of-network without referrals. It is a good option if you can afford high premiums and need frequent care. |
| Exclusive Provider Organization (EPO) | This plan is not commonly chosen and only covers in-network services. |
What Should I Consider When Picking a Health Plan?
When looking for a health plan, you should consider a few things. First, you must consider your health needs, finances, and how much you can afford. These are things that will likely change as time goes on, but having an understanding before selecting will help you make the best decision.
What are your health needs?
When picking a health plan, you want to consider your health needs. This includes what medications you currently take, chronic conditions like diabetes, and how often you need to see your medical provider. If necessary, do you need to see specialists? How will needing a referral from your PCP impact your experience? Finally, consider whether you plan on making any major life changes soon.
Life changes can include:
- Having a child
- Getting married
- Retiring early
- Moving
- Switching careers
Once you’ve figured out what your health needs are, you can move on to the next step of deciding which health plan is best for you. Some health plans also provide you with dental and vision care.
If you’re looking for a health plan to cover you and your family, you can still consider the above to help you rank all your options. If you’re married, your spouse may receive health insurance through their job; check to see if their plan offers more benefits.
What’s your financial situation?
After you’ve thought about your health needs, take the time to calculate your budget moving forward. Including things like housing, transportation, and even entertainment costs is important. Then you can see how much of your budget can go toward health insurance.
If you’re someone with an income that fluctuates, such as a freelancer or short-term contracted employee, you should think about how this will impact your budget at its highest and lowest. For people who live in cities with a high cost of living, you will find that the average cost of health insurance for one person varies compared to cities with a low cost of living.
You’ve done your budget, and you understand how much your current lifestyle affects your finances. Be mindful not to blow all your money on health insurance as you still need a savings account. We’ve even figured out a few things you should keep in mind when trying to lower your expenses.
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How much can you afford?
You have your health needs and budget figured out. Now you can select the health plan that will best meet your needs. If you find that you will have a high deductible, you can offset that with a service like Mira that offers a significant discount on lab tests and prescriptions.
If you decide to select a high deductible health plan (HDHP), you will find that you will have a lower monthly premium. These plans are typically helpful to relatively healthy people who don’t plan to have significant medical expenses. You can pair an HDHP with a Health Savings Account (HSA), which allows you to use your pre-taxed funds towards medical expenses like copays and deductibles. However, you cannot use this to pay for your monthly premium.
Average Lowest Cost Premiums by Metal Tier in Illinois (2023)
| Metal Tier | Lowest Cost Monthly Premium |
|---|---|
| Bronze | $340 |
| Silver | $449 |
| Gold | $482 |
What if you frequently travel?
If you travel a lot and need coverage during this time, look at PPO plans. Preferred Provider Organization plans will give you access to out-of-network coverage and allow you to see specialists without a referral. These plans do often come with a high premium. PPO plans are offered in Illinois, and with an additional cost, you can use out-of-network providers through such plans.
Look at PPO Coverage so you can be covered out of network - depending on the state, only some insurers are offered in that state - check if the plans in your state offer this coverage
What happens if you can’t afford any plan on the exchange?
If you cannot afford any plans on the exchange, there are alternative options available. Some of these options include care memberships, medical cost-sharing, and discount cards. However, Illinois does not have a penalty if you are uninsured. The federal law requiring tax penalties on those who are uninsured was repealed in 2019.
How to enroll in an ACA plan?
Illinois uses the federal Health Insurance Marketplace, where you can compare and sign up for an ACA health plan. You will need to gather personal and household information and consider your budget and ways you can qualify for savings when browsing plans. You can enroll online, over the phone, or mail in an application and find local assistance if you would like guidance with the process.
ACA Health Plans in Illinois Frequently Asked Questions (FAQs)
Below are some frequently asked questions about health insurance in Illinois we gathered for you.
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What health insurance terms should I understand during this enrollment period?
We’ve gone over PPO, HDHP, and HSA. You should also know what a Flexible Spending Account (FSA), Self-Pay Pricing (SPP), and Special Enrollment Period (SEP) are. We have a list with a few more insurance terms that will help you during this enrollment period.
What requirements do I need to meet to be eligible in Illinois?
To be eligible for enrollment through the Health Insurance Marketplace, you must be a US citizen residing in Illinois. You also cannot enroll in an ACA plan if you are incarcerated or if you already have Medicare coverage.
What are the benefits that my plan is required to provide?
Under the Affordable Care Act, there are ten benefits that every plan must cover (essential health benefits), including: doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more. However, not every plan is the same, and you will see what is offered by every plan when you compare them.
When is the special enrollment period?
If you miss open enrollment and you’ve had a qualifying life event such as having a baby, a change in income, or health insurance loss, you may be able to apply 60 days prior or 60 days after the event to enroll in a health plan. To see if you qualify, go to healthcare.gov and fill out a few questions. The site will direct you to either answer more questions or to the site for Illinois.
Bottom Line
You can enroll in an ACA health insurance plan in Illinois through the federal Health Insurance Marketplace. There are easy ways to browse through the plans by inputting your personal information and figuring out which plans work best for you. You should compare plans based on metal tiers and the differences between deductible and premium amounts. As open enrollment runs from November 1, 2022, through January 15, 2023, it is important to become familiar with the enrollment process.
If you’re looking for a more affordable alternative to health insurance, Mira might be a great fit for you. For an average of $45 per month, members get access to low-cost urgent care visits, affordable lab testing, and discounted prescriptions at up to 80% off. Sign up today and start saving on healthcare.
Michelle Fleming is a sophomore at the University of Texas at Austin majoring in Public Health, focusing on biostatistics and informatics and minoring in Health Communications. Michelle is passionate about bridging the gap in health inequalities through advocacy and policy, especially within minority groups.
