Compare Illinois Health Insurance Marketplace And Medigap Plans/Rates

Affordable health insurance Exchange plans in Illinois for single persons, families, Seniors, and businesses is available. Many low-cost medical plans are now offered through 2018 Open Enrollment, and we help you find the policies that are within your budget and flexible to meet your needs. Our three decades of knowledge allow us to customize Obamacare Marketplace and Medicare coverage, and make purchasing a plan simple and quick.

2019 low-cost options are also available if you apply for coverage after Open Enrollment ends. Cheap temporary contracts are typically offered along with separate enrollment periods (SEP) if you have a baby, lose existing group or private coverage, move to a different service area, reach age 26,  or several other approved exceptions. These “qualifying life events”  are offered at anytime of the year, regardless whether the Open Enrollment period has ended or is still active. Financial subsidies are applicable, if income qualifications are met.

Additional information regarding missing an OE period is listed below. Several approved exceptions allow you to choose any available  plan, and receive federal subsidies, if you meet qualification guidelines.

Senior Illinois Medigap plans are available to most persons that have reached age 65. Medicare Supplement and “Advantage” contracts often lower potential out-of-pocket costs that are not covered by standardized contracts. Prescription drug coverage is available through Part D plans or many Advantage contracts. The Medicare Open Enrollment period begins on October 15th and concludes on December 7th. If you reach age 65 after the OE period, and are Medicare-eligible, a separate  period is created.

 

Where Do I Find Rates?

We make it easy for you to view prices online. The quote box at the top of the page begins the quick and simple process of viewing rates. We typically show premiums in the monthly mode,  although alternative billing is available with many companies. Almost instantly, you can compare prices for all types of plans. We customize recommendations so they provide the most cost-effective options.

Catastrophic, Copay, Student, HSA, Self-employed and Temporary options are available. Small business owners can also research and compare the best options through the SHOP portion of the Exchange, which is available at any time throughout the year. You can terminate your own policy at any time. NOTE: Short-term plans are not eligible for federal subsidies and also do not satisfy the legal requirement of maintaining qualified coverage.

Open Enrollment begins every November, so pre-existing conditions are  covered and you can not be denied for medical underwriting reasons. More than 120 plans (all qualified) are available for individuals and businesses. Four “Metal” options are offered in the Marketplace along with a catastrophic policy for persons under age 30, or older adults that have no inexpensive contracts that they are able to buy. Proof of “financial hardship” may be required in these circumstances.

 

What Happens If I Miss Marketplace Open Enrollment In Illinois?

You still will probably be able to obtain affordable medical coverage. A common scenario is that you qualify for a “life event” that allows you to participate in a Special Enrollment Period (SEP). For example, the following would be considered approved “life events”: Marriage, having a baby (only the baby qualifies), becoming a US citizen, relocating to a different  service area, substantial change in income, getting out of prison, adoption or foster care, and becoming part of a recognized Indian Tribe.

SEP Exceptions For Health Marketplace

Marriage Qualifies As An SEP (Special Enrollment Period)

Qualifying for any of these situations will not only give you 60 days to compare and enroll, but you also become eligible for federal subsidies. For income verification purposes, your current-year projection should be used. It is possible that a substantial reduction in household income may allow you to immediately become eligible for Medicaid. If you become eligible for Medicare, you can consider a Medigap plan.

 

What About The  Federal Tax Subsidy?

Part of past legislation requires federal subsidies be provided to individuals and families based on the Federal Poverty Level guidelines, your age and number of qualified dependents. Listed below are some examples of the estimated amount of subsidies you could potentially receive. Dollars shown are annualized and we used the Chicago area (Cook County) for rating purposes.

$6,672 – Family of two with $36,000 total income. Husband and wife ages 40, with no children.

$3,076 – Family of one with $22,000 total income. Age 28 with no children.

$15,204 – Family of two with $60,000 total income. Husband and wife ages 60 with no children.

$7,920 – Family of four with $50,000 total income. Husband and wife ages 40 with two children covered by CHIP.

$17,160 – Family of three with $80,000 total income. Husband and wife ages 60 with one child.

 

These subsidies are in the form of instant credits to help pay your health insurance premium in Illinois. You also may be able to buy a health insurance plan with a zero deductible. These contracts will minimize costs for many major claims, and are often ideal if surgery is scheduled.

However, it may have to be a Platinum, Silver or Gold plan to have no deductible, instead of a lower-priced plan. Occasionally, HMO plans also offer no deductible. However, the “maximum out-of-pocket cost” must always be considered.  Silver plans offer a “cost-sharing” feature that allows you to substantially reduce the deductible and out-of-pocket costs, depending on your income. The lower the income, the higher the “cost-sharing.”

For instance, a 45-year old that makes $31,000 per year, will qualify for a $3,000 yearly credit, or about 40% of  one of the cheapest available Silver plan premiums. If that person is married with two children, and the household income is $60,000, the credit will be much more, although the children would be eligible for Illinois CHIP benefits.

If the household income exceeds the maximum allowed amounts, then no subsidy will be available. In that scenario, policies will be  purchased at full price or a better “deal” may be available by not using the Exchange. It is possible premiums may actually be slightly lower by selecting a plan that does not include the 10 required essential benefits. However, a tax penalty will be imposed, pre-existing conditions may not be covered, and benefits may be limited.

 

Which Companies Offer Under age-65 Coverage In The State?

The participating carriers in the state are  Ambetter, Blue Cross Blue Shield of Illinois,  Health Alliance Medical Plans, and Cigna.  Companies that previously offered private individual plans are Humana, UnitedHealthcare, Aetna, Harken, Coventry, and Land of Lincoln Health. Additional carriers offer “short-term” coverage and “limited benefit” options. In 2020, additional carriers may offer private individual and family plans, depending upon possible changes in legislation.

 

What Are the 13 Geographic Rating Areas?

Each service area is required to offer plans in a geographic area that includes a minimum of one county. Typically, several counties are included. Participating companies must ensure there are an acceptable number of available providers. If the entire area is not covered, an exception must be approved. The 13 areas are listed below:

Area 1 – Cook County

Area 2 – McHenry and Lake Counties

Area 3 – Kane and DuPage Counties

Area 4 – Will, Kendall, Kankakee, and Grundy Counties

Area 5 – Winnebago, Stephenson, Ogle, Lee, Jo Daviess, DeKalb, Carroll, and Boone Counties

Area 6 – Whiteside, Warren, Rock Island, Mercer, Henry, Henderson, Hancock, and Bureau Counties

Area 7 – Woodford, Tazewell, Stark, Putnam, Peoria, McDonough, Marshall, LaSalle, Knox, and Fulton Counties

Area 8 – Mclean, Livingston, and Dewitt Counties

Area 9 – Vermilion, Piatt, Iroquois, Ford, Edgar, Douglas, Cumberland, Coles, Clark, and Champaign Counties

Area 10 – Shelby, Scott, Schuyler, Sangamon, Pike, Moultrie, Morgan, Menard, Mason, Macon, Logan, Christian, Cass, Brown, and Adams Counties

Area 11 – Washington, Randolph, Montgomery, Macoupin, Jersey, Greene, Clinton, Calhoun, and Bond Counties

Area 12 – St. Clair, Monroe, and Madison Counties

Area 13 – Williamson, White, Wayne, Wabash, Union, Saline, Richland, Pulaski, Pope, Perry, Massac, Marion, Lawrence, Johnson, Jefferson, Jasper, Jackson, Hardin, Hamilton, Gallatin, Franklin, Fayette, Effingham, Edwards, Crawford, Clay, and Alexander

 

Which Companies Offer Age-65 And Over (Senior) Coverage In The State?

Medicare Supplement, Advantage, and Part D Prescription Drug coverage is offered by many companies, including major carriers that don’t offer options to persons under age 65. A comprehensive list of carriers offering MedSup contracts is listed near the bottom of this page. Companies offering Advantage contracts include Aetna, BCBS Of Illinois, Cigna-HealthSpring, Community Care Alliance, Coventry, Essence, Fresenius Health Plans, Health Alliance Healthcare, HealthPartners, UnityPoint, Humana, MeridianCare, Sunrise, UnitedHealthcare, and WellCare .

Part D drug prescription plans offered include SilverScript Choice, AARP MedicareRX Preferred, Blue Cross MedicareRX Value, Humana Walmart RX, Humana Preferred RX, AARP MedicareRX Walgreens, Blue Cross MedicareRX Basic, Symphonix Value RX, WellCare Classic, EnvisionRXPlus, and Aetna Medicare Rx Saver,

Safety and financial stability of each carrier is investigated by the Department of Insurance. In addition to financial and ratings information, you can also view proposed premium increases and the decision of the DOR regarding approving the rate increase.

 

Find Cheapest Medical Plan Illinois

Affordable Illinois Healthcare Is Available

How Much Does  Illinois Health Insurance Cost?  See Several Scenarios Below. Rates Are Monthly:

 

45 year-old residing in the Rockford area and Winnebago County, with household income of $32,000

 

$65BCBS Blue Precision Bronze HMO 205 – $6,000 deductible with 40% coinsurance. $50 and $85 office visit copays with $85 Urgent Care copay. Diagnostic tests (blood work and x-rays) are subject to copays only ($50 and $100) at freestanding facilities. Imaging (MRIs, PET and CT scans) are also subject to copay at freestanding facilities. Prescription drugs are subject to deductible and coinsurance.

$74 – Quartz Performance Bronze 7900 – Copay $50/$100 – $7,900 deductible with 0% coinsurance. $50 and $100 office visit copays.  Prescription drugs are subject to deductible and coinsurance.

$86  – Quartz Performance Bronze 7500 – Copay $80/$160$7,500 deductible with 50% coinsurance. $80 and $160 office visit copays (pcp and specialist) with $160 Urgent Care copay.  The preferred generic, preferred brand, and non-preferred brand drug copays are $35, $150, and $250.

$94 – Quartz Performance Bronze HSA 6750 – HSA-eligible plan with $6,750 deductible and 0% coinsurance.

$195  – BCBS Blue Precision Silver HMO 206 – $2,500 deductible with 50% coinsurance. $30 and $65 office visit copays (pcp and specialist) with $65 Urgent Care copay. Diagnostic test (blood work and x-rays) copay is $20 per visit, and the imaging (MRIs, PET and CT scans) copay is $250 per visit. Preferred generic drugs are covered at 100%. Coinsurance and deductible applies to all other drugs.

$201  – BCBS Blue Precision Gold HMO 207 – $500 deductible with 30% coinsurance. $20 and $40 office visit copays (pcp and specialist) with $40 Urgent Care copay. Diagnostic test (blood work and x-rays) copay is $40 per visit, and the imaging (MRIs, PET and CT scans) copay is $250 per visit. Prescriptions are subject to coinsurance and deductible.

 

35 year-old married couple (2 persons) residing in the Chicago area and Cook County, with household income of $40,000

$164 – BCBS Blue FocusCare Bronze 209 – $6,000 deductible with 40% coinsurance. $50 and $85 office visit copays with $85 Urgent Care copay. Diagnostic tests (blood work and x-rays) are subject to copays only ($50 and $100) at freestanding facilities. Imaging (MRIs, PET and CT scans) are also subject to copay at freestanding facilities. Prescription drugs are subject to deductible and coinsurance.

$175 – Cigna Connect 7150 – $7,150 deductible with 50% coinsurance. No copays on non-preventative office visits.

$239 – Ambetter Balanced Care 11 – $2,625 deductible with 40% coinsurance. $20 and $40 office visit copays with Urgent Care copay of $75.  Diagnostic test (blood work and x-rays) and imaging (MRIs, PET and CT scans) are also subject to deductible. The generic drug copay is $20 ($60 for mail-order), and the preferred brand drug copay is $50 ($150 for mail-order).

$256 – Cigna Connect 6650 – $6,650 deductible with 50% coinsurance. $25 pcp office visit copay for first three visits. Preferred generic drug copay is $10 ($30 for mail-order), and non-preferred generic drug copay is $40 ($120 for mail-order).

$270 – Ambetter Balanced Care 4 – $5,325 deductible with 0% coinsurance. $15 and $45 office visit copays with Urgent Care copay of $75.  Diagnostic test (blood work and x-rays) and imaging (MRIs, PET and CT scans) are also subject to deductible. The generic drug copay is $15 ($45 for mail-order), and the preferred brand drug copay is $50 ($150 for mail-order).

 

50 year-old and one child (2 persons) residing in the Joliet area and Will County with household income of $53,000

$240 – Cigna Connect 7150 – $7,150 deductible with 50% coinsurance. No copays on non-preventative office visits.

$270 – BCBS Blue Precision Bronze HMO 205 – $6,000 deductible with 40% coinsurance. $50 and $85 office visit copays with $85 Urgent Care copay. Diagnostic tests (blood work and x-rays) are subject to copays only ($50 and $100) at freestanding facilities. Imaging (MRIs, PET and CT scans) are also subject to copay at freestanding facilities. Prescription drugs are subject to deductible and coinsurance.

$316 – BCBS Blue Choice Preferred Bronze PPO 201 – Two $40 PCP Visits – $6,000 deductible with 50% coinsurance. $40 copay for first two pcp office visits and Urgent Care copay of $60.  The preferred generic drug copay is $10 ($30 for mail-order), and the non-preferred generic drug copay is $20 ($60 for mail-order).

$329 – Cigna Connect 6650 – $6,650 deductible with 50% coinsurance. $25 pcp office visit copay for first three visits. Preferred generic drug copay is $10 ($30 for mail-order), and non-preferred generic drug copay is $40 ($120 for mail-order).

$394 – Cigna Connect 5500 – $5,500 deductible with 50% coinsurance. $25 pcp office visit copay for first three visits. Urgent Care copay is $35. Preferred generic drug copay is $10 ($30 for mail-order), and generic drug copay is $25 ($75 for mail-order). Preferred brand drug copays are $60 and $180.

 

55 year-old married couple (2 persons) residing in the Naperville area and Dupage County, with household income of $60,000

$77 – Cigna Connect 7150 – $7,150 deductible with 50% coinsurance. No copays on non-preventative office visits.

$195 – BCBS Blue Precision Bronze HMO 205 – $6,000 deductible with 40% coinsurance. $50 and $85 office visit copays with $85 Urgent Care copay. Diagnostic tests (blood work and x-rays) are subject to copays only ($50 and $100) at freestanding facilities. Imaging (MRIs, PET and CT scans) are also subject to copay at freestanding facilities. Prescription drugs are subject to deductible and coinsurance.

$226 – BCBS Blue Choice Preferred Bronze PPO 201 – Two $40 PCP Visits – $6,000 deductible with 50% coinsurance. $40 copay for first two pcp office visits and Urgent Care copay of $60.  The preferred generic drug copay is $10 ($30 for mail-order), and the non-preferred generic drug copay is $20 ($60 for mail-order).

$229 – Cigna Connect 6650 – $6,650 deductible with 50% coinsurance. $25 pcp office visit copay for first three visits. Preferred generic drug copay is $10 ($30 for mail-order), and non-preferred generic drug copay is $40 ($120 for mail-order).

$339 – Cigna Connect 5500 – $5,500 deductible with 50% coinsurance. $25 pcp office visit copay for first three visits. Urgent Care copay is $35. Preferred generic drug copay is $10 ($30 for mail-order), and generic drug copay is $25 ($75 for mail-order). Preferred brand drug copays are $60 and $180.

 

Which Plans Are The Most Affordable?

Health Alliance HMO 3700 Elite Bronze

Health Alliance HMO 3700 OSF Bronze

Health Alliance HMO 3700 Methodist Bronze

Health Alliance HMO 4000d Elite Bronze

Health Alliance HMO 3800 Elite Bronze

Health Alliance HMO 6650a Elite Bronze

Health Alliance HMO HSA 6000 Elite Bronze

Health Alliance POS HSA 6550 Elite Bronze

Cigna Connect 7150

Cigna Connect 6650

BCBS Blue FocusCare Bronze

BCBS Blue Precision Bronze

BCBS Blue Precision Bronze HMO

BCBS Blue Choice Preferred Bronze PPO

Ambetter Balanced Care 4

Ambetter Balanced Care 2

Ambetter Balanced Care 11

Quartz Performance Bronze 7900 – Copay $50/$100

Quartz Performance Bronze 7500 – Copay $80/$160

 

Can I Cancel My Policy At Any Time?

You can terminate coverage by simply submitting a request. Typically, email, fax or letter is sufficient with all carriers. If there are unused benefits that you have paid for, a refund will be calculated and promptly sent. You will also receive a letter indicating the dates you were covered under that specific policy. This information was previously needed to verify you met the ACA legal requirements on IRS form 1095-A. This form provides information regarding your qualified healthcare plan, and the premium tax credit.

If you only need benefits for less than 90 days, perhaps a “temporary” policy is your best option. The price is cheap, and you can cover the catastrophic types of claims until you are insured under a different policy. Typically, applications are approved within 24 hours. However, you can not receive federal government subsidies to pay for these types of policies. Coverage up to 12 months can be purchased, without having to medically qualify for a new plan. Policies are offered at all times throughout the year.

 

What About Medigap Coverage?

Although prices can vary, in most areas of the state, many choices are available for Medicare Supplement, Advantage, or Part D prescription drug coverage. Listed below are the companies approved to offer Medicare Supplement plans in Illinois.

AARP (UnitedHealthcare)

Aetna

American Republic

American Retired Life (Cigna)

Americo

Assured Life

Bankers Fidelity

BCBS

Colonial Penn

Combined

Country Life

CSI

Equitable

Gerber

Globe

Government Personnel

Health Alliance

Humana

Individual Assurance

KSKJ Life

Liberty National

Medico

Mutual Of Omaha

Oxford Life

Pekin Life

Physicians Mutual

Reserve National

Sentinel Security

Standard Life And Accident

State Farm

Order Of United Commercial Travelers

Thrivent

Unified Life

United American

United National Life

USAA

 

Sample Illinois Medicare Supplement Rates

Illustrated below are current estimated monthly male (age 65) rates for popular Medigap plans. Prices and plan availability typically vary depending on your age, plan, and county of residence. Female rates are generally lower.

 

Cook And DuPage Counties

 

Plan A

$74 – BCBS

$82 – AARP-UnitedHealthcare

$108 – Humana

$117 – Lumico

$119 – Continental Life

$122 – CSI Life

$124 – Guarantee Trust Life

$125 – Loyal Christian Benefit

$125 – Mutual Of Omaha

$129 – United World Life

$129 – Americo

$132 – Western United Life

$134 – Thrivent

$144 – Cigna

$144 – Greek Catholic Union

$146 – New Era Life

$188 – Medico

$191 – Oxford Life

 

Plan C

$152 – AARP-UnitedHealthcare

$157 – BCBS

$165 – Western United Life

 

Plan F

$152 – Lumico

$153 – AARP-UnitedHealthcare

$157 – Guarantee Trust Life

$158 – BCBS

$160 – United World Life

$160 – Americo

$168 – Thrivent

$173 – Humana

$176 – Continental Life

$178 – Cigna

$178 – Greek Catholic Union

$181 – Mutual Of Omaha

$192 – CSI Life

$240 – New Era Life

$264 – Medico

$271 – Oxford Life

 

Plan F (High Deductible)

$49 – Cigna

$50 – Mutual Of Omaha

$50 – BCBS

$56 – Humana

$56 – New Era Life

$70 – Medico

$71 – Continental Life

 

Plan N

$102 – Lumico

$103 – Mutual Of Omaha

$103 – Greek Catholic Union

$104 – Americo

$106 – Guarantee Trust Life

$109 – BCBS

$112 – AARP-UnitedHealthcare

$112 – CSI Life

$112 – Thrivent

$113 – Cigna

$117 – Continental Life

$120 – Humana

$157 – New Era Life

$161 – Medico

$171 – Oxford Life

 

Lake County

 

Plan C

$152 – AARP-UnitedHealthcare

$157 – BCBS

$165 – Western United Life

 

Plan F

$152 – Lumico

$153 – AARP-UnitedHealthcare

$157 – Guarantee Trust Life

$158 – BCBS

$159 – United World Life

$160 – Americo

$168 – Thrivent

$173 – Humana

$176 – Continental Life

$178 – Greek Catholic Union

$181 – Mutual Of Omaha

$169 – Continental Life

$192 – CSI Life

$240 – New Era Life

$250 – Medico

$271 – Oxford Life

 

Plan F (High Deductible)

$37 – United American

$48 – Cigna

$50 – Mutual Of Omaha

$56 – New Era Life

$66 – Humana

$67 – Medico

$68 – Continental Life

$84 – Pekin Life

 

Plan G

$119 – Lumico

$123 – United World Life

$126 – Sentinel Security

$127 – Guarantee Trust Life

$127 – Americo

$129 – Loyal Christian Benefit

$131 –  AARP-UnitedHealthcare

$133 – Oxford Life

$133 – Thrivent

$133 – Cigna

$135 – CSI Life

$139 – Greek Catholic Union

$139 – Continental Life

$141 – Humana

$142 – Mutual Of Omaha

$142 – BCBS

$163 – Medico

$193 – New Era Life

$281 – Gerber

 

Plan N

$102 – Lumico

$102 – United World Life

$103 – Mutual Of Omaha

$103 – Greek Catholic Union

$104 – Americo

$109 – Loyal Christian Benefit

$110 – BCBS

$112 – AARP-UnitedHealthcare

$112 – CSI Life

$112 – Thrivent

$117 – Cigna

$117 – Continental Life

$120 – Humana

$153 – Medico

$157 – New Era Life

$170 – Oxford Life

 

Illinois Medicare 2019 Stand-Alone Part D Drug Prescription Plans

WellCare Value Script – $14.50 per month with $415 deductible. Preferred Pharmacy cost-sharing: $0 (Tier 1), $7 (Tier 2), $43 (Tier 3), 47% (Tier 4), and 25% (Tier 5).

WellCare Classic – $28.00 per month with $415 deductible. Preferred Pharmacy cost-sharing: $0 (Tier 1), $2 (Tier 2), $35 (Tier 3), 39% (Tier 4), and 25% (Tier 5).

WellCare Extra – $72.30 per month with $0 deductible. Preferred Pharmacy cost-sharing: $0 (Tier 1), $2 (Tier 2), $47 (Tier 3), 46% (Tier 4), and 33% (Tier 5).

Aetna Medicare Rx Select – $16.20 per month with $390 deductible. Preferred Pharmacy cost-sharing: $0 (Tier 1), $7 (Tier 2), $43 (Tier 3), 40% (Tier 4), and 25% (Tier 5).

Aetna Medicare Rx Saver – $24.10 per month with $345 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $2 (Tier 2), $30 (Tier 3), 35% (Tier 4), and 26% (Tier 5).

Aetna Medicare Rx Value Plus – $58.70 per month with $0 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $2 (Tier 2), $47 (Tier 3), 47% (Tier 4), and 33% (Tier 5).

Cigna-HealthSpring Rx Secure-Essential – $21.90 per month with $415 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $3 (Tier 2), $20 (Tier 3), 49% (Tier 4), and 25% (Tier 5).

Cigna-HealthSpring Rx Secure – $25.50 per month with $415 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $3 (Tier 2), $30 (Tier 3), 36% (Tier 4), and 25% (Tier 5).

Cigna-HealthSpring Rx Secure-Extra – $57.90 per month with $100 deductible. Preferred Pharmacy cost-sharing: $4 (Tier 1), $10 (Tier 2), $42 (Tier 3), 50% (Tier 4), and 31% (Tier 5).

Humana Walmart Rx Plan – $23.50 per month with $415 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $4 (Tier 2), 20% (Tier 3), 35% (Tier 4), and 45% (Tier 5).

Humana Preferred Rx Plan – $26.20 per month and $415 deductible. Preferred Pharmacy cost-sharing: $0 (Tier 1), $1 (Tier 2), 25% (Tier 3), 40% (Tier 4), and 25% (Tier 5).

Humana Enhanced – $77.10 per month and $0 deductible. Preferred Pharmacy cost-sharing: $5 (Tier 1), $10 (Tier 2), $47 (Tier 3), 50% (Tier 4), and 33% (Tier 5).

Express Scripts Medicare Saver – $24.00 per month with $415 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $4 (Tier 2), 18% (Tier 3), 32% (Tier 4), and 25% (Tier 5).

Express Scripts Medicare Value – $43.10 per month with $415 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $3 (Tier 2), $36 (Tier 3), 48% (Tier 4), and 25% (Tier 5).

Express Scripts Medicare Choice – $96.80 per month with $350 deductible. Preferred Pharmacy cost-sharing: $2 (Tier 1), $7 (Tier 2), $42 (Tier 3), 48% (Tier 4), and 26% (Tier 5).

AARP MedicareRx  Saver Plus  – $26.10 per month with $415 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $8 (Tier 2), $25 (Tier 3), 33% (Tier 4), and 25% (Tier 5).

AARP MedicareRx  Walgreens  – $28.10 per month with $415 deductible. Preferred Pharmacy cost-sharing: $0 (Tier 1), $5 (Tier 2), $30 (Tier 3), 32 % (Tier 4), and 25% (Tier 5).

AARP MedicareRx  Preferred  – $69.20 per month with $0 deductible. Preferred Pharmacy cost-sharing: $5 (Tier 1), $10 (Tier 2), $40 (Tier 3), 40 % (Tier 4), and 33% (Tier 5).

SilverScript Plus – $83.40 per month with $0 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $5 (Tier 2), $35 (Tier 3), 40 % (Tier 4), and 33% (Tier 5).

SilverScript Choice – $26.80 per month with $0 deductible. Preferred Pharmacy cost-sharing: $9 (Tier 1), $19 (Tier 2), $46 (Tier 3), 49 % (Tier 4), and 33% (Tier 5).

SilverScript Allure – $80.00 per month with $0 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $5 (Tier 2), 20% (Tier 3), 40 % (Tier 4), and 33% (Tier 5).

EnvisionRxPlus – $26.90 per month with $415 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $3 (Tier 2), 15% (Tier 3), 32 % (Tier 4), and 25% (Tier 5).

Mutual Of Omaha Rx Value – $28.10 per month with $415 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $4 (Tier 2), 15% (Tier 3), 36 % (Tier 4), and 25% (Tier 5).

Mutual Of Omaha Rx Plus – $45.80 per month with $415 deductible. Preferred Pharmacy cost-sharing: $3 (Tier 1), $6 (Tier 2), $29 (Tier 3), 48 % (Tier 4), and 25% (Tier 5).

Blue Cross MedicareRx Basic – $32.70 per month with $415 deductible. Preferred Pharmacy cost-sharing: $1 (Tier 1), $4 (Tier 2), 16% (Tier 3), 33 % (Tier 4), and 25% (Tier 5).

Blue Cross MedicareRx Value – $70 per month with $415 deductible. Preferred Pharmacy cost-sharing: $0 (Tier 1), $8 (Tier 2), $42 (Tier 3), 40 % (Tier 4), and 25% (Tier 5).

Blue Cross MedicareRx Plus – $130.60 per month with $0 deductible. Preferred Pharmacy cost-sharing: $0 (Tier 1), $2 (Tier 2), $30 (Tier 3), 35 % (Tier 4), and 33% (Tier 5).

 

Medicare Advantage Plans

Illinois Medicare Advantage (MA) coverage is offered through many private insurers as an alternative to original Medicare benefits. Most plans cover prescription drugs, and also offer dental, vision, or hearing benefits. HMO, PPO, Special Needs, Fee-For-Service, and Medical Savings Accounts (MSA) are available. Listed below are many of the plan options offered (with prescription drug benefits, unless specified) by licensed companies in Cook County Including the Chicago area). Plan availability and premiums can differ, depending upon your county of residence.

AARP MedicareComplete Access (HMO) – $0 monthly premium, and $100 deductible with $3,600 maximum out-of-pocket expenses. Preferred pharmacy 30-day drug copays are $3 (Tier 1), $12 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 31% (Tier 5).  The inpatient hospital copay is $250 for the first 6 days, and the outpatient hospital copay is $250 per visit. Office visit copays are $5 and $35, and the ER and Urgent Care copays are $90 and $30-$40. Lab service and outpatient x-ray copays are $6 and $14. Outpatient mental health group and individual copays are $30 and $40. Occupational, physical, and language therapy copays are $35. Comprehensive dental benefits are available for an additional $39 per month.

Aetna Medicare Value Plan (HMO) – $0 monthly premium, and $95 deductible with $4,000 maximum out-of-pocket expenses. Preferred pharmacy 30-day drug copays are $2 (Tier 1), $5 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 31% (Tier 5).  The inpatient hospital copay is $325 for the first 5 days, and the outpatient hospital copay is $35-$250 per visit. Office visit copays are $10 and $35, and the ER and Urgent Care copays are $90 and $10-$35. Lab service and outpatient x-ray copays are $20 and $5. Outpatient mental health group and individual copays are $40. Occupational, physical, and language therapy copays are $40. Comprehensive dental benefits are available for an additional $11 per month. Adding eyewear and hearing aid coverage adds another $9 per month.

Aetna Medicare Value Plan (PPO) – $0 monthly premium, and $0 deductible with $3,450 maximum out-of-pocket expenses. Preferred pharmacy 30-day drug copays are $0 (Tier 1), $10 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5).  The inpatient hospital copay is $285 for the first 7 days, and the outpatient hospital copay is $30-$275 per visit. Office visit copays are $0 and $30, and the ER and Urgent Care copays are $90 and $0-$30. Lab service and outpatient x-ray copays are $10 and $20. Outpatient mental health group and individual copays are $40. Occupational, physical, and language therapy copays are $40.

Allwell Medicare – $0 monthly premium, and $0 deductible with $3,200 maximum out-of-pocket expenses. Preferred pharmacy 30-day drug copays are $0 (Tier 1), $6 (Tier 2), $39 (Tier 3), $85 (Tier 4), and 33% (Tier 5).  The inpatient hospital copay is $225 for the first 5 days, and the outpatient hospital copay is $175. Office visit copays are $0 and $35, and the ER and Urgent Care copays are $120 and $35. Lab service and outpatient x-ray copays are $0 and $25. Outpatient mental health group and individual copays are $35. Occupational, physical, and language therapy copays are $35.

Blue Cross Medicare Advantage Basic – $0 monthly premium, and $0 deductible with $3,400 maximum out-of-pocket expenses. Preferred pharmacy 30-day drug copays are $0 (Tier 1), $8 (Tier 2), $39 (Tier 3), $95 (Tier 4), and 33% (Tier 5).  The inpatient hospital copay is $225 for the first 7 days, and the outpatient hospital copay is $275 per visit. Office visit copays are $0-5 and $30, and the ER and Urgent Care copays are $90 and $30. Lab service and outpatient x-ray copays are $0. Outpatient mental health group and individual copays are $30. Occupational, physical, and language therapy copays are $35. The preventative dental services copay is $5.

Blue Cross Medicare Advantage Basic Plus – $0 monthly premium, and $0 deductible with $4,500 maximum out-of-pocket expenses. Preferred pharmacy 30-day drug copays are $0 (Tier 1), $8 (Tier 2), $39 (Tier 3), $95 (Tier 4), and 33% (Tier 5).  The inpatient hospital copay is $220 for the first 7 days, and the outpatient hospital copay is $275 per visit. Office visit copays are $10 and $40, and the ER and Urgent Care copays are $90 and $30. Lab service and outpatient x-ray copays are $0. Outpatient mental health group and individual copays are $30. Occupational, physical, and language therapy copays are $35 and $40. Comprehensive dental coverage with eyewear and hearing aids benefits, is available for an extra $32 per month.

Cigna HealthSpring Premier – $o monthly premium, and $0 deductible with $3,400 maximum out-of-pocket expenses. Preferred pharmacy 30-day drug copays are $5 (Tier 1), $10 (Tier 2), $42 (Tier 3), 45% (Tier 4), and 33% (Tier 5).  The inpatient hospital copay is $275 for the first 7 days, and the outpatient hospital copay is $0-$320 per visit. Office visit copays are $0-$8 and $40, and the ER and Urgent Care copays are $90 and $45. Lab service and outpatient x-ray copays are $0 and $30. Outpatient mental health group and individual copays are $40. Occupational, physical, and language therapy copays are also $40.  Comprehensive dental coverage with eyewear  benefits, is available for an extra $20 per month.

Community Advantage – $0 deductible with $3,950 maximum out-of-pocket expenses. Preferred pharmacy 30-day drug copays are $1 (Tier 1), $5 (Tier 2), $35 (Tier 3), 50% (Tier 4), and 33% (Tier 5).  The inpatient hospital copay is $220 for the first 7 days, and the outpatient hospital copay is $150 per visit. Office visit copays are $5 and $0-$25, and the ER and Urgent Care copays are $90 and $50. Lab service and outpatient x-ray copays are $0. Outpatient mental health group and individual copays are $25. Occupational, physical, and language therapy copays are $20. Comprehensive dental benefits are included with a $0 copay.

Humana Gold Plus – $0 deductible with $2,750 maximum out-of-pocket expenses. Preferred pharmacy 30-day drug copays are $1 (Tier 1), $5 (Tier 2), $47 (Tier 3), $100 (Tier 4), and 33% (Tier 5).  The inpatient hospital copay is $175 for the first 7 days, and the outpatient hospital copay is $175 per visit. Office visit copays are $0 and $25, and the ER and Urgent Care copays are $120 and $0-$25. Lab service and outpatient x-ray copays are $0-$25. Outpatient mental health group and individual copays are $25. Occupational, physical, and language therapy copays are $20. Preventative dental benefits are included with a $0 copay.

HumanaChoice – $0 deductible with $6,700 maximum out-of-pocket expenses.   The inpatient hospital copay is $295 for the first 6 days, and the outpatient hospital copay is $250 per visit. Office visit copays are $15 and $45, and the ER and Urgent Care copays are $90 and $15-$45. Lab service and outpatient x-ray copays are $0-$40 and $15-$95. Outpatient mental health group and individual copays are $40. Occupational, physical, and language therapy copays are $40. Prescription drug coverage is not included. Preventative dental coverage is included with a $0 copay. Comprehensive dental benefits are offered for an additional $38.70 per month.

 

How Do I Apply For Medicaid If I Am Eligible?

If you are eligible, you have a choice of picking your own physicians for the services you receive, or choosing a “primary care physician,” that will be part of a managed care program. Either a PHP or HMO type of coverage will be offered. The HMO will likely have a broader network, but you will have to verify that they accept Medicaid patients. If your household income falls under 100% of the Federal Poverty Level, you will likely automatically qualify. You can also purchase conventional plans, but you can not utilize a federal subsidy if you are Medicaid-eligible.

 

What Are The Cheapest Cities In Illinois To Buy Healthcare?

Although premiums are subject to change, and each situation is different, some of the cities that offer the most affordable rates are: Aurora, Naperville, Waukegan, Evanston, Schaumburg, Palatine, Glenview, Quincy, Pekin, Danville and Park Forest. Don’t panic if your city is not on this list! There are many other low-cost areas in the state.

Illinois Health Exchange plans for 2017 are very affordable, especially if you qualify for the government subsidy. Our website will make it easy for you to view the best online quotes for these plans. We also provide expert help and guidance with choosing the best plan, calculating and applying the subsidy, and enrolling for coverage.

 

News From The Past:

Get Covered Illinois” has a new Executive Director. Karin Zosel will replace Jennifer Koehler who resigned in February to pursue other potential job opportunities. Zosel  has a unique background including working more than a decade for the CIA as an intelligence specialist.  She will now focus on available federal grant and aid programs that lower the cost for state residents to purchase coverage.

Rate filings have been submitted by Illinois carriers. Although yet to be approved, some of the  requested rate increases are listed below:

53.2% – Time Individual Medical

33.6% – Aetna POS-PD

28.5% – Aetna HMO Individual

19.5% – UnitedHealthcare Off-Exchange

18.4% – Consumer’s Choice CC PPO Individual

14.4% – Coventry Carolinas SC Small Group PPO