Health Insurance for Registered Nurses in Illinois
Most registered nurses in Illinois are paid in ways that leave them shopping for their own coverage, whether they work around Chicago or anywhere else in the state. Most of the ones I work with choose a private plan priced on their health, not their income, that can start any month if approved. Illinois Marketplace premiums are rising 14% to 14.1% on average for 2027, so the private option is worth pricing first.
Private health insurance in Illinois
Most registered nurses I help in Illinois end up on a private plan, not a Marketplace plan. Private, medically underwritten health insurance is priced on your age, zip code and health instead of your income, so a strong year never raises your premium and there is no tax credit to pay back in April.
Why people leave the Marketplace
- Premiums keep climbing. Illinois Marketplace premiums are rising 14% to 14.1% on average for 2027.
- The subsidy cliff. Above 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four) you pay full price.
- Surprise tax bills. Underestimate your income and you repay the tax credit in April.
- Narrow networks. Many plans are local HMOs or EPOs that need referrals and cover little outside the area.
- High out-of-pocket costs. 2027 out-of-pocket maximums reach $12,000 per person and $24,000 per family.
- One window a year. Outside open enrollment you need a qualifying life event to enroll or switch.
What a private plan does differently
- Start any month. If approved, coverage can begin the first of next month, with no wait for open enrollment.
- Networks that travel. Many private plans use national PPO networks, which can give you in-network doctors outside Illinois too. Networks vary by plan.
- Can cost less than full-price Marketplace plans for some healthy applicants above the subsidy line.
- Accident coverage the Marketplace does not offer. A private plan can be paired with accident coverage, a separate policy. What it includes varies by plan.
- Approval is based on health. You answer health questions, and acceptance is not guaranteed.
With a significant health condition, or income low enough for a large tax credit, a Marketplace plan can be the better fit, and I will tell you if it is. Either way you see both side by side.
Private plans are not ACA Marketplace plans. Benefits, exclusions and pre-existing condition rules differ by plan and by state, so review the plan details before you enroll.
Get a private plan quoteLearn more: coverage not based on income · how underwriting works · private vs Obamacare · PPO plans for individuals · switching from the Marketplace
Illinois health insurance in 2027
Illinois' finalized 2027 individual-market increase averages about 14 percent, close to the national average, while small-group plans rise faster at about 18 percent. Six insurers filed individual plans, which gives Illinois more choice than many states.
- Marketplace rates: up 14% to 14.1% on average for 2027 (final), with 6 insurers filing.
- Benchmark silver plan, age 40: $707 a month in 2027, up from $646 in 2026.
- The subsidy cliff in Illinois: earning $1 over $63,840 costs a single 60-year-old about $11,492 more a year for that plan, and $1 over $86,560 costs a 60-year-old couple about $27,187.
- Where to enroll: Get Covered Illinois, the state's own exchange, which sets its own 2027 enrollment dates.
More: Illinois 2027 rate changes · 2027 subsidy cliff by state. General information, not tax advice.
How registered nurses work in Illinois
The state's 2024 nursing survey describes per diem nurses as hired on an as-needed basis and usually without benefits, and about 12 percent of Illinois RNs hold more than one job. Illinois hospitals must have written staffing plans drawn up by nursing care committees, but the state sets no fixed nurse-to-patient ratios. The Safe Patient Limits Act, which would set them, has sat in a Senate committee since early 2025, with the Illinois Nurses Association, a union, pushing for it. Nurses who piece together PRN shifts or work part-time often have no employer plan and buy their own coverage.
Illinois licensing for registered nurses
Registered nurses in Illinois are licensed by IDFPR with the Illinois Board of Nursing under the Nurse Practice Act. Applicants must finish an approved nursing program, pass the NCLEX and clear a criminal history records check, and recent graduates who wait more than 180 days to test or fail twice must take a review course before retesting. RN licenses expire May 31 of even-numbered years and require 20 continuing education hours each cycle. Illinois grants nurse practitioners full practice authority once they document 4,000 clinical hours in collaboration with a physician and 250 continuing education hours.
The Illinois market for registered nurses
Illinois had 138,910 registered nurses on payrolls in May 2025, about 100,000 of them in the Chicago metro area, plus 9,270 nurse practitioners, according to BLS. The Illinois Nursing Workforce Center's 2024 survey found that 41 percent of RNs are 55 or older and about a quarter plan to retire within five years, while about 60 percent of nursing faculty are also 55 or older. The state graduates about 7,000 new RNs a year. The survey named behavioral health, primary care, long-term care, geriatrics, school health and maternal health as the specialties with the clearest shortages.
Illinois coverage rules that apply to you
- Leaving a job: Illinois requires insured group plans to offer up to 12 months of continuation after three months of coverage, and gives divorced or widowed spouses up to two years, or until Medicare if they are 55 or older.
- Short-term plans: Illinois banned new short-term health plans starting January 1, 2025.
- Where to enroll: Illinois uses its own exchange, Get Covered Illinois, which replaced HealthCare.gov for 2026. Get Covered Illinois sets its own open enrollment dates; check its site for 2027 deadlines. Private, medically underwritten plans can start the first of any month if approved.
- 2027 rates: individual plans 14% to 14.1% on average. See the Illinois 2027 rate page.
PRN, part-time and between jobs
Staff nurses usually have a hospital plan, but PRN and part-time nurses often get no benefits at all, and nurses changing systems can face a waiting period. Those are the moments an RN buys coverage on their own.
What the Marketplace gets wrong for nurses
Marketplace premiums are rising again for 2027, and a nurse picking up extra shifts can land above the 400 percent income line and owe the tax credit back in April. Many Marketplace plans are narrow networks that may not include the hospital you work at. A private, medically underwritten plan is priced on health instead of income, so overtime never changes the premium, and if approved, it can start the first of any month.
When the Marketplace still fits
A nurse with a significant health condition, or a single-income household well under the subsidy line, may do better on the Marketplace because acceptance is guaranteed and the credit can be large. I compare both before you choose.
When the Marketplace still makes sense
The Marketplace fits registered nurses with a significant health condition, because acceptance is guaranteed, and households whose 2027 income stays under 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four), where a tax credit lowers the price. Above that line it costs full price. The full guide for registered nurses goes deeper.
Quote for a registered nurse in Illinois
Private plans priced first, with the Marketplace alongside when it fits. No fee.
Questions from Illinois registered nurses
What license do registered nurses need in Illinois?
Registered nurses in Illinois are licensed by IDFPR with the Illinois Board of Nursing under the Nurse Practice Act. Applicants must finish an approved nursing program, pass the NCLEX and clear a criminal history records check, and recent graduates who wait more than 180 days to test or fail twice must take a review course before retesting. RN licenses expire May 31 of even-numbered years and require 20 continuing education hours each cycle. Illinois grants nurse practitioners full practice authority once they document 4,000 clinical hours in collaboration with a physician and 250 continuing education hours.
How much are Illinois health insurance premiums rising for 2027?
Individual-market premiums in Illinois are set to rise 14% to 14.1% on average for 2027. Households above 400 percent of the poverty level get no tax credit and pay the full increase.
What happens to my coverage if I leave a job in Illinois?
Illinois requires insured group plans to offer up to 12 months of continuation after three months of coverage, and gives divorced or widowed spouses up to two years, or until Medicare if they are 55 or older. Losing employer coverage also opens a 60-day Marketplace special enrollment period, and if approved, a private plan can start the first of any month.
Do PRN nurses get health insurance?
Often not. Many hospitals offer benefits only to nurses scheduled above a set number of hours, so PRN nurses usually buy their own private or Marketplace plan.
Can extra shifts affect a nurse's Marketplace tax credit?
Yes. The credit is based on household income for the year, so overtime and extra shifts can reduce it or require repaying part of it at tax time. A private plan's premium does not depend on income.
Sources: nursing.illinois.gov, ilga.gov, ilga.gov, www.ilga.gov. Facts checked October 2026. See all Illinois health insurance rules.
Registered Nurses in other states
Written by Frank Caballero, licensed health insurance agent in Illinois and 30 other states, NPN 21032307.