All states State rules

Illinois Health Insurance in 2027: Rules and Options

Illinois buyers use Get Covered Illinois, the state's own exchange since the 2026 plan year. Final 2027 individual rates rise about 14 percent on average across five insurers, and two insurers are leaving the exchange, so some enrollees must pick new plans. Illinois now requires prior approval of individual and small-group rates. The state banned short-term plans in 2025, so the alternatives to Marketplace coverage are private, medically underwritten plans and employer or union coverage. Continuation rights are relatively strong: 12 months for employees, and up to two years, or until Medicare for those 55 and older, for divorced or widowed spouses.

Private health insurance in Illinois

Most people 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 quote

Learn more: coverage not based on income · how underwriting works · private vs Obamacare · PPO plans for individuals · switching from the Marketplace

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 are sold outside the exchange by licensed agents and can start the first of any month if you are approved.

Leaving a small employer

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.

Short-term health plans

Illinois banned new short-term health plans starting January 1, 2025. Short-term plans are medically underwritten, exclude pre-existing conditions and cap benefits, so they fit only a defined gap.

2027 premium changes

Illinois individual-market premiums are set to rise 14% to 14.1% on average for 2027, with small-group plans up about 17.6%. The full breakdown is on the Illinois 2027 rate page.

More Illinois guides by job and situation

Illinois questions

Where do Illinois residents buy individual health insurance for 2027?

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.

What happens to my group coverage if I leave a small employer in Illinois?

How long can a short-term health plan last in Illinois?

Illinois banned new short-term health plans starting January 1, 2025.

How much are Illinois premiums rising for 2027?

Individual-market premiums are set to rise 14% to 14.1% on average, and small-group plans about 17.6%, based on final rate filings.

Sources: ilga.gov, dph.illinois.gov, ilga.gov, getcovered.illinois.gov. Checked October 21, 2026. More on health insurance in Illinois.

Licensed in Illinois. I compare Marketplace and private plans side by side for your household, no fee.

Get a quote