Ambetter Health Insurance Plans in Cicero, Illinois
- Ambetter is one of 5 health insurance carriers offering marketplace plans in Cicero, Illinois (Cook County Rating Area 1) for 2026.
- Illinois residents with household incomes up to 400% of the Federal Poverty Level may qualify for significant subsidies to reduce monthly premiums.
- Illinois expanded Medicaid in 2014, covering adults up to 138% FPL, and pregnant women up to 213% FPL.
- Marketplace plans in Illinois include Health Maintenance Organization (HMO), Exclusive Provider Organization (EPO), and Preferred Provider Organization (PPO) options.
Get Your Free Health Insurance Quote
A licensed agent can compare coverage options for you at no cost.
You're all set!
A licensed agent will reach out shortly.
What Ambetter Plans Are Available in Cicero?
Ambetter health insurance plans in Cicero, Illinois are primarily structured as Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans. These plans emphasize coordinated care through a network of doctors and hospitals. With an HMO, you typically choose a primary care provider (PCP) who manages your care and provides referrals to specialists. EPO plans offer more flexibility than HMOs by not requiring a PCP referral for specialists, but you must still stay within the plan's network for covered services. Illinois offers a robust marketplace, and unlike some states, Preferred Provider Organization (PPO) plans are also available on GetCoveredIllinois from other carriers, providing a broader choice of plan types for Cicero residents. Ambetter plans, like all marketplace plans, are categorized into metal tiers: Bronze, Silver, Gold, and Platinum, each offering different levels of cost-sharing.| Metal Tier | Key Feature | Best For |
|---|---|---|
| Bronze | Lowest monthly premium, highest out-of-pocket costs (deductible, copay, coinsurance). | Healthy individuals who want protection against catastrophic medical bills. |
| Silver | Moderate premiums and out-of-pocket costs. Eligible for Cost-Sharing Reductions. | Individuals and families who qualify for subsidies and expect moderate healthcare use. |
| Gold | Higher monthly premium, lower out-of-pocket costs. | Those who expect frequent medical care or have ongoing health conditions. |
| Platinum | Highest monthly premium, lowest out-of-pocket costs (very low deductibles/copays). | Individuals with extensive healthcare needs who want maximum predictability in costs. |
Who Qualifies for Financial Help with Ambetter Plans in Illinois?
Many Cicero residents may qualify for financial assistance to help pay for their Ambetter health insurance premiums and out-of-pocket costs. Illinois is a Medicaid expansion state, and its marketplace offers significant subsidies. Eligibility for subsidies is based on your household income relative to the Federal Poverty Level (FPL):- Premium Tax Credits (PTC): If your household income is between 100% and 400% FPL, you may qualify for tax credits that lower your monthly premium for any metal-tier plan. These credits are paid directly to your insurer, reducing your upfront cost.
- Cost-Sharing Reductions (CSRs): If your household income is between 100% and 250% FPL, you may also qualify for CSRs. These subsidies reduce the amount you pay for deductibles, copayments, and coinsurance, significantly lowering your out-of-pocket costs when you receive care. CSRs are only available with Silver-tier plans.
- Illinois Medicaid: For adults with household incomes at or below 138% FPL, Illinois Medicaid provides comprehensive coverage with no premiums. Illinois also has generous Medicaid eligibility for pregnant women (up to 213% FPL) and children through Illinois All Kids (CHIP equivalent, up to 313% FPL).
Health Insurance Carriers in Cicero
Cicero, Illinois is located in Cook County, which constitutes Illinois Rating Area 1. For the 2026 plan year, 5 carriers offer marketplace plans in Rating Area 1, providing a competitive selection for residents. These carriers include Ambetter, Blue Cross and Blue Shield of Illinois, Molina Healthcare, Oscar Health, and United Healthcare. Cook County's 46 acute care hospitals, including Macneal Hospital in Berwyn and Loyola Gottlieb Memorial Hospital in Melrose Park, serve a population of 5.18 million. The city of Cicero itself has a population of 82,797 with an uninsured rate of 20.0% as per U.S. Census Bureau ACS 2024 5-year estimates. This specific geographic context highlights the importance of choosing a plan with a strong local network. When selecting a plan, it is crucial to verify that your preferred doctors and any local hospitals you wish to use, such as Macneal Hospital or Rush Oak Park Hospital, are in the plan's network.Next Steps: Getting Covered in Cicero
Choosing the right health insurance plan depends on your specific needs, income, and healthcare preferences. Here's a guide to help you decide:- If your income is below 138% FPL: You likely qualify for Illinois Medicaid. Apply directly through ABE (abe.illinois.gov) or call the DHS helpline.
- If your income is between 100% and 250% FPL: Focus on Silver-tier plans from Ambetter or other carriers. You'll qualify for both Premium Tax Credits and Cost-Sharing Reductions, making Silver plans the best value with lower premiums and out-of-pocket costs.
- If your income is between 250% and 400% FPL: You will qualify for Premium Tax Credits. Compare Bronze, Silver, and Gold plans. A Silver plan will still offer moderate cost-sharing, while a Gold plan will have lower deductibles and copays for higher premiums.
- If your income is above 400% FPL: You will not qualify for income-based subsidies. You can still purchase a plan through GetCoveredIllinois or directly from an insurer. Consider Bronze plans for catastrophic coverage or Gold/Platinum for more comprehensive coverage with predictable costs.
Frequently Asked Questions
Can I get Ambetter health insurance in Cicero, Illinois?
Yes, Ambetter is one of 5 health insurance carriers offering marketplace plans in Cicero, Illinois, which is part of Rating Area 1 in Cook County, for the 2026 plan year. You can enroll in Ambetter plans through GetCoveredIllinois, the state's official health insurance marketplace.
What types of plans does Ambetter offer in Illinois?
In Illinois, Ambetter primarily offers Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans. These plans typically require you to choose a primary care provider within their network and may require referrals for specialist visits. PPO plans are also available on GetCoveredIllinois from other carriers.
How do I know if I qualify for subsidies on an Ambetter plan?
Eligibility for subsidies (Premium Tax Credits and Cost-Sharing Reductions) on Ambetter plans depends on your household income relative to the Federal Poverty Level (FPL). In Illinois, individuals and families earning between 100% and 400% FPL may qualify for tax credits to lower monthly premiums. Those earning between 100% and 250% FPL may also qualify for Cost-Sharing Reductions to lower out-of-pocket costs.
Is Illinois Medicaid an option if my income is low?
Yes, Illinois expanded its Medicaid program in 2014. If your household income is at or below 138% of the Federal Poverty Level, you may qualify for Illinois Medicaid, which provides comprehensive health coverage with no monthly premiums. You can apply through ABE (abe.illinois.gov) or call the DHS helpline.