Updated July 2026 · IllinoisPlanFinder.com — Licensed Health Insurance Producer (NPN #21249133)

Ambetter Health Insurance in Romeoville, Illinois

Ambetter is one of 5 carriers offering marketplace plans in Romeoville's Rating Area 4 for 2026.
Illinois residents with incomes up to 400% FPL may qualify for subsidies to reduce Ambetter plan costs.
Ambetter plans, like other marketplace options in Illinois, can include HMO, EPO, and PPO structures.
Romeoville's uninsured rate is 7.3%, slightly higher than Will County's 5.2% rate, per U.S. Census Bureau ACS 2024 5-year estimates.

For residents of Romeoville, Illinois, finding affordable and comprehensive health insurance is a key concern. Ambetter is a prominent health insurance carrier offering plans through GetCoveredIllinois, the state's official health insurance marketplace. As a resident of Romeoville, located in Will County, you have access to Ambetter plans alongside options from other insurers. These plans are designed to meet the requirements of the Affordable Care Act (ACA), ensuring essential health benefits and consumer protections. Your eligibility for financial assistance, such as premium tax credits and cost-sharing reductions, will depend on your household income and family size, making coverage more accessible for many.

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What Ambetter Plans Are Available in Romeoville?

In 2026, Ambetter is one of 5 health insurance carriers confirmed to offer plans in Rating Area 4, which covers Grundy, Kankakee, Will, and Williamson counties. This means Romeoville residents have several options when exploring Ambetter plans on GetCoveredIllinois. Illinois's marketplace allows for a variety of plan types, including Health Maintenance Organizations (HMOs), Exclusive Provider Organizations (EPOs), and Preferred Provider Organizations (PPOs). This is a key advantage for Illinois consumers, as PPO plans are available on-exchange, unlike in some other states. Ambetter typically offers plans across different metal tiers: Bronze, Silver, Gold, and sometimes Platinum. Each tier represents a different balance between monthly premiums and out-of-pocket costs:

Bronze Plans: These plans have the lowest monthly premiums but the highest deductibles and out-of-pocket maximums. They are designed for those who want protection from catastrophic medical costs and rarely visit the doctor.
Silver Plans: Offering a moderate balance of premiums and out-of-pocket costs, Silver plans are popular. Crucially, if you qualify for cost-sharing reductions (CSRs) based on your income, these benefits are only available with Silver plans, making them significantly more valuable.
Gold Plans: With higher monthly premiums, Gold plans offer lower deductibles and out-of-pocket maximums. They are suitable for individuals or families who anticipate needing more medical care throughout the year and prefer more predictable costs.

It's important to review the specific benefits, deductibles, co-pays, and provider networks for each Ambetter plan to ensure it aligns with your healthcare needs and budget.

How Financial Assistance Lowers Ambetter Costs in Romeoville

The Affordable Care Act provides financial assistance to help make health insurance more affordable. Romeoville residents who purchase an Ambetter plan through GetCoveredIllinois may qualify for subsidies if their household income falls within certain Federal Poverty Level (FPL) guidelines. There are two main types of subsidies:

Premium Tax Credits (PTCs): These credits reduce your monthly premium payment. The amount you receive is based on your income, household size, and the cost of the benchmark Silver plan in your area. Many people qualify for PTCs, even those with moderate incomes.
Cost-Sharing Reductions (CSRs): Available only with Silver plans, CSRs lower your out-of-pocket costs like deductibles, co-payments, and co-insurance. You must have an income between 100% and 250% of the FPL to qualify for CSRs.

Illinois expanded Medicaid in 2014. If your income is at or below 138% of the Federal Poverty Level, you may qualify for Illinois Medicaid, which provides comprehensive coverage with little to no out-of-pocket costs. For a single individual in 2026, 138% FPL is approximately $20,782 annually. Pregnant women in Illinois qualify for Medicaid up to 213% FPL, and children up to 313% FPL through Illinois All Kids (CHIP equivalent), making Illinois one of the most expansive states for maternal and child coverage. You can apply for Illinois Medicaid through ABE (abe.illinois.gov) or by calling the DHS helpline.

2026 Federal Poverty Level (FPL) Guidelines for Subsidy Eligibility (Approximate)
Household Size	100% FPL (Medicaid/Subsidies)	138% FPL (Medicaid Expansion)	250% FPL (CSR Eligibility)	400% FPL (Premium Tax Credit Eligibility)
1	$15,060	$20,782	$37,650	$60,240
2	$20,440	$28,207	$51,100	$81,760
3	$25,820	$35,632	$64,550	$103,280
4	$31,200	$43,056	$78,000	$124,800
Note: FPL figures are subject to annual updates. Use these as estimates for 2026.

Health Insurance Carriers in Romeoville

For 2026, residents of Romeoville, Illinois, residing in Rating Area 4, have a choice of 5 health insurance carriers offering plans through GetCoveredIllinois. These carriers provide a range of options, including HMO, EPO, and PPO plans, to meet diverse needs and budgets. The confirmed carriers for Rating Area 4 are:

Ambetter
Blue Cross and Blue Shield of Illinois
Molina Healthcare
Oscar Health
United Healthcare

Romeoville, a city with a population of 41,152 and a median income of $106,325 per U.S. Census Bureau ACS 2024 5-year estimates, is part of Will County, which has a population of 701,462. Will County's healthcare infrastructure includes Saint Joseph Medical Center in Joliet, Silver Cross Hospital and Medical Centers in New Lenox, and Uchicago Medicine Adventhealth Bolingbrook in Bolingbrook. When selecting an Ambetter plan or any other carrier, it is crucial to verify that your preferred doctors and hospitals, such as those in Will County, are part of the plan's network.

How to Enroll in an Ambetter Plan in Romeoville

Enrolling in an Ambetter health insurance plan in Romeoville typically occurs during the annual Open Enrollment Period (OEP). During this time, you can sign up for new coverage, switch plans, or re-enroll in your existing plan through GetCoveredIllinois. Here's a general guide to the enrollment process:

Gather Information: You will need personal details for all household members, income information (pay stubs, W-2s, tax returns), and any current health insurance policy numbers.
Visit GetCoveredIllinois: Go to the official state marketplace website, GetCoveredIllinois.gov, to browse plans and apply for financial assistance.
Compare Plans: Use the tools on the marketplace to compare Ambetter plans with those from other carriers. Pay attention to premiums, deductibles, co-pays, and network types (HMO, EPO, PPO).
Apply for Subsidies: As you complete your application, GetCoveredIllinois will determine your eligibility for premium tax credits and cost-sharing reductions based on your income and household size.
Select and Enroll: Choose the Ambetter plan that best fits your needs and budget, and complete the enrollment process online.
Pay Your First Premium: Your coverage will typically begin once you've paid your first month's premium directly to Ambetter.

Outside of Open Enrollment, you may still be able to enroll if you experience a Qualifying Life Event (QLE), such as losing other health coverage, getting married, having a baby, or moving to a new area. These events trigger a Special Enrollment Period (SEP), usually lasting 60 days from the date of the QLE.

Frequently Asked Questions

Is Ambetter health insurance available in Romeoville, Illinois?

Yes, Ambetter is one of 5 health insurance carriers offering plans on GetCoveredIllinois for residents in Rating Area 4, which includes Romeoville, for the 2026 plan year.

What types of Ambetter plans can I find in Romeoville?

In Illinois, marketplace plans, including those from Ambetter, are available as Health Maintenance Organizations (HMOs), Exclusive Provider Organizations (EPOs), and Preferred Provider Organizations (PPOs). The specific plan types offered by Ambetter can vary, so it's important to check the details on GetCoveredIllinois.

Can I get financial help to pay for Ambetter plans in Romeoville?

Yes, if your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for premium tax credits and cost-sharing reductions through GetCoveredIllinois to lower your Ambetter plan costs. Illinois residents with incomes below 138% FPL may qualify for Illinois Medicaid.

Where can I get medical care with an Ambetter plan in Will County?

Ambetter plans utilize specific provider networks. In Will County, major hospitals include Saint Joseph Medical Center in Joliet, Silver Cross Hospital and Medical Centers in New Lenox, and Uchicago Medicine Adventhealth Bolingbrook in Bolingbrook. You should always verify that your preferred doctors and hospitals are in-network with the specific Ambetter plan you choose before enrolling.

What is the difference between an HMO, EPO, and PPO plan in Illinois?

HMO (Health Maintenance Organization) plans typically require you to choose a primary care provider (PCP) and get referrals to see specialists. They usually have lower premiums but less flexibility outside the network. EPO (Exclusive Provider Organization) plans do not require a PCP referral for specialists but only cover care received from providers in the plan's network, except for emergencies. PPO (Preferred Provider Organization) plans offer the most flexibility, allowing you to see any provider without a referral, both in-network and out-of-network, though out-of-network care will cost more. In Illinois, all three types are available on-exchange.