Can I get Blue Cross and Blue Shield of Illinois plans on GetCoveredIllinois?

Yes, Blue Cross and Blue Shield of Illinois offers plans directly through GetCoveredIllinois, the state-based marketplace for Illinois residents. This means you can apply for subsidies to help reduce your monthly premiums.

Do I qualify for financial assistance with Blue Cross and Blue Shield of Illinois plans?

Most Evanston residents with incomes between 100% and 400% of the Federal Poverty Level (FPL) qualify for premium tax credits. Those between 100% and 250% FPL may also qualify for cost-sharing reductions, which lower out-of-pocket costs like deductibles and copays.

How does Illinois Medicaid work with Blue Cross and Blue Shield of Illinois plans?

If your income is below 138% of the Federal Poverty Level, you may qualify for Illinois Medicaid, which provides comprehensive, low-cost coverage. You cannot enroll in a Blue Cross and Blue Shield of Illinois marketplace plan if you qualify for Medicaid. Pregnant women in Illinois can qualify for Medicaid up to 213% FPL.

Blue Cross and Blue Shield of Illinois Health Insurance in Evanston, IL

Q: What types of Blue Cross and Blue Shield of Illinois plans are available in Evanston?

In Evanston, Blue Cross and Blue Shield of Illinois offers HMO, EPO, and PPO plans on the GetCoveredIllinois marketplace. PPO plans provide more flexibility to see out-of-network providers, while HMO and EPO plans typically have lower premiums with a more restricted network.

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

Blue Cross and Blue Shield of Illinois offers marketplace health plans in Evanston, IL, for the 2026 plan year.
Evanston residents can choose from HMO, EPO, and PPO plan types from Blue Cross and Blue Shield of Illinois on GetCoveredIllinois.
Most households with incomes between 100% and 400% FPL qualify for significant subsidies, potentially reducing monthly premiums by over 80%.
In 2026, 5 carriers offer marketplace plans in Rating Area 1, which includes Evanston and all of Cook County.

For Evanston residents seeking health insurance, Blue Cross and Blue Shield of Illinois is a prominent option available through GetCoveredIllinois, the state's official health insurance marketplace. As a major insurer in Illinois, Blue Cross and Blue Shield of Illinois provides a range of plans, including HMO, EPO, and PPO options, allowing individuals and families to find coverage that fits their needs and budget. Many Evanston residents will qualify for financial assistance, known as subsidies, which can significantly lower monthly premiums and out-of-pocket costs when enrolling through GetCoveredIllinois. Understanding these options is key to securing affordable and comprehensive health coverage in Evanston.

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What Blue Cross and Blue Shield of Illinois Plans Are Available in Evanston?

Blue Cross and Blue Shield of Illinois offers a variety of health insurance plans on the GetCoveredIllinois marketplace for Evanston residents. These plans are categorized into metal tiers: Bronze, Silver, Gold, and Platinum, each providing different levels of cost-sharing. In Illinois, you can find HMO (Health Maintenance Organization), EPO (Exclusive Provider Organization), and PPO (Preferred Provider Organization) plans from Blue Cross and Blue Shield of Illinois. PPO plans are particularly notable as they offer more flexibility for out-of-network care, a feature not always available on-exchange in every state, but explicitly offered by Blue Cross and Blue Shield of Illinois in Illinois. The choice between plan types depends on your healthcare needs and budget. HMOs typically have lower premiums but require you to choose a primary care provider (PCP) and get referrals for specialists. EPOs offer a slightly broader network without requiring referrals but generally don't cover out-of-network care. PPOs provide the most flexibility, allowing you to see specialists without referrals and offering some coverage for out-of-network services, though at a higher cost.

Understanding Financial Assistance for Blue Cross and Blue Shield of Illinois Plans

Many Evanston residents can receive financial assistance to help pay for their Blue Cross and Blue Shield of Illinois health insurance plans. These subsidies are available through GetCoveredIllinois and are based on your household income and family size. There are two main types of subsidies:

Premium Tax Credits (PTC): These credits reduce your monthly health insurance premiums. Most households with incomes between 100% and 400% of the Federal Poverty Level (FPL) qualify. For a single individual in 2026, 400% FPL is approximately $60,240.
Cost-Sharing Reductions (CSRs): These subsidies lower your out-of-pocket costs, such as deductibles, copayments, and coinsurance. CSRs are only available with Silver-tier plans and are typically for individuals and families with incomes between 100% and 250% FPL.

For example, a single individual in Evanston earning $30,000 (around 200% FPL) would likely qualify for significant premium tax credits and cost-sharing reductions, making a Silver plan much more affordable. These financial aids are crucial for making comprehensive health insurance accessible to a wider range of Evanston residents.

Health Insurance Carriers in Evanston

Evanston is part of Illinois Rating Area 1, which encompasses all of Cook County. For the 2026 plan year, 5 carriers offer marketplace health plans in Rating Area 1. This provides Evanston residents with a robust selection of options beyond just Blue Cross and Blue Shield of Illinois. The confirmed local carriers for Rating Area 1 in 2026 are:

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

Each of these carriers offers various plans across the Bronze, Silver, Gold, and Platinum metal tiers, including HMO, EPO, and PPO options. When comparing plans, consider not only the premiums but also the deductibles, out-of-pocket maximums, and the network of doctors and hospitals. Evanston, Illinois, with a population of 76,340 and a median income of $96,434 per U.S. Census Bureau ACS 2024 5-year estimates, is a vibrant part of Cook County. The county is served by 46 acute care hospitals, including Northshore University Healthsystem - Evanston Hospital and Saint Francis Hospital-evanston, both located directly in Evanston. The county's uninsured rate is 8.9%, higher than Evanston's 4.3% uninsured rate, indicating the importance of robust insurance options in the area.

Illinois Medicaid and CHIP for Evanston Residents

Illinois has expanded its Medicaid program, known as Illinois Medicaid, making it available to adults with household incomes up to 138% of the Federal Poverty Level (FPL). This means that many Evanston residents who earn too much to qualify for traditional Medicaid but are still low-income can receive comprehensive health coverage at little to no cost. For families, Illinois offers some of the most expansive coverage programs in the country:

Pregnant Women Medicaid: Illinois Medicaid covers pregnant women with income up to 213% FPL. This includes prenatal care, labor, delivery, and 12 months of postpartum care. Applications can be made through ABE (abe.illinois.gov) or by calling the DHS helpline.
Illinois All Kids (CHIP equivalent): This program provides low-cost health coverage for children with family incomes up to 313% FPL.

If you qualify for Illinois Medicaid or Illinois All Kids, you will not be eligible for subsidies on GetCoveredIllinois, as these programs provide a more comprehensive and affordable coverage option.

Making the Right Health Insurance Decision in Evanston

Choosing the right health insurance plan in Evanston involves considering your financial situation, healthcare needs, and preferred providers. Here’s a guide to help you navigate your options:

If your income is below 138% FPL: You likely qualify for Illinois Medicaid. Apply directly through abe.illinois.gov or call the DHS helpline for comprehensive, low-cost coverage.
If your income is between 100% and 250% FPL: Focus on Silver-tier plans from carriers like Blue Cross and Blue Shield of Illinois, Ambetter, or Oscar Health on GetCoveredIllinois. You will qualify for both premium tax credits and cost-sharing reductions, which significantly lower your monthly premiums and out-of-pocket costs.
If your income is above 250% FPL but below 400% FPL: You will still qualify for premium tax credits. Compare Bronze, Silver, and Gold plans. A Bronze plan will have lower premiums but higher out-of-pocket costs, while a Gold plan offers more coverage before your deductible is met, but at a higher monthly premium.
If your income is above 400% FPL: While you won't qualify for subsidies, you can still enroll in a Blue Cross and Blue Shield of Illinois plan or other carrier plans through GetCoveredIllinois or directly with the insurer. Compare plans based on network, deductibles, and overall cost.

A licensed health insurance producer can provide personalized guidance, help you compare plans, and ensure you receive all eligible financial assistance, all at no cost to you.

Frequently Asked Questions

Can I keep my current doctors with a Blue Cross and Blue Shield of Illinois plan?

It depends on the plan type and your doctor's network participation. PPO plans typically offer the most flexibility, often covering out-of-network care at a higher cost. HMO and EPO plans have more restricted networks. Always verify your doctor's network status with your chosen plan before enrolling to ensure continued coverage.

What is the difference between an HMO, EPO, and PPO plan from Blue Cross and Blue Shield of Illinois?

An HMO (Health Maintenance Organization) plan requires you to choose a primary care provider (PCP) and get referrals for specialists within its network. An EPO (Exclusive Provider Organization) plan offers a network without requiring referrals but generally doesn't cover out-of-network care. A PPO (Preferred Provider Organization) plan provides the most flexibility, allowing you to see specialists without referrals and offering some coverage for out-of-network services.

What happens if I move out of Evanston or Cook County with a Blue Cross and Blue Shield of Illinois plan?

Moving to a new rating area or county is a qualifying life event (QLE) that allows you to change your health insurance plan outside of the Open Enrollment Period. You would need to update your address on GetCoveredIllinois and select a new plan available in your new location, as plan availability varies by rating area.

When is the Open Enrollment Period for Blue Cross and Blue Shield of Illinois plans?

The annual Open Enrollment Period (OEP) for marketplace plans in Illinois, including those from Blue Cross and Blue Shield of Illinois, typically runs from November 1 to January 15. Outside of this window, you can only enroll or change plans if you experience a qualifying life event (QLE), such as losing other coverage, getting married, or having a baby.