Blue Cross and Blue Shield of Illinois Health Insurance in Matteson, Illinois

Blue Cross and Blue Shield of Illinois offers HMO, EPO, and PPO plans on GetCoveredIllinois, the state marketplace, for Matteson residents.
Matteson is part of Illinois Rating Area 1, where 5 carriers offer marketplace plans in 2026.
Households in Matteson with incomes between 100% and 400% FPL may qualify for premium subsidies to reduce monthly costs.
Illinois Medicaid covers adults up to 138% FPL, pregnant women up to 213% FPL, and children up to 313% FPL.

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

For residents of Matteson, Illinois, seeking health insurance, Blue Cross and Blue Shield of Illinois is a prominent option available through GetCoveredIllinois, the state-based health insurance marketplace. As part of Illinois Rating Area 1, Matteson residents have access to a variety of plan types, including Health Maintenance Organization (HMO), Exclusive Provider Organization (EPO), and Preferred Provider Organization (PPO) plans, with PPOs notably available on-exchange in Illinois. Understanding your options with Blue Cross and Blue Shield of Illinois, alongside potential financial assistance like subsidies and Medicaid, is crucial for securing comprehensive and affordable coverage in Matteson.

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Understanding Blue Cross and Blue Shield of Illinois Plans in Matteson

Blue Cross and Blue Shield of Illinois (BCBSIL) is one of the key carriers offering individual and family health insurance plans on GetCoveredIllinois, the official health insurance marketplace for the state. For Matteson residents, BCBSIL provides a range of plan structures designed to meet diverse healthcare needs and budgets. These include:

HMO (Health Maintenance Organization): These plans typically require you to choose a primary care provider (PCP) within the network and get referrals for specialists. They often have lower premiums.
EPO (Exclusive Provider Organization): EPO plans offer a network of doctors and hospitals you must use, but generally do not require a PCP referral for specialists. They usually don't cover out-of-network care except in emergencies.
PPO (Preferred Provider Organization): Unlike some states, PPO plans ARE available on-exchange in Illinois. PPOs offer more flexibility, allowing you to see any doctor or specialist without a referral, both in and out of network (though out-of-network care typically costs more).

When selecting a Blue Cross and Blue Shield of Illinois plan, consider your preferred doctors, hospitals, and prescription needs. The University of Chicago Medical Center and Advocate Christ Hospital & Medical Center are examples of major health systems in Cook County that may be part of BCBSIL networks, providing comprehensive care options for Matteson residents.

Who Qualifies for Subsidies on GetCoveredIllinois?

Many Matteson residents can significantly reduce the cost of their Blue Cross and Blue Shield of Illinois health insurance through financial assistance available via GetCoveredIllinois. These subsidies, known as Advanced Premium Tax Credits (APTCs) and Cost-Sharing Reductions (CSRs), are designed to make coverage more affordable.

Advanced Premium Tax Credits (APTCs): These credits lower your monthly premium payments. Eligibility is based on household income relative to the Federal Poverty Level (FPL). In Illinois, if your income is between 100% and 400% FPL, you are likely to qualify for APTCs.
Cost-Sharing Reductions (CSRs): Available only on Silver-tier plans, CSRs reduce your out-of-pocket costs like deductibles, copayments, and coinsurance. You may qualify for CSRs if your income is up to 250% FPL.

For a Matteson household of one, 100% FPL is approximately $14,580 and 400% FPL is approximately $58,320 in 2024. These figures adjust annually and vary by household size. Applying through GetCoveredIllinois will automatically determine your eligibility for these savings, making Blue Cross and Blue Shield of Illinois plans more accessible.

Illinois Medicaid and CHIP Eligibility in Matteson

Illinois has a robust safety net for low-income residents, having expanded its Medicaid program in 2014. This means that many Matteson individuals and families with limited incomes can qualify for comprehensive, low-cost health coverage through Illinois Medicaid. The program is specifically named Illinois Medicaid.

Adults: Adults with household incomes up to 138% of the Federal Poverty Level are eligible for Illinois Medicaid. This eliminates the "coverage gap" present in non-expansion states, ensuring that low-income adults have access to care.
Pregnant Women: Illinois Medicaid covers pregnant women with incomes up to an impressive 213% FPL. This includes prenatal care, labor, delivery, and an extended 12 months of postpartum care, enacted under the American Rescue Plan. This is one of the highest thresholds among production states.
Children (Illinois All Kids): Illinois All Kids, the state's Children's Health Insurance Program (CHIP) equivalent, provides low-cost coverage for children with household incomes up to 313% FPL. This makes Illinois' child coverage program one of the most expansive in the country.

Applications for Illinois Medicaid and All Kids can be submitted through ABE (abe.illinois.gov) or by calling the DHS helpline. Given Matteson's 9.7% poverty rate (per U.S. Census Bureau ACS 2024 5-year estimates), these programs are vital resources for many in the community.

Health Insurance Carriers in Matteson

Matteson, Illinois, is located in Illinois Rating Area 1, which is a single-county rating area covering Cook County. For the 2026 plan year, 5 confirmed carriers offer marketplace health insurance plans in Rating Area 1. This competitive market provides Matteson residents with several options beyond Blue Cross and Blue Shield of Illinois.

The confirmed carriers offering plans in Matteson for 2026 are:

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

Cook County, with a population of 5,182,090 and an uninsured rate of 8.9% (per U.S. Census Bureau ACS 2024 5-year estimates), hosts 46 hospitals. Major acute care facilities like Loyola Gottlieb Memorial Hospital in Melrose Park, Franciscan Health Olympia & Chicago Heights in Olympia Fields, and Ingalls Memorial Hospital in Harvey are among the many options available for care within the county.

Making Your Health Insurance Decision in Matteson

Choosing the right health insurance plan in Matteson requires considering your income, health needs, and preferred provider access. With Blue Cross and Blue Shield of Illinois and other carriers offering a range of HMO, EPO, and PPO options, you have choices that can be tailored to your situation.

If your income is below 138% FPL: You likely qualify for Illinois Medicaid. This is often the most comprehensive and lowest-cost option.
If your income is between 100% and 400% FPL: Focus on plans available on GetCoveredIllinois. You will likely qualify for Advanced Premium Tax Credits (APTCs) to reduce your monthly premiums. Consider Silver plans for additional Cost-Sharing Reductions if your income is up to 250% FPL.
If your income is above 400% FPL: You will pay the full premium but still benefit from the consumer protections and standardized benefits of ACA-compliant plans. Compare plans from Blue Cross and Blue Shield of Illinois and other carriers based on network, deductible, and out-of-pocket maximums.

Navigating these choices can be complex. A licensed health insurance producer can provide free, unbiased assistance, helping you compare Blue Cross and Blue Shield of Illinois plans with those from other carriers, verify network access, and apply for subsidies on GetCoveredIllinois.

Frequently Asked Questions

What types of Blue Cross and Blue Shield of Illinois plans are available in Matteson?

In Matteson, Blue Cross and Blue Shield of Illinois offers HMO, EPO, and PPO plans through GetCoveredIllinois, the state-based marketplace. PPO plans are available on-exchange in Illinois, giving residents more choice in provider networks.

Can I get a subsidy for a Blue Cross and Blue Shield of Illinois plan in Matteson?

Yes, if your household income falls between 100% and 400% of the Federal Poverty Level, you may qualify for Advanced Premium Tax Credits (APTCs) to lower your monthly premiums. Cost-Sharing Reductions (CSRs) are also available for those with incomes up to 250% FPL, reducing out-of-pocket costs on Silver plans.

Is Medicaid available in Matteson, Illinois?

Yes, Illinois expanded Medicaid in 2014, meaning adults with incomes up to 138% of the Federal Poverty Level can qualify for comprehensive, low-cost health coverage through Illinois Medicaid. Pregnant women up to 213% FPL and children up to 313% FPL also qualify for generous coverage.

How many health insurance carriers offer plans in Matteson's rating area?

For the 2026 plan year, 5 confirmed carriers offer marketplace health insurance plans in Rating Area 1, which includes Matteson. These carriers are Ambetter, Blue Cross and Blue Shield of Illinois, Molina Healthcare, Oscar Health, and United Healthcare.