Health Insurance in Des Plaines, Illinois for 2026

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

Des Plaines residents can choose from HMO, EPO, and PPO plans on GetCoveredIllinois.
In 2026, 5 confirmed carriers, including Ambetter and Blue Cross and Blue Shield of Illinois, offer marketplace plans in Rating Area 1.
Illinois Medicaid covers adults up to 138% of the Federal Poverty Level and pregnant women up to 213% FPL.
The uninsured rate in Des Plaines is 8.1%, per U.S. Census Bureau ACS 2024 5-year estimates.

Navigating health insurance options in Des Plaines, Illinois, for 2026 involves understanding your choices through GetCoveredIllinois, the state's official health insurance marketplace. Whether you're seeking individual, family, or small business coverage, you can find a variety of plans that fit your needs and budget. Illinois is a state-based marketplace, meaning residents access plans directly through GetCoveredIllinois, which offers subsidies (premium tax credits) to make coverage more affordable for eligible individuals and families. This guide will walk you through the available plans, local carriers, and financial assistance options to help you secure comprehensive health coverage in Des Plaines.

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How to Find Affordable Health Insurance in Des Plaines

For most Des Plaines residents, the primary avenue for obtaining individual and family health insurance is through GetCoveredIllinois. This marketplace allows you to compare plans, check your eligibility for financial assistance, and enroll in coverage. The affordability of your plan will largely depend on your household income and family size, which determine your eligibility for premium tax credits and cost-sharing reductions. Premium tax credits can significantly lower your monthly health insurance premiums. These credits are available to individuals and families with incomes between 100% and 400% of the Federal Poverty Level (FPL), though higher income households may still qualify due to recent legislative changes. Cost-sharing reductions are another form of financial aid that helps reduce out-of-pocket expenses like deductibles, copayments, and coinsurance. These are available to those with incomes up to 250% FPL and are tied to Silver-tier plans. To maximize these savings, it's often advisable to choose an Enhanced Silver plan if you qualify for cost-sharing reductions. The enrollment process typically occurs during the annual Open Enrollment Period, which usually runs from November 1st to January 15th each year. However, you may qualify for a Special Enrollment Period outside of this window if you experience a qualifying life event, such as marriage, birth of a child, loss of other health coverage, or a move to a new rating area.

Understanding Marketplace Plans in Des Plaines

In Des Plaines, residents have access to a range of plan types through GetCoveredIllinois, including Health Maintenance Organization (HMO), Exclusive Provider Organization (EPO), and Preferred Provider Organization (PPO) plans. Unlike some states, PPO plans ARE available on-exchange in Illinois, offering greater flexibility in choosing healthcare providers. For instance, Blue Cross and Blue Shield of Illinois offers PPO plans on-exchange, providing marketplace shoppers with diverse options. Plans are categorized into metal tiers: Bronze, Silver, Gold, and 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 expect to use healthcare services infrequently.
Silver Plans: Offering moderate premiums and moderate out-of-pocket costs, Silver plans are a popular choice. They are especially beneficial for individuals who qualify for cost-sharing reductions, as these subsidies are only applicable to Silver plans, effectively enhancing their value.
Gold Plans: These plans have higher monthly premiums but lower deductibles and out-of-pocket maximums. Gold plans are suitable for individuals who anticipate needing more medical care and prefer to pay more upfront for lower costs when they receive services.
Platinum Plans: With the highest monthly premiums, Platinum plans offer the lowest deductibles and out-of-pocket costs. They are ideal for those who expect extensive medical needs and want predictable healthcare expenses.

When selecting a plan, consider your anticipated healthcare usage, your budget for monthly premiums, and your comfort level with potential out-of-pocket expenses.

Illinois Medicaid and CHIP Eligibility in Cook County

Illinois has expanded its Medicaid program, known as Illinois Medicaid, making coverage accessible to more residents in Des Plaines and across Cook County. Adults with household incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Illinois Medicaid. This expansion, enacted in 2014, ensures that many low-income individuals and families have access to comprehensive health benefits without facing a "coverage gap" that exists in non-expansion states. The state also provides robust coverage for pregnant women and children. Illinois Medicaid covers pregnant women with incomes up to 213% FPL, providing extensive prenatal, labor, delivery, and 12 months of postpartum care. This is one of the highest thresholds among production states, reflecting Illinois's commitment to maternal and child health. Children in Cook County can receive low-cost coverage through Illinois All Kids, the state's Children's Health Insurance Program (CHIP) equivalent, with eligibility extending up to 313% FPL. Enrollment for both Illinois Medicaid and Illinois All Kids can be done through ABE (abe.illinois.gov) or by calling the DHS helpline. Des Plaines, with a population of 59,156 and an uninsured rate of 8.1% per U.S. Census Bureau ACS 2024 5-year estimates, is situated in Cook County, part of Illinois Rating Area 1. Residents benefit from access to 5 marketplace carriers and numerous facilities across Cook County, including Loyola Gottlieb Memorial Hospital in nearby Melrose Park. Cook County, with a population of 5,182,090 and an uninsured rate of 8.9%, offers a broad network of 46 acute care hospitals and specialized facilities.

Health Insurance Carriers in Des Plaines

For 2026, residents of Des Plaines, located within Illinois Rating Area 1, have a choice of 5 health insurance carriers offering plans through GetCoveredIllinois. These carriers provide a range of plan types, including HMO, EPO, and PPO options, to meet diverse healthcare needs. It is important to compare the specific networks, formularies, and benefits offered by each carrier before making a decision. The confirmed carriers offering marketplace plans in Rating Area 1 for 2026 are:

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

When reviewing plans, pay close attention to the provider networks to ensure your preferred doctors and hospitals are included. For example, Cook County is home to 46 hospitals, including major systems like Loyola University Medical Center, Northwestern Memorial Hospital, and Rush University Medical Center. Verifying network participation is a critical step in choosing the right plan.

Navigating Your Health Insurance Choices in Des Plaines

Choosing the right health insurance plan in Des Plaines requires careful consideration of your personal circumstances, health needs, and financial situation. Here’s a general guide to help you make an informed decision:

If your income is below 138% FPL: You likely qualify for Illinois Medicaid, offering comprehensive coverage with minimal or no cost. Apply directly through ABE (abe.illinois.gov).
If your income is between 100% and 250% FPL: You are eligible for substantial premium tax credits and cost-sharing reductions. Choosing a Silver plan will allow you to maximize these savings, lowering both your monthly premiums and your out-of-pocket costs.
If your income is between 250% and 400% FPL: You qualify for significant premium tax credits. Compare Bronze, Silver, and Gold plans to find the best balance of premium and deductible that fits your budget and health needs.
If your income is above 400% FPL: You may still qualify for premium tax credits, especially if the cost of the benchmark Silver plan exceeds 8.5% of your household income. You will pay the full premium, but can still compare plans on GetCoveredIllinois for the best value.

A licensed health insurance producer can provide personalized guidance, help you navigate the GetCoveredIllinois marketplace, and compare plans from different carriers like Ambetter, Blue Cross and Blue Shield of Illinois, and Oscar Health, all at no cost to you.

Frequently Asked Questions

What types of health insurance plans are available in Des Plaines, Illinois?

In Des Plaines, Illinois, residents can choose from Health Maintenance Organization (HMO), Exclusive Provider Organization (EPO), and Preferred Provider Organization (PPO) plans through GetCoveredIllinois. PPO plans are available on-exchange in Illinois, with options from carriers like Blue Cross and Blue Shield of Illinois.

Who are the health insurance carriers offering plans in Des Plaines for 2026?

For 2026, five health insurance carriers offer marketplace plans in Des Plaines, which is part of Illinois Rating Area 1. These carriers include Ambetter, Blue Cross and Blue Shield of Illinois, Molina Healthcare, Oscar Health, and United Healthcare.

Can I get help paying for health insurance in Des Plaines?

Yes, many Des Plaines residents qualify for subsidies (premium tax credits) through GetCoveredIllinois, the state-based marketplace. Eligibility depends on your household income and size. These subsidies can significantly reduce your monthly premiums, making coverage more affordable. You can also qualify for cost-sharing reductions if your income is below 250% of the Federal Poverty Level.

What are the income limits for Illinois Medicaid in Des Plaines?

Illinois expanded its Medicaid program in 2014. Adults in Des Plaines with household incomes up to 138% of the Federal Poverty Level may qualify for comprehensive, low-cost coverage through Illinois Medicaid. Pregnant women may qualify with incomes up to 213% FPL, and children up to 313% FPL through Illinois All Kids.